The 60-second diabetes screen every Indian over 30 should do — IDRS

Quick frame: The Madras Diabetes Research Foundation's IDRS is a 4-question screen that flags high diabetes risk before you have symptoms. Score ≥60 → get an HbA1c done. India has 100M+ diabetics and an estimated 50M more pre-diabetics — roughly 1 in 5 adults. Half don't know.

The four questions

1. Age — <35 (0 points), 35-49 (20), ≥50 (30)
2. Waist —
   • Men: <90cm (0), 90-99 (10), ≥100 (20)
   • Women: <80cm (0), 80-89 (10), ≥90 (20)
3. Physical activity — Vigorous (0), Moderate (10), Sedentary (20), None (30)
4. Family history — None (0), One parent (10), Both parents (20)

Total interpretation:

• <30 → low risk, routine screening
• 30-59 → moderate risk, HbA1c every 2 years
• ≥60 → high risk, HbA1c now

Why waist beats BMI for Indians

Indians develop type 2 diabetes at lower BMI thresholds than Caucasians — the "thin-fat phenotype". Visceral fat (around organs, measured by waist) is a stronger predictor than total fat (BMI). The IAP / MDRF cut-offs are 90cm for men and 80cm for women — both 10cm lower than the WHO Caucasian thresholds.

For a deeper BMI check, the Asian-Indian BMI Calculator uses 23 (overweight) and 25 (obese) thresholds — five lower than the WHO defaults.

What an HbA1c says

HbA1c reflects your average blood glucose over the last 2-3 months:

• <5.7% → normal
• 5.7-6.4% → pre-diabetic (window to reverse with diet + exercise)
• ≥6.5% → diabetic

Convert HbA1c to mg/dL average glucose with the HbA1c ↔ eAG Converter. 7% HbA1c = ~154 mg/dL average glucose — borderline-okay for type 2 diabetics on medication.

What you can do today

If your IDRS is ≥60:

1. Get HbA1c — costs ~₹400. Walk-in at any diagnostic chain.
2. Cut refined carbs — start with white rice portion control. The Glycemic Load Calculator shows you which foods spike sugar fastest.
3. Walk 30 min daily — moves you from sedentary (20 pts) to moderate (10 pts).
4. Repeat IDRS in 6 months — reassess.

FAQ

Q. I'm thin but have a family history. Should I worry? A. Yes. The thin-fat phenotype means you can have visceral fat without an obvious gut. Get HbA1c regardless of weight if family history is positive.

Q. Does IDRS work for kids? A. No. IDRS is validated for adults. Pediatric diabetes screening is different.

Q. I'm diabetic. Do I still need to do IDRS? A. No — IDRS is a screening tool. You've already crossed that gate. Track HbA1c every 3-6 months instead.