CHENNAI: A comprehensive ongoing national study on the prevalence of diabetes and prediabetes by the Indian Council of Medical Research (ICMR) has confirmed a long-held belief. States with higher per capita GDP seemed to have a higher prevalence of diabetes. In rural areas, it was more prevalent among individuals of higher socioeconomic status. Or, in simpler words, diabetes indeed is a rich man’s problem.
The study funded by ICMR and the Department of Health Research, Union Health and Family Welfare Ministry revealed that Chandigarh, which has the highest GDP of $3,433, had the highest prevalence, almost double of the average of 15 States where the study was conducted. Bihar, on the other end of the economic spectrum, had less than one-third of Chandigarh’s.
It also showed that diabetes is more prevalent in mainland States when compared to the northeast. In urban areas of the more affluent Tamil Nadu, Chandigarh and Maharashtra showed the prevalence was higher even among people from the lower socioeconomic strata.
The study was proposed to be conducted in 28 States in India, of which it has been completed in 14 States including Tamil Nadu. A total of 57,117 individuals aged 20 years or older were part of the study.
“Because of the complexity and logistics involved, it has been divided into phases,” said Dr Tanvir Kaur of ICMR, one of the principal scientists of the cross-sectional, door-to-door study, who was presenting the study at the fourth edition of Dr Mohan’s International Diabetes Update 2017 that was inaugurated on Friday.
In Phase I, samples were collected from Chhattisgarh, Jharkhand, Maharashtra and Tamil Nadu between 2008 and 2010. Phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka and Punjab, from where samples were taken between 2012 and 2013. The northeast phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur and Meghalaya where sampling was done in 2012 and 2015.
A uniform methodology is being used in all the States, as there are no studies that were conducted with uniformity. Physical activity, dietary profile and compliance to the drugs were considered, Dr Tanvir added.
Capillary oral glucose tolerance tests were used to diagnose diabetes and prediabetes in accordance with WHO criteria, added the authors. They also used multiple logistic regression analysis to examine the association of various factors with the prevalence of diabetes and prediabetes.
The study assessed the prevalence of diabetes in different States in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product of each State. It found that States with higher per-capita GDP seemed to have a higher prevalence of diabetes.
In rural areas of all the States, diabetes was more prevalent in individuals of higher SES, said Dr RM
Anjana, one of the investigators and also joint managing director of Dr Mohan’s Group of Diabetes Institutions.
The overall prevalence of diabetes in all the 15 States of India was 7.3%, while that of prediabetes was 10.3%.
Age, sex, obesity, hypertension and family history of diabetes were independent risk factors for diabetes in both urban and rural areas, added Dr V Mohan, national coordinator of the study.
NOT SO SWEET