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High Prevalence of Diabetes and Cardiovascular Risk Factors Associated with urbanization in India

India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, 28, Marshall's Road, Egmore, Chennai – 600 008, India

ramachandran{at}vsnl.com

ABSTRACT

Aims: To compare prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glucose(IFG) and cardiovascular risk factors between a city, a town and periurban villages(PUV) in southern India and to look for temporal changes in city and PUV.

Methods: Subjects aged20 years were studied in Tamilnadu, India in Chennai (City, n=2192 M:W-1053:1139), Kanchipuram (Town, n=2290 M:W-988:1302), and Panruti (PUV, n=2584, M:W-1280:1304) in 2006. Demographic, socio economic and anthropometric details, blood pressure, physical activity (PA), diet habits and lipids were studied. Risk associations with diabetes were analysed using multiple logistic regression analyses. Present and previous data in city and PUV were compared.

Results: Mean BMI, waist circumference(WC) and family history of diabetes were significantly lower in PUV. PUV had lower prevalence(%) of diabetes [9.2 (95% CI, 8.0–10.5] (p<0.0001) than the city [18.6(16.6–20.5)] and town [16.4(14.1–18.6)]. Approximately 40% were newly diagnosed. Prevalence(%) of IGT was higher (p<0.0001) in the city [7.4(6.2–8.5)] than in town [4.3(3.3–5.3)] and PUV [5.5 (4.6–6.5)]. Prevalence of IFG was generally low. Age, family history and WC were significantly associated with diabetes, while PA was not. Overweight, elevated WC, hypertension and dyslipidaemia were more in the city.

Conclusion: In the city, diabetes increased from 13.9% to 18.6% in 6 years and IGT decreased significantly. Town and city had similar prevalences; PUV had lower diabetes prevalence, but prevalence had increased compared to a previous survey. Cardio metabolic abnormalities were more in urban populations.

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