High Prevalence of Diabetes and Cardiovascular Risk Factors Associated With Urbanization in India

  1. Ambady Ramachandran, MD,
  2. Simon Mary, BSC,
  3. Annasami Yamuna, PHD,
  4. Narayanasamy Murugesan, PHD and
  5. Chamukuttan Snehalatha, DSC
  1. From the India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Egmore, Chennai, India
  1. Corresponding author: Prof. A. Ramachandran, MD, PhD, India Diabetes Research Foundation, Chairman and Managing Director, Dr. A. Ramachandran's Diabetes Hospitals, 28 Marshall's Road, Egmore, Chennai 600008, India. E-mail: ramachandran{at}vsnl.com


OBJECTIVE—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 (PUVs) in southern India and to look for temporal changes in the city and PUVs.

RESEARCH DESIGN AND METHODS—Subjects aged ≥20 years were studied in Tamilnadu, India, in Chennai (city, n = 2,192; 1,053 men and 1,138 women), Kanchipuram (town, n = 2,290; 988 men and 1,302 women), and Panruti (PUVs, n = 2,584; 1,280 men and 1,304 women) in 2006. Demographic, socioeconomic, and anthropometric details; blood pressure; physical activity; diet habits; and lipids were studied. Risk associations with diabetes were analyzed using multiple logistic regression analyses. Present and previous data in the city and the PUVs were compared.

RESULTS—Mean BMI, waist circumference, and family history of diabetes were significantly lower in the PUVs. The PUVs had a 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% of subjects were newly diagnosed. Prevalence of impaired glucose tolerance (IGT) was higher (P < 0.0001) in the city (7.4 [6.2–8.5]) than in the town (4.3 [3.3–5.3]) and the PUVs (5.5 [4.6–6.5]). Prevalence of IFG was generally low. Age, family history, and waist circumference were significantly associated with diabetes, while physical activity was not. Overweight, elevated waist circumference, hypertension, and dyslipidemia were more prevalent in the city.

CONCLUSIONS—In the city, diabetes increased from 13.9 to 18.6% in 6 years and IGT decreased significantly. The town and city had similar prevalences; the PUVs had lower diabetes prevalence, but prevalence had increased compared with that in a previous survey. Cardiometabolic abnormalities were more prevalent in urban populations.


  • Published ahead of print at http://care.diabetesjournals.org on 12 March 2008. DOI: 10.2337/dc07-1207.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted February 13, 2008.
    • Received June 25, 2007.
| Table of Contents

This Article

  1. Diabetes Care vol. 31 no. 5 893-898
  1. All Versions of this Article:
    1. dc07-1207v1
    2. 31/5/893 most recent