The ICMR-INDIAB study showed for the first time a clear epidemiological transition with diabetes now becoming common among poor people.

 

 

 

 

It has also started affecting younger people and rural populations. This calls for urgent preventive steps. Mass awareness programmes are needed. Moreover, identifying people in the pre-diabetes stage and instituting preventive steps eg., healthy diet and increasing physical activity can help to stem the tide of the epidemic of diabetes in India.

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Introduction 

Till recently, diabetes was considered a disease of the rich.

Recently, the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study which is the largest nationally representative, government-funded study of diabetes in India was published in Lancet Diabetes and Endocrinology by Dr. R.M. Anjana and Dr. V. Mohan and colleagues.

In this study, it was seen that by and large, this was still true, there was a fairly good correlation between the GDP and prevalence rate of diabetes. However, the study had many surprising findings which were quite worrisome from the public health point of view.

 

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Methods

We used a stratified multistage design to obtain a community-based sample of 57,117 individuals aged 20 years or older.

The sample population represented 14 of India’s 28 states (eight from the mainland and six from the northeast of the country) and one union territory. States were sampled in a phased manner:

States were sampled in a phased manner. It started in 2008 and we completed sampling in 2015.

Capillary oral glucose tolerance tests (OGTT’s) were used to diagnose diabetes and prediabetes in accordance with WHO criteria.

The prevalence of diabetes in different states was assessed in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product (GDP) of each state.

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Results

The prevalence of diabetes across all 15 states was 7.3%. States with higher GDP reported having a higher prevalence of diabetes.

There is an alarming increase in the prevalence of Diabetes among the urban poor in 7 of India’s more affluent states which includes Chandigarh, Tamil Nadu, Andhra Pradesh and Maharashtra.

Age, male sex, obesity, hypertension, and family history of diabetes were independent risk factors for diabetes in both urban and rural areas.

Over 50% of people who participated in the study were unaware of their condition- indicating low awareness about the disease.

The prevalence of the disease in urban India is twice that of rural India.

In most states, the rate of pre-diabetes exceeded the rate of diabetes, a forewarning on the impeding pressure on the healthcare facility and infrastructure.

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Contributed by Dr. V.Mohan And Dr. R.M. Anjana, Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, Chennai.

 

 

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