First, it was the bitter news of losing its second slot among the top 10 cleanest cities in the country.

Now, Chandigarh has to live with the harsh reality of the not-so-sweet truth of having the highest incidence of diabetics.Added to that is the realisation that the incidence of diabetes among its poor is more than double of that among the rich.A study carried out in 15 states of the country, under the aegis of the Indian Council of Medical Research (ICMR) has ranked Chandigarh at the top in diabetes prevalence with over 13.6 percent of the city's 1.1 million population being affected by the disease which is seen as a 'silent killer' in health circles.This figure is certainly greater than the 7.3 percent average in 15 states. The comprehensive study covered over 51 percent of India's 1,250 million population.

"What is even more concerning is the fact that the high incidence of diabetes is not limited to the rich or economically better-off people. In urban areas of more affluent states like Chandigarh, Maharashtra and Tamil Nadu, the diabetes incidence is more among people in the lower SES (socio-economic status) category than the rich," Dr Anil Bhansali, Head of Department of the Department of Endocrinology at the Post-Graduate Institute of Medical Education and Research (PGIMER), told IANS here.In Chandigarh, the incidence of diabetes, as per the study, among the lower SES or poor is at a staggering nearly 27 per cent. The incidence among the well-off or rich is less than half of that, -- at nearly 13 percent, Bhansali pointed out. Equally concerning for doctors is the fact that the rich people in rural areas have more incidence of diabetes than those with lower SES in rural areas."Rich rurals and poor urbans had more diabetes than poor rural and rich urbans (respectively). Our results show evidence of an Epidemiological Transition, with higher prevalence of diabetes in low SES groups in the urban areas of the more economically developed states, said Dr Bhansali, who is a leading diabetologist and internationally-known for research on stem cell therapy for treatment of Type 2 diabetes.

Explaining the reason for the higher incidence of diabetes among lower SES people in Chandigarh, Bhansali said: "In Chandigarh, the cost of living is quite high. People from the lower SES are competing with the rich in matching up to standards of eating and lifestyle. In this struggle, the poor are eating inexpensive food, which is full of carbohydrates, to remain in the competition. This is leading to more diabetes incidence in lower SES. Chandigarh, as per the study, has the highest per capita income of $3,433."We have found that wherever economic reforms have impacted, the incidence of diabetes has gone up. Initially, the rich, in an economic reform era, tend to have lifestyle diseases like diabetes. But with awareness levels rising and the rich being able to afford health promotion activities like Gyms and healthy foods, the incidence of the disease becomes lower in their category," he added.