AsianScientist (Jun. 20, 2017) – India’s diabetes epidemic is shifting, with the disease now increasingly common among people from low socio-economic backgrounds living in urban areas of the more affluent states, according to a study published in The Lancet Diabetes & Endocrinology journal.
These findings should cause concern in a country where most treatment costs are paid out-of-pocket by patients, and highlight the urgent need for effective prevention measures.
The Indian Council of Medical Research – India Diabetes (ICMR-INDIAB) study is the largest nationally representative study of diabetes in India and includes data from 57,000 people across 15 states. As part of the study, each person had their bodyweight, height, waist circumference and blood pressure measured. Glucose tolerance tests were used to diagnose diabetes and pre-diabetes.
The prevalence of diabetes across all 15 states was 7.3 percent and rates varied from 4.3 percent in Bihar to 13.6 percent in Chandigarh. Almost half of the people in the study did not know they had diabetes until they were tested.
On average, diabetes was twice as common in urban areas (11.2 percent) compared to rural areas (5.2 percent). Overall, diabetes was more common among people with higher socio-economic status, compared to people with low socio-economic status. However, in urban areas in seven states—most of which rank among the more economically advanced states—diabetes was higher among people from low socio-economic status.
For example, in urban areas of Chandigarh, the rate of diabetes was 26.9 percent for among people from low socio-economic background, compared to 12.9 percent for people from high socio-economic backgrounds. In urban areas of Punjab, the rates were 16.1 percent and 11.9 percent respectively.
Additionally, the rates of diabetes in rural areas were much higher than those identified in previous studies. The authors note that since 70 percent of the population in India lives in rural areas, even small increases can translate into several million more people requiring chronic care in areas with poor access to health care.
“Our study suggests that cities in the country’s more affluent states have transitioned further along the diabetes epidemic. As the overall prosperity of individual states and the country as a whole increases, the diabetes epidemic is likely to disproportionately affect the poorer sections of society, a transition that has already been seen in high income countries,” explained senior author Dr. Viswanathan Mohan, President of the Madras Diabetes Research Foundation, the national coordinating centre for the study.
“This trend is a matter of great concern because it suggests that the diabetes epidemic is spreading to individuals who can least afford to pay for its management,” added Dr. R. M. Anjana, lead author of the study and Vice-President of the Madras Diabetes Research Foundation.
Finally, prevalence of pre-diabetes was 10.3 percent across all 15 states. In most states, the rate of pre-diabetes exceeded the rate of diabetes.
“The high rates of pre-diabetes across the country imply the existence of a huge number of individuals who could conceivably develop diabetes in the near future. Our findings have serious implications for the country’s health and socioeconomic development and highlight the urgent need for implementing effective preventative measures,” said Mohan.
The article can be found at: Anjana et al. (2017) Prevalence of Diabetes and Prediabetes in 15 States of India: Results from the ICMR–INDIAB Population-based Cross-sectional Study.
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Source: The Lancet; Photo: Shutterstock.
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