A current government funded clinical research project to understand the present pattern of diabetes across states portrays that the disease is catching up with the urban poor in the developed states of the countries. The project is one of the biggest ever of the kind, conducted in India.
The findings of the ICMR-India DIABetes study, published in the international medical journal Lancet, says that the urban areas of more affluent states have proceeded further along the diabetes epidemic. Less affluent individuals have a greater prevalence of diabetes than their more affluent counterparts in the rich states.
Chandigarh, which had the highest per capita GDP of US$ 3433 among the Indian states and union territories, has the highest prevalence of diabetes among the urban poor. The trend remained is same in Maharashtra and Tamil Nadu as well. But, in rural areas of all states, diabetes is more prevalent among the rich than the economically and socially weaker sections of the society.
The report says that as the overall prosperity of the states and India as a whole increases, the diabetes epidemic is likely to affect the poorer sections of the society, a serious transition that has recently been noted in high-income countries. This trend is worrisome because it suggests that the diabetes epidemic is spreading to those individuals who least can afford to pay for its management.
The researchers claimed that while the previous studies did not sufficiently capture the heterogeneous nature of the diabetes epidemic in India, the ongoing study aims to estimate the national prevalence of diabetes and pre-diabetes in India by proper estimation of the prevalence by state.
The overall prevalence of diabetes in the 15 states of India was 7.3 per cent. The prevalence of diabetes varied from 4.3 per cent in Bihar to 10 per cent in Punjab and was higher in urban areas (11.2 per cent) than in rural areas (5.2 per cent) and higher in mainland states (8.3 percent) than in the northeast (5.9 per cent).
The overall spread of prediabetes in all 15 states was 10.3 per cent. The presence of prediabetes varied from 6 per cent in Mizoram to 14.7 per cent in Tripura, and the presence of impaired fasting glucose was generally higher than the presence of impaired glucose tolerance.
Age, male sex, obesity, hypertension, and family history were independent risk factors for diabetes in both urban and rural areas, the study said.
The researchers mentioned that the rural prevalence estimates are much higher than identified in earlier studies. Given that approximately 70 per cent of India’s population resides in rural areas, even a little increase in the rural prevalence of diabetes will translate into several millions of individuals who will need chronic care. To mention about the additional burden that arises due to the overall younger age of onset type 2 diabetes in south Asian people compared with other populations, the pressure on our country’s health-care system is to be immense.
The study has been funded by the Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare.
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