The data on the incidence of diabetes in Kerala — the number or proportion of population developing new cases of diabetes in a year — is scarce.
A study conducted by the Achutha Menon Centre for Health Science Studies, which provides the first incidence data on Type 2 diabetes in Kerala, has reported an incidence rate of 138.2 per 1,000 person years among those in the pre-diabetic stage.
The study appears in the latest issue of the International Journal of Diabetes in Developing Countries .
Incidence of diabetes among people with normal glucose tolerance at baseline was 30.7 per 1,000 person years, while the incidence of pre-diabetes among people with normal glucose tolerance was 165.2 per 1,000 person years.
First-ever such data
“This is the first ever data on the actual incidence of diabetes in Kerala and is one of the highest incidence rates anywhere in the world. The high incidence of diabetes among our men had a significant association to the current use of tobacco and alcohol. The study has its limitations because it was conducted among industrial workers and not among the general population and has to be contextualised as risk factors and conversion rate of pre-diabetes to diabetes state could be different across States,” says K.R. Thankappan, the head of AMCHSS, who led the study.
The objective of the study was to find the incidence of pre-diabetes and diabetes among people with normal glucose tolerance levels in Kerala. The study also looked at the rate of progression from pre-diabetes to diabetes in this population.
The study was conducted among 2,000 workers from two major industries in southern Kerala, aged 18-64 years. Baseline data was first collected from the group in 2009 and the data was collected again from the group in 2011. Though the initial sample was 2,000, the number of persons who participated in the study in 2009 and the repeat study in 2011 was 326.
In both surveys, diabetes was defined as Fasting Plasma Glucose (FPG) of 126 mg/dl or more, pre-diabetes as FPG between100-125 mg/dl and normal glucose tolerance as FPG of less than 100 mg/dl.
The mean age of the group was 51 years. Prevalence of current tobacco use was 23.9 per cent and current alcohol consumption, 36.2 per cent.
Of the 326 workers, at the baseline study conducted in 2009, 85 were found to be diabetic, 107 were pre diabetic and 134 had normal FPG levels.
After two years, of the 134 with normal FPG levels, 28.4 per cent had progressed to pre-diabetic stage; 5.2 per cent developed diabetes.
Among the 107 workers with pre-diabetes, 23.4 per cent developed diabetes at the end of two years. The odds of progressing from pre-diabetes to diabetes were five times compared to those progressing from normal FPG to diabetes.
The incidence of diabetes at two-year follow-up among tobacco users – 23.7 per cent – was significantly higher compared to the diabetes incidence of 11 per cent in the non-smoking group. Similarly, the incidence of diabetes – 21.2 per cent – among alcohol users was significantly higher compared to the diabetes incidence of 10.6 per cent among the non-alcohol users.
