‘Diabetes prevalence up in towns, villages’

Study finds no significant link with income; points to rising obesity all round

January 31, 2019 01:41 am | Updated 01:41 am IST - CHENNAI

Significant increases in prevalence ratios of diabetes, and the sheer number of people with diabetes in rural areas and towns have epidemiologists worried even more than they already are.

An online publication in an ahead-of-print issue of the American journal Diabetes Care has turned the focus, perhaps yet again, on the way in which diabetes, once believed to be a disease of the affluent, particularly in cities, is now radiating outwards across various socio-economic and geographic profiles.

The paper, by Arun, Nanditha et al, has demonstrated that expectedly, the prevalence of diabetes and prediabetes increased in all locations; but the rise was significant only in the town and peri urban villages. Similarly, abdominal obesity was also significantly increasing, even among villagers.

“These are worrying trends,” says A. Ramachandran of Dr. A. Ramachandran’s Diabetes Hospital, one of the authors of the study. “We used a sophisticated comparative statistical analytical tool - prevalence ratio - to measure changes over a decade.” He explained that the study was conducted in two phases, the first in 2006, and subsequently, a decade later in 2016 in the same three centres – Chennai, Kancheepuram and Panruti. The PR showed significant increases in prevalence of diabetes and prediabetes in Kancheepuram and Panruti.

Rampant obesity

The researchers also advanced the argument that the main reason for the increased prevalence of diabetes is abdominal obesity, though general obesity had also increased in the decade under study. Higher percentages of increase in abdominal obesity were seen in all populations - 34 % in Chennai, 35.2 % in Kancheepuram and 57.2% in Panruti.

In the earlier studies, diabetes prevalence in Chennai was higher in the high socioeconomic stratum. Now, this association can no longer be made; in 2016, income did not exhibit a tenuous link with diabetes prevalence in any of the three locations, whereas in the 2006 survey in the city, high income was associated with a higher prevalence of diabetes. The current study suggests a rising trend of diabetes in the low, and middle income groups.

Rural focus

Dr. Nandita, senior consultant diabetologist, Dr. A.Ramachandran’s Diabetes Hospital, points out that the transition in the epidemic should not be missed, and there is a need to focus on rural populations too with health and lifestyle interventions. Tamil Nadu, for instance, launched some years ago, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke under which it offers screening for men and women over 30 years of age for diabetes, and referrals for confirmatory tests, and further treatment if any.

Notably, other studies, including the Indian Council for Medical Research-Diabetes (INDIAB) study had observed a transition occurring in India, with diabetes prevalence increasing in rural India as well as among the people of lower socioeconomic status living in urban areas.

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