Prediabetes in India

In countries such as India, buy there are going to be as many as eighty percent of all diabetics from the entire world population concentrated there which makes India the diabetic capital of the world

In India, all persons over the age of 25 years should undergo an annual test to rule out the presence of diabetes.

Incidence of Diabetes and Pre-diabetes in a Selected Urban South Indian Population (Cups – 19)

  • Among subjects with normal glucose tolerance (NGT) at baseline [n=476], 64 (13.4%) developed diabetes and 48 (10.1%) developed pre-diabetes (IGT or IFG).
  • The incidence rate of diabetes was 20.2 per 1000 person years and that of pre-diabetes was 13.1 per 1000 person years among subjects with NGT.
  • Of the 37 individuals who were pre-diabetic at baseline, 15 (40.5%) developed diabetes [incidence rate: 64.8 per 1000 person years], 16 (43.2%) remained as pre-diabetic and 6 (16.2%) reverted to normal during the follow-up period.
  • Regression analysis revealed obesity [Odds Ratio (OR): 2.1, p=0.001], abdominal obesity [OR: 2.23, p<0.001] and hypertension [OR: 2.57, p<0.001] to be significantly associated with incident diabetes.
  • The Indian Diabetes Risk Score (IDRS) showed the strongest association with incident diabetes [OR: 5.14, p<0.001].

 

The burden of diabetes and impaired glucose tolerance in India using the WHO 1999 criteria: prevalence of diabetes in India study (PODIS)

  • Multistage cross-sectional population survey
  • The study was carried out in 77 centers (40 urban and 37 rural).
  • 18363 (9008 males and 9355 females) subjects were studied
  • The standardized prevalence rate for DM in the total Indian, urban and rural populations was 4.3, 5.9 and 2.7%, respectively.
  • The corresponding IGT rates in the three populations was 5.2, 6.3 and 3.7%, respectively
  • The urban prevalence of DM and IGT was significantly greater than in the rural population (P < 0.001 in both instances)

 

High Prevalence of Type 2 Diabetes Mellitus and Other Metabolic Disorders in Rural Central Kerala

  • The crude- and age-adjusted prevalence of DM was 14.6 percent and 12.5 percent respectively, and that of IFG was 5.1 percent and 4.6 percent respectively.
  • The crude prevalence of hypertension (BP? 140/90), hypercholesterolemia (fasting total serum cholesterol ? 200 mg/dL) and central obesity (WHR ? 0.80 [women] and ? 0.90 [men]) was 36.1 percent, 37.0 percent and 85.6 percent respectively.
  • High prevalence of DM even in rural community validates the pandemic trend of DM.
  • The co¬≠existence of other non-communicable diseases amplifies the burden of DM.
  • The impact of socioeconomic transition on the occurrence of DM needs to be explored further

 

Rising prevalence of NIDDM in an urban population in India

  • A survey conducted in 1988-1989, in the city of Madras, South India, showed that the prevalence of diabetes mellitus in adults was 8.2% and prevalence of impaired glucose tolerance (IGT) was 8.7%.
  • Multiple regression analysis showed age, waist:hip ratio, body mass index (BMI) and female sex were correlated to diabetes.
  • Prevalence of IGT correlated to age, BMI and waist:hip ratio.
  • This study highlights the rising trend in the prevalence of non-insulin-dependent diabetes (NIDDM) in urban Indians.
  • The persistent high prevalence of IGT may also be a predictor of a further increase in NIDDM in the future.

 

High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey

  • Prevalences of diabetes and impaired glucose tolerance were 12.1% and 14.0% respectively, with no gender difference.
  • Diabetes and impaired glucose tolerance showed increasing trend with age.
  • Subjects under 40 years of age had a higher prevalence of impaired glucose tolerance than diabetes (12.8% vs 4.6%, p < 0.0001).
  • Diabetes showed a positive and independent association with age, BMI, WHR, family history of diabetes, monthly income and sedentary physical activity.
  • Age, BMI and family history of diabetes showed associations with impaired glucose tolerance

 

Prediabetes associated with increased CVD risk

  • A study to find out the proportion of prediabetes in patients with acute coronary syndrome in a medical college of Kolkata.
  • N=62 acute coronary syndrome patients
  • The study showed 48.4% of all acute coronary syndrome patients were prediabetic and 25% were diabetic.
  • The proportion of impaired fasting glucose and impaired glucose tolerance were 19.4% and 22.6% respectively
  • So, altogether 72.4% patients were dysglycaemic.
  • Out of all acute coronary syndrome patients, non-ST elevated myocardial infarction group had 50% prediabetic patients, ST elevated myocardial infarction group had 50% prediabetic patients and unstable angina group have 45.8% prediabetic patients
  • So, all patients of acute coronary syndrome should be screened to detect hyperglycaemia in early stage to prevent further development of diabetes mellitus and also further cardiovascular events.
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