A large community-based study involving over 57,000 adults from 14 States and a Union Territory (Chandigarh) in the country has revealed that the average prevalence of diabetes in these States stands at 7.3%.

The prevalence varied from 4.3% of the population in the case of Bihar, to 10.4% in Tamil Nadu; Chandigarh was found to have a prevalence of 13.6%. The study also showed that the economically more developed States had a higher prevalence than economically less developed States. The overall prevalence of diabetes was lower in the northeast States compared with other States.

The prevalence of pre-diabetes in all the 14 States and Chandigarh was found to be 10.3%. It varied from 6% (Mizoram) to 14.7% (Tripura). This high prevalence implies the existence of a huge number of people who could develop the disease in the near future.

More than 47% studied were unaware of having diabetes until they tested. The prevalence was higher in urban areas (11.2%) compared to rural areas (5.2%). With 5.9%, the northeast States registered lesser prevalence compared with other States studied (8.3%).

While people with better socio-economic status in rural areas had a higher prevalence of the disease, in the relatively more affluent States such as Tamil Nadu and Gujarat, the reverse was was found to be true.

Epidemiological shift

“We are seeing an epidemiological transition. Awareness is high among the rich and they are taking care of themselves, while diabetes is hitting the poorer people in these States,” says Dr. V. Mohan from Dr. Mohan’s Diabetes Specialities Centre, Chennai and one of the authors of the paper.

The Phase I of the study included Tamil Nadu, Chandigarh, Jharkhand, and Maharashtra (2008-2010) and Phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka, and Punjab (2012-2013), and the northeastern phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur, and Meghalaya (2012-2015).

“In Tamil Nadu, the prevalence of diabetes is lower in rural areas compared with urban areas but the difference is narrowing. While in Jharkhand, the difference is huge — nearly 13% in urban areas and about 3.5% in rural areas,” says Dr. Mohan.

Similarly, in the urban areas, people with low socio-economic status had a higher prevalence than people with high socio-economic status in the economically well-developed States like Tamil Nadu, Punjab, Andhra Pradesh and Maharashtra. Tripura too showed a similar trend. The reverse was found in the case of States that are economically less developed.

In the case of rural areas, people with high socio-economic status had higher prevalence than those with low socio-economic status in all the 14 States and Chandigarh.

The results of the ICMR–INDIAB study were published on Wednesday in the journal The Lancet nDiabetes & Endocrinology.

Published in The Hindu on June 7, 2017