RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/2321-0656.188001
Socioeconomic and demographic trends in the prevalence of type 2 diabetes in India
Publikationsverlauf
Publikationsdatum:
23. November 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00041241/201602/lookinside/thumbnails/10-4103-2321-0656-188001-1.jpg)
Abstract
Noncommunicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. The rapid demographic and epidemiologic transition that India is facing today is paralleled by a massive increase in NCD prevalence, of which diabetes remains the most dominant. Besides genetic and environmental factors, an increase in life expectancy, urbanization, influenced unhealthy lifestyle changes, affluence associated with dietary excess, and reduced physical activity appear to be major drivers for increased burden of diabetes in India. Inappropriate nutrition and physical inactivity lead to obesity, a positive predictor for diabetes. Moreover, early onset of diabetes accompanied by prevailing poverty, low awareness, and poor health consciousness across socioeconomic and demographic strata is reflected in the large burden of undiagnosed cases of diabetes. In addition, reversal of socioeconomic gradient of disease burden observed in India can have serious health and financial implications on individual and healthcare system, which, if left unaddressed, may result in an adverse impact on the nation's economy. Keeping in view, a major shift in India's burden of disease, there is an imperative need for robust, systematic measures for data reporting supported by effective public healthcare interventions to reduce the burden of diabetes. Comprehensive multisectoral actions prioritizing identification of risk factors, early diagnosis, and effective implementation of cost-effective interventions can curb the epidemic of diabetes. A multifaceted approach for implementation of evidence-based policy measures involving various departments of the government and nongovernmental agencies is required to address both preventive and curative aspects of diabetes management. Policies that ensure better surveillance and increase in access to affordable and essential medicines providing universal health coverage should be developed. Policymakers should take lead in the development or strengthening the existing policies and see that they are not only implemented but also evaluated for their effectiveness. A strong commitment from both public and private sectors toward implementation and intensification of population-based prevention strategies through proven programs and policies is required to address the growing burden of diabetes.
-
References
- 1 Pradeepa R, Prabhakaran D, Mohan V. Emerging economies and diabetes and cardiovascular disease. Diabetes Technol Ther 2012; 14 Suppl 1: S59-S67
- 2 Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK. et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001; 44: 1094-1101
- 3 Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence and trends of the diabetes epidemic in South Asia: A systematic review and meta-analysis. BMC Public Health 2012; 12: 380
- 4 Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C. High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care 2008; 31: 893-898
- 5 Colagiuri S, Borch-Johnsen K, Glümer C, Vistisen D. There really is an epidemic of type 2 diabetes. Diabetologia 2005; 48: 1459-1463
- 6 International Diabetes Federation. Diabetes Atlas. 7th edn.. International Diabetes Federation; 2015
- 7 Ramachandran A, Snehalatha C, Shetty AS, Nanditha A. Trends in prevalence of diabetes in Asian countries. World J Diabetes 2012; 3: 110-117
- 8 Agrawal S, Ebrahim S. Prevalence and risk factors for self-reported diabetes among adult men and women in India: Findings from a national cross-sectional survey. Public Health Nutr 2012; 15: 1065-1077
- 9 Kinra S, Bowen LJ, Lyngdoh T, Prabhakaran D, Reddy KS, Ramakrishnan L. et al. Sociodemographic patterning of non-communicable disease risk factors in rural India: A cross sectional study. BMJ 2010; 341: c4974
- 10 Available from: http://www.censusindia.gov.in/Census_And_You/age_structure_and_marital_status.aspx [Last accessed on date 2016 Jul 10].
- 11 Basu R, Breda E, Oberg AL, Powell CC, Dalla Man C, Basu A. et al. Mechanisms of the age-associated deterioration in glucose tolerance: Contribution of alterations in insulin secretion, action, and clearance. Diabetes 2003; 52: 1738-1748
- 12 Basu R, Dalla Man C, Campioni M, Basu A, Klee G, Toffolo G. et al. Effects of age and sex on postprandial glucose metabolism: Differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction. Diabetes 2006; 55: 2001-2014 Erratum in: Diabetes 2006;55:2665.
- 13 Qiao Q, Hu G, Tuomilehto J, Nakagami T, Balkau B, Borch-Johnsen K. et al. Age-and sex-specific prevalence of diabetes and impaired glucose regulation in 11 Asian cohorts. Diabetes Care 2003; 26: 1770-1780
- 14 World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO. Improving the Built Environment in India. Preventing Chronic Diseases: A Vital Investment. WHO Report 2005. Geneva: World Health Organization; 2003
- 15 ICMR. Assessment of Burden of NCDs. Indian Council of Medical Research; 2006
- 16 Venkataraman K, Kannan AT, Mohan V. Challenges in diabetes management with particular reference to India. Int J Diabetes Dev Ctries 2009; 29: 103-109
- 17 Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R. et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia 2011; 54: 3022-3027
- 18 Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A. et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India – The Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 2006; 49: 1175-1178
- 19 Kumpatla S, Michael C, Aravindalochanan V, Viswanathan V. Changing trend in one decade in the profile of newly diagnosed subjects with type 2 diabetes in India. Int J Diabetes Metab 2011; 19: 107-112
- 20 Anjana RM, Ali MK, Pradeepa R, Deepa M, Datta M, Unnikrishnan R. et al. The need for obtaining accurate nationwide estimates of diabetes prevalence in India – Rationale for a national study on diabetes. Indian J Med Res 2011; 133: 369-380
- 21 Available from: http://www.censusindia.gov.in/2016 [Last accessed on date 2016 Jul 10].
- 22 Patil RS, Gothankar JS. Prevalence of type-2 diabetes mellitus and associated risk factors in an urban slum of Pune city, India. Natl J Med Res 2013; 3: 346-349
- 23 Deo SS, Zantye A, Mokal R, Mithbawkar S, Rane S, Thakur K. To identify the risk factors for high prevalence of diabetes and impaired glucose tolerance in Indian rural population. Int J Diabetes Dev Ctries 2006; 26: 19-23
- 24 Chow CK, Raju PK, Raju R, Reddy KS, Cardona M, Celermajer DS. et al. The prevalence and management of diabetes in rural India. Diabetes Care 2006; 29: 1717-1718
- 25 Zargar AH, Khan AK, Masoodi SR, Laway BA, Wani AI, Bashir MI. et al. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent. Diabetes Res Clin Pract 2000; 47: 135-146
- 26 Basavanagowdappa H, Prabhakar AK, Prasannaraj P, Gurudev KC. Virupaksha, Suma. Study of prevalence of diabetes mellitus and impaired fasting glucose in a rural population. Int J Diabetes Dev Ctries 2005; 25: 98-101
- 27 Menon VU, Kumar KV, Gilchrist A, Sugathan TN, Sundaram KR, Nair V. et al. Prevalence of known and undetected diabetes and associated risk factors in central Kerala – ADEPS. Diabetes Res Clin Pract 2006; 74: 289-294
- 28 Balagopal P, Kamalamma N, Patel TG, Misra R. A community-based diabetes prevention and management education program in a rural village in India. Diabetes Care 2008; 31: 1097-1104
- 29 Khatib NM, Quazi ZS, Gaidhane AM, Waghmare TS, Goyal RC. Risk factors of type-2 diabetes mellitus in rural Wardha: A community based study. Int J Diabetes Dev Ctries 2008; 28: 79-82
- 30 Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India 2009; 57: 563-567
- 31 Rao CR, Kamath VG, Shetty A, Kamath A. A study on the prevalence of type 2 diabetes in coastal Karnataka. Int J Diabetes Dev Ctries 2010; 30: 80-85
- 32 Zaman FA, Pal R, Zaman GS, Swati IA, Kayyum A. Glucose indices, frank and undetected diabetes in relation to hypertension and anthropometry in a South Indian rural population. Indian J Public Health 2011; 55: 34-37
- 33 Radhakrishnan S, Balamurugan S. Prevalence of diabetes and hypertension among geriatric population in a rural community of Tamil Nadu. Indian J Med Sci 2013; 67: 130-136
- 34 Ahmad J, Masoodi MA, Ashraf M, Rashid R, Ahmad R, Ahmad A. et al. Prevalence of diabetes mellitus and its associated risk factors in age group of 20 years and above in Kashmir, India. Al Ameen J Med Sci 2011; 4: 38-44
- 35 Obesity in Asia Collaboration, Huxley R, Barzi F, Lee CM, Lear S, Shaw J. et al. Waist circumference thresholds provide an accurate and widely applicable method for the discrimination of diabetes. Diabetes Care 2007; 30: 3116-3118
- 36 Misra A, Pandey RM, Devi JR, Sharma R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in Northern India. Int J Obes Relat Metab Disord 2001; 25: 1722-1729
- 37 Misra A, Shrivastava U. Obesity and dyslipidemia in South Asians. Nutrients 2013; 5: 2708-2733
- 38 Kurpad AV, Varadharajan KS, Aeberli I. The thin-fat phenotype and global metabolic disease risk. Curr Opin Clin Nutr Metab Care 2011; 14: 542-547
- 39 Onwudiwe NC, Mullins CD, Winston RA, Shaya FT, Pradel FG, Laird A. et al. Barriers to self-management of diabetes: A qualitative study among low-income minority diabetics. Ethn Dis 2011; 21: 27-32
- 40 Skar M, Villumsen AB, Christensen DL, Petersen JH, Deepa M, Anjana RM. et al. Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: The Chennai urban rural epidemiology study (CURES-116). Indian J Endocrinol Metab 2013; 17: 1084-1089
- 41 Deepa M, Anjana RM, Manjula D, Narayan KM, Mohan V. Convergence of prevalence rates of diabetes and cardiometabolic risk factors in middle and low income groups in urban India: 10-year follow-up of the Chennai Urban Population Study. J Diabetes Sci Technol 2011; 5: 918-927
- 42 Bhojani U, Beerenahalli TS, Devadasan R, Munegowda CM, Devadasan N, Criel B. et al. No longer diseases of the wealthy: Prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India. BMC Health Serv Res 2013; 13: 306
- 43 Ramachandran A, Ramachandran S, Snehalatha C, Augustine C, Murugesan N, Viswanathan V. et al. Increasing expenditure on health care incurred by diabetic subjects in a developing country: A study from India. Diabetes Care 2007; 30: 252-256
- 44 Corsi DJ, Subramanian SV. Association between socioeconomic status and self-reported diabetes in India: A cross-sectional multilevel analysis. BMJ Open 2012 2. pii: E000895.
- 45 Mitra A, Bhattacharya D. Effects of overall consumption, dietary patterns, cooking, on patients suffering from non insulin dependent diabetes mellitus. J Interacademicia 2005; 9: 635-642
- 46 Mitra A, Basu B, Mukherjee S. Significance of different dietary habits in sections of Indian diabetics. J Hum Ecol 2009; 26: 89-98
- 47 Salmerón J, Hu FB, Manson JE, Stampfer MJ, Colditz GA, Rimm EB. et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr 2001; 73: 1019-1026
- 48 Mitra A, Bhattacharya D. Effect of fatty substances on health particularly to patients suffering from NIDDM and dyslipidaemia. J Interacademicia 2006; 10: 74-85
- 49 Mitra A, Bhattacharya D. Role of retrograded starches particularly rice containing retrograded starches in non-insulin dependent diabetes mellitus.All India Seminar on Advances in Agro-Processing and Rural Empowerment. Agriculture Engineering Division, The Institution of Engineers (India), West Bengal State Center, Kolkata, 17-18 February, 2006
- 50 Ebrahim S, Kinra S, Bowen L, Andersen E, Ben-Shlomo Y, Lyngdoh T. et al. The effect of rural-to-urban migration on obesity and diabetes in India: A cross-sectional study. PLoS Med 2010; 7: e1000268
- 51 Henry CJ, Lightowler HJ, Newens K, Sudha V, Radhika G, Sathya RM. et al. Glycaemic index of common foods tested in the UK and India. Br J Nutr 2008; 99: 840-845
- 52 Ramaiya KL, Kodali VR, Alberti KG. Epidemiology of diabetes in Asians of the Indian subcontinent. Diabetes Metab Rev 1990; 6: 125-146
- 53 Mohan D, Raj D, Shanthirani CS, Datta M, Unwin NC, Kapur A. et al. Awareness and knowledge of diabetes in Chennai – The Chennai Urban Rural Epidemiology Study [CURES-9]. J Assoc Physicians India 2005; 53: 283-287
- 54 Rai M, Kishore J. Myths about diabetes and its treatment in North Indian population. Int J Diabetes Dev Ctries 2009; 29: 129-132
- 55 Mohan V, Mathur P, Deepa R, Deepa M, Shukla DK, Menon GR. et al. Urban rural differences in prevalence of self-reported diabetes in India – The WHO-ICMR Indian NCD risk factor surveillance. Diabetes Res Clin Pract 2008; 80: 159-168
- 56 Todi S. Chronic hyperglycemia in critically ill: Another piece in the glycemic control puzzle. Indian J Crit Care Med 2014; 18: 3-5
- 57 Pearson TA. Education and income: Double-edged swords in the epidemiologic transition of cardiovascular disease. Ethn Dis 2003; 13 (02) (Suppl. 02) S158-S163
- 58 Hussain A, Rahim MA, Azad Khan AK, Ali SM, Vaaler S. Type 2 diabetes in rural and urban population: Diverse prevalence and associated risk factors in Bangladesh. Diabet Med 2005; 22: 931-936
- 59 Singh P, Yadav RJ, Pandey A. Utilization of indigenous systems of medicine and homoeopathy in India. Indian J Med Res 2005; 122: 137-142
- 60 World Health Organization. Demographic trends.In Health Situation in the South-East Asia Region 1998-2000. Regional Office for South East Asia, New Delhi: 2002: 17-30
- 61 Khongsdier R. Malnutrition, social inequality and natural selection in human populations. J Hum Ecol 2006; 14: 53-67
- 62 Popkin BM. The nutrition transition: An overview of world patterns of change. Nutr Rev 2004; 62 (07) (Pt 2): S140-S143
- 63 Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: Meta-analysis and systematic review. BMJ 2012; 344: e1454
- 64 Rani M, Bonu S. Rural Indian women's care-seeking behavior and choice of provider for gynecological symptoms. Stud Fam Plann 2003; 34: 173-185
- 65 Shrestha AD, Kosalram K, Gopichandran V. Gender difference in care of type 2 diabetes. JNMA J Nepal Med Assoc 2013; 52: 245-250
- 66 Ganie MA, Koul S, Razvi HA, Laway BA, Zargar AH. Hyperglycemic emergencies in Indian patients with diabetes mellitus on pilgrimage to Amarnathji yatra. Indian J Endocrinol Metab 2012; 16 (Suppl. 01) S87-S90
- 67 Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U. et al. Prevalence of diagnosed and undiagnosed diabetes and hypertension in India – Results from the Screening India's Twin Epidemic (SITE) study. Diabetes Technol Ther 2012; 14: 8-15
- 68 Bajaj S, Jawad F, Islam N, Mahtab H, Bhattarai J, Shrestha D. et al. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement. Indian J Endocrinol Metab 2013; 17: 548-562
- 69 Mather HM, Keen H. The Southall Diabetes Survey: Prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed) 1985; 291: 1081-1084
- 70 Shriraam V, Mahadevan S, Anitharani M, Selvavinayagam. Sathiyasekaran B. National health programs in the field of endocrinology and metabolism – Miles to go. Indian J Endocrinol Metab 2014; 18: 007-012
- 71 Arunachalam S, Gunasekaran S. Diabetes research in India and China Today: From literature-based mapping to health – Care policy. Curr Sci 2002; 82: 1086-1097
- 72 Siegel K, Narayan KM, Kinra S. Finding a policy solution to India's diabetes epidemic. Health Aff (Millwood) 2008; 27: 1077-1090
- 73 Bhojani U, Thriveni BS, Devadasan R, Munegowda CM, Devadasan AN, Criel B. et al. Challenges in organizing quality diabetes care for the urban poor: A local health system perspective. BMC Proceedings 2012; 6 (Suppl. 05) O13
- 74 Ministry of Health and Family Welfare. Pilot Phase of the National Programme for Prevention and Control of Diabetes, Cardio-Vascular Diseases, and Stroke Launched. Press Release 4 January, 2008.
- 75 Puska P. Health in all policies. Eur J Public Health 2007; 17: 328
- 76 Available from: http://www.idf.org/sites/default/files/Global_Diabetes_Plan_Final.pdf [Last accessed on date 2016 Jul 10].
- 77 World Health Organization. Adelaide Statement on Health in All Policies. Geneva: World Health Organization (WHO); 2010
- 78 Verma R, Khanna P, Mehta B. National programme on prevention and control of diabetes in India: Need to focus. Australas Med J 2012; 5: 310-315
- 79 Available from: http://www.michigan.gov/documents/MAPreportOct05_final_150918_7.pdf [Last accessed on date 2016 Jul 10].
- 80 Coitinho D, Monteiro CA, Popkin BM. What Brazil is doing to promote healthy diets and active lifestyles. Public Health Nutr 2002; 5: 263-267
- 81 João Leopoldo OliveiraAraujo. et al. Access to medicines for diabetes treatment in Brazil: evaluation of “health has no price” program. Diabetol Metab Syndr 2016; 8: 035 10.1186/s13098-016-0150-8.
- 82 Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, Ebrahim S. Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study?. PLoS Med 2014; 11 (01) e1001582 10.1371/journal.pmed.1001582.
- 83 Ministry of Urban Development, National Urban Transport Policy. New Delhi: Government of India; 2005
- 84 Faghri PD, Li R. Effectiveness of financial incentives in a worksite diabetes prevention program. Open Obes J 2014; 6: 1-12