Diabetes Rural Semi-urban Populations

• In earlier years there was a very low prevalence of diabetes in rural populations.¹  However, two recent studies, from Maharashtra and Andhra Pradesh report very high prevalence rates similar to those in urban Indian populations.²

• A striking correlation exists between body mass index (BMI) and diabetes. Rural-urban disparities in the prevalence of diabetes observed in earlier studies could be due to the low prevalence of obesity in rural subjects compared to urban subjects.^{3, 4}

•  BMI on average is 3 to 5 units lower in rural compared to urban areas in India. In one large study, prevalence of obesity (BMI>25) was 3 times higher and diabetes was 2 times higher in urban India compared to rural India.⁵

• Prevalence of diabetes in semi-urban areas in India is intermediate between those of rural and urban India. This is also true for urban slums.

• Prevalence of diabetes, obesity, metabolic syndrome, and other cardiovascular disease (CVD) risk factors except smoking is higher in middle income groups than the low income groups regardless of where they live.⁶

• It appears that regional and national heterogeneity in diabetes prevalence is rooted in more recent (environmental) events rather than genetic factors.

Sources

1. Kutty VR, Soman CR, Joseph A, Pisharody R, Vijayakumar K. Type 2 diabetes in southern Kerala: variation in prevalence among geographic divisions within a region. Natl Med J India. 2000;13(6):287-292.

2. Chow CK, Raju PK, Raju R, et al. The prevalence and management of diabetes in rural India. Diabetes Care. Jul 2006;29(7):1717-1718.

3. Gupta R, Misra A, Pais P, Rastogi P, Gupta VP. Correlation of regional cardiovascular disease mortality in India with lifestyle and nutritional factors. Int J Cardiol. Apr 14 2006;108(3):291-300.

4. Ramachandran A, Snehalatha C, Baskar AD, et al. Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India. Diabetologia. May 2004;47(5):860-865.

5. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: the need & scope. Indian J Med Res. Nov 2010;132(5):634-642.

6. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. Mar 2007;125(3):217-230.