Diabetes in the Kokan region of India

Abstract

BACKGROUND BKL Walawalkar Hospital is situated near the village of Dervan in the Kokan region of the state of Maharashtra in India. A survey of 2200 surrounding villages showed 51.8% adults had body mass index (BMI) below <18.5 kg/m 2 and only 4.5% were overweight. A survey of 11521 adolescent girls from rural schools showed 64% prevalence of thinness. In the same region, government survey reported the prevalence of diabetes around 7%, and 70% prevalence of leanness. This reinforced the fact that the overall population of Kokan is lean. Hence, we decided to investigate body composition of diabetic people from our hospital clinic by carrying out a clinic-based case control study. AIM To study body composition of diabetics in a rural clinic of Kokan. METHODS In a case-control study, 168 type 2 diabetic patients (102 men) attending the outpatient department at a rural hospital and 144 non-diabetic controls (68 men) in the Chiplun area of the Kokan region were recruited. History of diabetes (age of onset, duration), anthropometric measurements (height, weight, waist and hip circumference) were recorded. Body composition was measured by bioimpedance using the TANITA analyzer. RESULTS More than 45% of diabetic subjects had a 1 st degree family history of diabetes, and more than 50% had macrovascular complications. The average BMI in diabetic subjects was 24.3 kg/m 2 . According to World Health Organization standards, prevalence of underweight was 8% and that of normal BMI was around 50%. Underweight and normal diabetic subjects (men as well as women) had significantly lower body fat percentage, higher muscle mass percentage, lower visceral fat and lower basal metabolic rate when compared to their overweight counterparts. CONCLUSION The diabetic population in Kokan has near normal body composition, and BMI has considerable limitations in assessing body composition and it also lacks sensitivity for assessing risk for diabetes in this population. High prevalence of family history of diabetes may point towards genetic predisposition. Leanness is an inherent characteristic of this population and its metabolic significance needs further investigations with a larger sample size.

Prevalence, risk factors, and glycaemic control of type 2 diabetes mellitus in eastern Sudan: a community-based study

“…36,37 In our study, obesity was not associated with DM. Different concepts have been reported for obesity and DM, such as general obesity, 8 BMI, 30,38 the duration of obesity and body fat distribution 7 and waist circumference for men and BMI for women. 5,31 However, a controversial suggestion has been that obesity protects against DM because of the presence of anti-diabetogenic effects of fat tissues in some obese patients, 39 or genetic factors.…”

“…29 The association between DM and a family history of DM has been observed in India. 30,31 Generally, the association between a family history of DM and DM suggests shared genetic or environmental factors in the aetiology of DM. 32 Our study and the previous study in Sudan 28 showed no association between sex and DM.…”