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)

Skar, Mette; Villumsen, Anne Berg; Christensen, Dirk L.; Petersen, Joergen Holm; Deepa, Mohan; Anjana, Ranjit Mohan; Mohan, Viswanathan

doi:10.4103/2230-8210.122632

Cited by 13 publications

(3 citation statements)

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“…Studies from high income countries generally find that pregnant women belonging to lower socio-economic groups have a higher risk of developing GDM compared to their counterparts from higher socio-economic strata [ 25 ; 26 ]. In India, on the other hand, studies indicate that GDM may be associated with increasing socio-economic status [ 23 ], and similar trends have been found for type 2 diabetes [ 27 ]. The difference may be explained by the mismatch between the predicted environment for survival programming and the actual environment in adult life due to rapid urbanisation and economic, nutritional and lifestyle transition [ 28 ; 29 ].…”

Section: Introductionmentioning

confidence: 70%

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

et al. 2016

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IntroductionHyperglycaemia in pregnancy (HIP), i.e. gestational diabetes mellitus (GDM) and diabetes in pregnancy (DIP), increases the risk of various short- and long-term adverse outcomes. However, much remains to be understood about the role of different risk factors in development of HIP.ObjectiveThe aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India.MethodologyPregnant women underwent a 75 g oral glucose tolerance test. Data on potential risk factors was collected and analysed using logistical regression analysis. Receiver operating characteristic (ROC) curves, sensitivity, specificity and predictive values were calculated for significant risk factors and a risk factor scoring variable was constructed.ResultsHIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP). Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health centre a doubling of income corresponded to an 80% increased risk of HIP (OR 1.80, 95%CI 1.10–2.93; p = 0.019), whereas it was not significantly associated with HIP among women attending the other health centres. The performance of the individual risk factors and the constructed scoring variable differed substantially between the three health centres, but none of them were good enough to discriminate between those with and without HIP.ConclusionsThe findings highlight the importance of socio-economic circumstances and intergenerational risk transmission in the occurrence of HIP as well as the need for universal screening.

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Section: Introductionmentioning

confidence: 70%

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

et al. 2016

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“…Covariates known to influence diabetes risk, including age, sex, family history of diabetes, BMI, smoking status, alcohol intake, physical activity, residence, daily energy intake, daily carbohydrate intake, stress and depression, were adjusted to assess the independent associations between SES and diabetes. 12 , 13 , 14 , 15 The results are presented as ORs with 95% confidence intervals (95% CIs). All data were analyzed using SPSS statistical software (version 19.0, SPSS Inc., Chicago, IL, USA).…”

Section: Methodsmentioning

confidence: 99%

Effect of Socio-Economic Status on the Prevalence of Diabetes

et al. 2015

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PurposeAs Korean society has become industrialized and westernized, the prevalence of diabetes has increased rapidly. Environmental factors, especially socio-economic status (SES), may account for the increased prevalence of diabetes. We evaluated the associations between the prevalence of diabetes and SES as reflected by household income and education level.Materials and MethodsThis study was based on data obtained from the fifth Korea National Health and Nutrition Examination Survey, conducted in 2010-2012. Diabetes referred to a fasting plasma glucose ≥126 mg/dL in the absence of known diabetes, previous diagnosis of diabetes made by a physician, and/or current use of oral hypoglycemic agents or insulin.ResultsHousehold income and education level were inversely associated with the prevalence of diabetes among individuals aged 30 years or older. These associations were more prominent in females aged 30-64 years. According to household income, the odds ratio (OR) [95% confidence interval (CI)] for the lowest quartile group versus the highest quartile group was 4.96 (2.87-8.58). According to education level, the OR (95% CI) for the lowest quartile group versus the highest quartile group was 8.02 (4.47-14.4).ConclusionPublic policies for the prevention and management of diabetes should be targeted toward people of lower SES, especially middle-aged females.

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“…69,70 Diabetes mellitus continues to have a positive social gradient (with a higher burden among the rich and well educated), with the exception of certain settings such as industrial worksites. 66,75,76 However, a recently concluded study on risk factors of CVD in urban and rural Delhi suggests that there is no difference in the prevalence of diabetes mellitus across various SES groups (D. Prabhakaran, unpublished data, 2014).…”

Section: Figurementioning

confidence: 99%

Cardiovascular Diseases in India

2016

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Abstract-Cardiovascular diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Some aspects of the CVD epidemic in India are particular causes of concern, including its accelerated buildup, the early age of disease onset in the population, and the high case fatality rate. In India, the epidemiological transition from predominantly infectious disease conditions to noncommunicable diseases has occurred over a rather brief period of time. Premature mortality in terms of years of life lost because of CVD in India increased by 59%, from 23.2 million (1990) to 37 million (2010). Despite wide heterogeneity in the prevalence of cardiovascular risk factors across different regions, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas. The progression of the epidemic is characterized by the reversal of socioeconomic gradients; tobacco use and low fruit and vegetable intake have become more prevalent among those from lower socioeconomic backgrounds. In addition, individuals from lower socioeconomic backgrounds frequently do not receive optimal therapy, leading to poorer outcomes. Countering the epidemic requires the development of strategies such as the formulation and effective implementation of evidencebased policy, reinforcement of health systems, and emphasis on prevention, early detection, and treatment with the use of both conventional and innovative techniques. Several ongoing community-based studies are testing these strategies.

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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)

Cited by 13 publications

References 20 publications

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

Effect of Socio-Economic Status on the Prevalence of Diabetes

Cardiovascular Diseases in India

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