Prevalence of Diabetes in Asian Indians Based on Glycated Hemoglobin and Fasting and 2-H Post-Load (75-g) Plasma Glucose (CURES-120)

Nazir, Adamsha; Papita, Rozario; Anbalagan, Viknesh Prabu; Anjana, Ranjit Mohan; Deepa, Mohan; Mohan, Viswanathan

doi:10.1089/dia.2012.0059

Cited by 29 publications

(28 citation statements)

References 11 publications

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“…Other studies among Asian Indians, have also reported that, use of HbA1c criteria resulted in markedly higher prevalence of diabetes. 30 It is of interest to note that based on fasting glucose measurements alone, 36.9% of urban residents in three large South Asian cities have dysglycemia (14.9% with diabetes, 21.9% with prediabetes). If 2-hour post-load glucose measurements were done, an even higher proportion of the population would likely have dysglycemia.…”

Section: Discussionmentioning

confidence: 99%

High burden of prediabetes and diabetes in three large cities in South Asia: The Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study

Deepa¹,

Grace²,

Binukumar³

et al. 2015

Diabetes Research and Clinical Practice

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Aim To estimate the prevalence of, and assess factors associated with, diabetes and prediabetes in three South Asian cities. Methods Using a multi-stage cluster random sample representative of each city, 16,288 subjects aged ≥20 years (Chennai: 6906, Delhi: 5365 and Karachi: 4017) were recruited to the Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) Study. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were measured in 13720 subjects. Prediabetes was defined as FPG 100-125mg/dl (5.6-6.9 mmol/l) and/or HbA1c 5.7-6.4% (39-46mmol/mol) and diabetes as self-report and/or drug treatment for diabetes and/or FPG ≥126 mg/dl (≥7.0mmol/l) and/or HbA1c ≥6.5% (48mmol/mol). We assessed factors associated with diabetes and prediabetes using polytomous logistic regression models. Results Overall 47.3-73.1% of the population had either diabetes or prediabetes: Chennai 60.7% [95%CI: 59.0-62.4%] (diabetes-22.8% [21.5-24.1%], prediabetes-37.9% [36.1-39.7%]); Delhi 72.7% [70.6-74.9%] (diabetes-25.2% [23.6-26.8%], prediabetes-47.6% [45.6-49.5%]); and Karachi 47.4% [45.7-49.1%]; (diabetes-16.3% [15.2-17.3%], prediabetes-31.1% [29.5-32.8%], respectively). Proportions of self-reported diabetes were 55.1%, 39.0%, and 48.0% in Chennai, Delhi, and Karachi, respectively. City, age, family history of diabetes, generalized obesity, abdominal obesity, body fat, high cholesterol, high triglyceride, and low HDL cholesterol levels were each independently associated with prediabetes, while the same factors plus waist-to-height ratio and hypertension were associated with diabetes. Conclusion Six in ten adults in large South Asian cities have either diabetes or prediabetes. These data call for urgent action to prevent diabetes in South Asia.

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Section: Discussionmentioning

confidence: 99%

High burden of prediabetes and diabetes in three large cities in South Asia: The Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study

Deepa¹,

Grace²,

Binukumar³

et al. 2015

Diabetes Research and Clinical Practice

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“…(2, 23, 24) Compared to other ethnic groups, South Asians have a higher prevalence of pre-diabetes and diabetes. (22, 25–27) Since the MASALA study excluded individuals with cardiovascular disease, our prevalence estimates may be lower than in the overall population of middle-older aged US South Asians.…”

Section: Discussionmentioning

confidence: 99%

Correlates of prediabetes and type II diabetes in US South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

Shah¹,

Vittinghoff²,

Kandula³

et al. 2015

Annals of Epidemiology

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Purpose In this study, we aim to elucidate the role of sociodemographic, lifestyle and cultural factors in pre-diabetes and diabetes in South Asian immigrants to the United States (US), a population at high risk of type 2 diabetes. Methods We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Glycemic status was determined by fasting glucose, 2-hour post-challenge glucose and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle and cultural factors with pre-diabetes and diabetes, adjusting for confounders identified using directed acyclic graphs. Results Approximately 33% of participants had pre-diabetes and 25% had diabetes. In multivariate analyses, an independent correlate of pre-diabetes was low exercise. Additional covariates associated with diabetes included: lower family income, less education, high chronic psychological burden score, and greater time spent watching television, and fasting monthly or annually was inversely associated with diabetes prevalence. Conclusions We found several modifiable risk factors associated with pre-diabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the US.

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“…Iron deficiency anemia is highly prevalent in India, especially among women in the reproductive agegroup. Our earlier studies from the same Chennai Urban Rural Epidemiology Study (CURES) cohort used in this study (4), as well as another cohort, showed that the use of HbA 1c criteria, even in the absence of anemia, resulted in a markedly higher prevalence of diabetes compared with the use of the glucose values. Higher diabetes and prediabetes rates could have huge economic implications, leading to significantly higher health care costs.…”

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confidence: 76%

“…In the baseline of our CURES cohort, we assessed the prevalence of diabetes based on HbA 1c and fasting and 2-h glucose and reported that the use of HbA 1c criteria identifies a different set of individuals with milder glucose intolerance and lower serum triglyceride levels (4). Although this has some advantages in identifying individuals at an earlier stage in the natural history of the disease, it probably identifies individuals at lower cardiometabolic risk.…”

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confidence: 99%

Response to Comment on Anjana et al. Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES). Diabetes Care 2015;38:1441–1448

2016

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Prevalence of Diabetes in Asian Indians Based on Glycated Hemoglobin and Fasting and 2-H Post-Load (75-g) Plasma Glucose (CURES-120)

Abstract: In Asian Indians, use of A1c criteria would result in markedly higher prevalence rates of diabetes. It also identifies a different set of individuals with milder glucose intolerance and lower serum triglyceride levels.

Cited by 29 publications

References 11 publications

High burden of prediabetes and diabetes in three large cities in South Asia: The Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study

High burden of prediabetes and diabetes in three large cities in South Asia: The Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study

Correlates of prediabetes and type II diabetes in US South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

Response to Comment on Anjana et al. Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES). Diabetes Care 2015;38:1441–1448

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