Skip to main content
×
Home
    • Aa
    • Aa

Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey

  • Sutapa Agrawal (a1) and Shah Ebrahim (a1) (a2)
Abstract
AbstractObjective

We examined the distribution of diabetes and modifiable risk factors to provide data to aid diabetes prevention programmes in India.

Design

Population-based cross-sectional survey of men and women included in India's third National Family Health Survey (NFHS-3, 2005–2006).

Setting

The sample is a multistage cluster sample with an overall response rate of 98 %. All states of India are represented in the sample (except the small Union Territories), covering more than 99 % of the country's population.

Subjects

Women (n 99 574) and men (n 56 742) aged 20–49 years residing in the sample households.

Results

Prevalence of diabetes was 1598/100 000 (95 % CI 1462, 1735) among men and 1054/100 000 (95 % CI 974, 1134) among women in India. Rural–urban and marked geographic variation were found with higher rates in south and north-eastern India. Weekly and daily fish intake contributed to a significantly higher risk of diabetes among both women and men. Risks of diabetes increased with increased BMI, age and wealth status of both women and men, but no effects of the consumption of milk/curd, vegetables, eggs, television watching, alcohol consumption or smoking were found. Daily consumption of pulse/beans or fruits was associated with a significantly reduced risk of diabetes among women, whereas non-significant inverse associations were observed in the case of men.

Conclusions

Prevalence was underestimated using self-reports. The wide variation in self-reported diabetes is unlikely to be due entirely to reporting biases or access to health care, and indicates that modifiable risk factors exist. Prevention of diabetes should focus on obesity and target specific socio-economic groups in India.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey
      Available formats
      ×
Copyright
The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.
Corresponding author
*Corresponding author: Email sutapa.agrawal@phfi.org
References
Hide All
1.King H, Aubert RE & Herman WH (1998) Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 21, 14141431.
2.Shaw JE, Sicree RA & Zimmet PZ (2010) Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 87, 414.
3.Wild S, Roglic G, Green A et al. (2004) Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27, 10471053.
4.Diamond JED (2011) Diabetes in India. Nature 469, 479.
5.Ramachandran A & Snehalatha C (2009) Current scenario of diabetes in India. J Diabetes 1, 1828.
6.Tiwari RR, Deb PK, Debbarma A et al. (2008) Risk factor analysis in self-reported diabetes in a rural Kerala population. Int J Diabetes Dev Ctries 28, 9194.
7.Mohan V, Shantirani CS & Deepa R (2003) Glucose intolerance (diabetes and IGT) in a selected South Indian population with special reference to family history, obesity and lifestyle factors – The Chennai Urban Population Study (CUPS 14). J Assoc Physicians India 51, 771777.
8.Ramachandran A, Snehalatha C, Kapur A et al. (2001) Diabetes Epidemiology Study Group in India (DESI): high prevalence of diabetes and impaired glucose tolerance in India: national urban diabetes survey. Diabetologia 44, 10941101.
9.Asha Bai PV, Krishnaswami CV & Chellamariappan M (1999) Prevalence and incidence of type-2 diabetes and impaired glucose tolerance in a selected Indian urban population. J Assoc Physicians India 47, 10601064.
10.Ramachandran A, Jali MV, Mohan V et al. (1986) High prevalence of diabetes in an urban population in South India. BMJ 297, 587590.
11.Simmons D (1995) Ethnic comparisons in diabetes and insulin levels. Asia Pac J Clin Nutr 4, 346348.
12.Knight TM, Smith Z, Whittles A et al. (1992) Insulin resistance, diabetes and risk markers for ischaemic heart disease in Asian men and non-Asian men in Bradford. Br Heart J 67, 343350.
13.Ramaiya K, Kodali VRR & Alberti KGMM (1990) Epidemiology of diabetes in Asians of the Indian subcontinent. Diabetes Metab Rev 6, 125146.
14.Gupta R & Misra A (2007) Type 2 diabetes in India: regional disparities. Br J Diabetes Vasc Dis 7, 1216.
15.Mohan V, Deepa M, Deepa R et al. (2006) Secular trends in the prevalence of diabetes and glucose tolerance in urban South India – the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 49, 11751178.
16.Misra A, Pandey RM, Devi JR et al. (2001) High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes Relat Metab Disord 25, 17221729.
17.Ramachandran A, Snehalatha C, Latha E et al. (1997) Rising prevalence of NIDDM in an urban population in India. Diabetologia 40, 232237.
18.Vijayakumar G, Arun R & Kutty VR (2009) High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural central Kerala. J Assoc Physicians India 57, 563567.
19.Ramachandran A, Snehalatha C & Vijay V (2004) Low risk threshold for acquired diabetogenic factors in Asian Indians. Diabetes Res Clin Pract 65, 185195.
20.Mohan V, Radhika G, Vijayalakshmi P et al. (2010) Can the diabetes/cardiovascular disease epidemic in India be explained, at least in part, by excess refined grain (rice) intake? Indian J Med Res 131, 369372.
21.Pradeepa R, Anjana RM, Unnikrishnan R et al. (2010) Risk factors for microvascular complications of diabetes among south Indian subjects with type 2 diabetes – the Chennai Urban Rural Epidemiology Study (CURES) Eye Study-5. Diabetes Technol Ther 12, 755761.
22.Ramachandran A, Ma RCW & Snehalatha C (2010) Diabetes in Asia. Lancet 375, 408418.
23.Chan JCN, Malik V, Jia W et al. (2009) Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA 301, 21292140.
24.Mehta SR, Kashyap AS & Das S (2009) Diabetes mellitus in India: the modern scourge. MJAFI 65, 5054.
25.Fall CH (2001) The genesis of ‘Fetal origins of adult disease’. Int J Diabetes Dev Ctries 21, 38.
26.Hu FB, Leitzmann MF, Stampfer MJ et al. (2001) Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 161, 15421548.
27.Gopalan C (1992) Nutrition in developmental transition in South-East Asia WHO/SEARO, New Delhi. Asia Pac J Clin Nutr 1, 191.
28.Popkin BM, Horton S, Kim S et al. (2001) Trends in diet, nutritional status, and diet-related non-communicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev 59, 379390.
29.Zimmet P, de Courten M, Allison M et al. (editors) (2001) Epidemiology, Evidence for Prevention of Type 2 Diabetes. The Epidemiology of Diabetes Mellitus: An International Perspective, pp. 4249. Chichester: John Wiley & Sons Ltd.
30.World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series no. 894. Geneva: WHO.
31.Colditz GA, Willett WC, Rotnitzky A et al. (1995) Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 122, 481486.
32.Colditz GA, Willett WC, Stampfer MJ et al. (1990) Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 132, 501513.
33.Hu FB, Sigal RJ, Rich-Edwards JW et al. (1999) Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 282, 14331439.
34.Lynch J, Helmrich SP, Lakka TA et al. (1996) Moderately intense physical activities and high levels of cardiorespiratory fitness reduce risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 156, 13071314.
35.Helmrich SP, Ragland DR, Leung RW et al. (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325, 147152.
36.Manson JE, Rimm EB, Stampfer MJ et al. (1991) Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 338, 774778.
37.Hu FB, Manson JE & Stampfer MJ (2001) Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 345, 790797.
38.Manson JE, Ajani UA, Liu S et al. (2000) A prospective study of cigarette smoking and the incidence of diabetes mellitus among US male physicians. Am J Med 109, 538542.
39.Rimm EB, Chan J, Stampfer MJ et al. (1995) Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 310, 555559.
40.Wei M, Gibbons LW, Mitchell TL et al. (2000) Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care 23, 1822.
41.Ajani UA, Hennekens CH, Spelsberg A et al. (2000) Alcohol consumption and risk of type 2 diabetes mellitus among US male physicians. Arch Intern Med 160, 10251030.
42.Djoussé L, Gaziano JM, Buring JE et al. (2009) Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care 32, 295300.
43.Aune D, Ursin G & Veierød MB (2009) Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia 52, 22772287.
44.Steinbrecher A, Erber E, Grandinetti A et al. (2010) Meat consumption and risk of type 2 diabetes: the Multiethnic Cohort. Public Health Nutr 13, 17.
45.Fung TT, Schulze M, Manson JE et al. (2004) Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med 164, 22352240.
46.van Dam RM, Willet WC, Rimm EB et al. (2002) Dietary fat and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care 25, 417424.
47.Woudenbergh GJV, Ballegooijen AJV, Kuijsten A et al. (2009) Eating fish and risk of type 2 diabetes a population-based, prospective follow-up study. Diabetes Care 32, 20212026.
48.Villegas R, Shu Xo, Gao YT et al. (2008) Vegetable but not fruit consumption reduces the risk of type 2 diabetes in Chinese women. J Nutr 138, 574580.
49.Bazzano LA, Li TY, Joshipura KJ et al. (2008) Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 31, 13111317.
50.Villegas R, Gao Y, Yang G et al. (2008) Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women's Health Study. Am J Clin Nutr 87, 162167.
51.Venn BJ & Mann JI (2004) Cereal grains, legumes and diabetes. Eur J Clin Nutr 58, 14431461.
52.International Institute for Population Sciences & Macro International (2007) National Family Health Survey (NFHS-3), 2005–06: India: Vol. I. Mumbai: IIPS.
53.StataCorp. (2003) STATA Statistical Software Release 8, p. 24. College Station, TX: StataCorp.
54.Ebrahim S, Kinra S, Bowen L et al. (2010) The effect of rural to urban migration on obesity and diabetes in India: cross sectional study. PLoS Med 7, e10000268.
55.Elwood PC, Givens DI, Andrew D et al. (2008) The survival advantage of milk and dairy consumption: an overview of evidence from cohort studies of vascular diseases, diabetes and cancer. J Am Coll Nutr 27, issue 6, 723S734S.
56.van Dam RM, Hu FB, Rosenberg L et al. (2006) Dietary calcium and magnesium, major food sources, and risk of type 2 diabetes in US black women. Diabetes Care 29, 22382243.
57.Liu S, Choi HK, Ford E et al. (2006) A prospective study of dairy intake and the risk of type 2 diabetes in women. Diabetes Care 29, 15791584.
58.Choi HK, Willett WC, Stampfer MJ et al. (2005) Dairy consumption and risk of type 2 diabetes mellitus in men: a prospective study. Arch Intern Med 165, 9971003.
59.Villegas R, Gao YT, Dai Q et al. (2009) Dietary calcium and magnesium intakes and the risk of type 2 diabetes: the Shanghai Women's Health Study. Am J Clin Nutr 89, 10591067.
60.Vang A, Singh PN, Lee JW et al. (2008) Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann Nutr Metab 52, 96104.
61.Snowdon DA & Phillips RL (1985) Does a vegetarian diet reduce the occurrence of diabetes? Am J Public Health 75, 507512.
62.Song Y, Manson JAE, Buring JE et al. (2004) A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women's health study. Diabetes Care 27, 21082115.
63.Feskens EJ, Virtanen SM, Rasanen L et al. (1995) Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabetes Care 18, 11041112.
64.Feskens EJ, Bowles CH & Kromhout D (1991) Inverse association between fish intake and risk of glucose intolerance in normoglycemic elderly men and women. Diabetes Care 14, 935941.
65.Nkondjock A & Receveur O (2003) Fish-seafood consumption, obesity, and risk of type 2 diabetes: an ecological study. Diabetes Metab 29, 635642.
66.Panagiotakos DB, Zeimbekis A, Boutziouka V et al. (2007) Long-term fish intake is associated with better lipid profile, arterial blood pressure, and blood glucose levels in elderly people from Mediterranean islands (MEDIS epidemiological study). Med Sci Monit 13, CR307CR312.
67.Ruidavets JB, Bongard V, Dallongeville J et al. (2007) High consumptions of grain, fish, dairy products and combinations of these are associated with a low prevalence of metabolic syndrome. J Epidemiol Community Health 61, 810817.
68.Adler AI, Boyko EJ, Schraer CD et al. (1994) Lower prevalence of impaired glucose tolerance and diabetes associated with daily seal oil or salmon consumption among Alaska Natives. Diabetes Care 17, 14981501.
69.Harding AH, Day NE, Khaw KT et al. (2004) Habitual fish consumption and glycated haemoglobin: the EPIC-Norfolk study. Eur J Clin Nutr 58, 277284.
70.Bjerregaard P, Pedersen HS & Mulvad G (2000) The associations of a marine diet with plasma lipids, blood glucose, blood pressure and obesity among the Inuit in Greenland. Eur J Clin Nutr 54, 732737.
71.Kaushik M, Mozaffarian D, Spiegelman D et al. (2009) Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. Am J Clin Nutr 90, 613620.
72.Patel PS, Sharp SJ, Robert N et al. (2009) Association between type of dietary fish and seafood intake and the risk of incident type 2 diabetes: the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort study. Diabetes Care 32, 18571863.
73.Schulze MB, Manson JE, Willett WC et al. (2003) Processed meat intake and incidence of type 2 diabetes in younger and middle aged women. Diabetologia 46, 14651473.
74.World Health Organization (2003) Diet, Nutrition and the Prevalence of Chronic Diseases. WHO Technical Report Series no. 916. Geneva: WHO.
75.Hall JN, Moore S, Harper SB et al. (2009) Global variability in fruit and vegetable consumption. Am J Prev Med 36, 402409.e5.
76.International Agency for Research on Cancer (2001) Changing Structure of Global Food Consumption and Trade: Agricultural and Trade Report. Lyon: IARC Press.
77.Kanungsukkasem U, Ng N, Minh HV et al. (2009) Fruit and vegetable consumption in rural adults population in INDEPTH HDSS sites in Asia. Global Health Action Supplement 1 , DOI: 10.3402/gha.v2i0.1988.
78.Pollack SL (2001) Consumer Demand for Fruits and Vegetables: The US Example. Washington, DC: Economic Research Service, US Department of Agriculture.
79.Rehm J, Gmel G, Sempos CT et al. (2003) Alcohol-related morbidity and mortality. Alcohol Res Health 27, 3951.
80.English DR, Holman CDJ, Milne E et al. (1995) The Quantification of Drug Caused Morbidity and Mortality in Australia 1995. Canberra: Commonwealth Department of Human Services and Health.
81.Perry IJ, Wannamethee SG & Walker MK (1995) Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. BMJ 310, 560564.
82.Rimm EB, Chan J & Stampfer MJ (1995) Prospective study for cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 310, 555559.
83.Bowman SA (2006) Television-viewing characteristics of adults: correlations to eating practices and overweight and health status. Prev Chronic Dis 3, A38.
84.Hu FB, Li TY, Colditz GA et al. (2003) Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289, 17851791.
85.Maty SC, James SA & Kaplan GA (2010) Life-course socioeconomic position and incidence of diabetes mellitus among blacks and whites: The Alameda County Study, 1965–1999. Am J Public Health 100, 137145.
86.Reddy KS, Prabhakaran D & Jeemon P (2007) Educational status and cardiovascular risk profile in Indians. Proc Natl Acad Sci USA 104, 1626316268.
87.Bhopal R, Hayes L & White M (2002) Ethnic and socio-economic inequalities in coronary heart disease, diabetes and risk factors in Europeans and South Asians. J Public Health Med 24, 95105.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 11
Total number of PDF views: 137 *
Loading metrics...

Abstract views

Total abstract views: 220 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th October 2017. This data will be updated every 24 hours.