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Secular trends in the prevalence of diabetes and prediabetes among the rural population of South India

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International Journal of Diabetes in Develo** Countries Aims and scope Submit manuscript

Abstract

Objective

This study aimed to assess the secular trends in the prevalence of diabetes and pre-diabetes from two cross-sectional studies done 11 years apart, in rural Tamil Nadu.

Methods

The Telemedicine PRoject for screENing Diabetes and its complications in rural Tamil Nadu(TREND) study is a cross-sectional survey that screened 14,117 individuals aged ≥ 18 years between 2018–2021. TREND was conducted in 30 villages of Chengalpattu/Kancheepuram districts of Tamil Nadu in Southern India. The prevalence of diabetes and prediabetes was compared with an earlier study the Chunampet Rural Diabetes Prevention Project(CRDPP) which screened 23,380 individuals aged ≥ 20 years between 2006–2010 using similar methodology, in 42 villages in the same area. Diabetes and prediabetes were diagnosed using the WHO criteria.

Results

Individuals screened in TREND were significantly older (43.7 ± 14.5 vs.40.5 ± 15.2 years) and had higher BMI (23 ± 5 vs.21.4 ± 4.1) compared to CRDPP participants. The age and gender adjusted prevalence of diabetes increased from 5.3% to 13.7% (158.5% increase) during this 11-year period. There was a significant increase in prevalence of both self-reported diabetes (3.8% to 9.7%) and newly diagnosed diabetes (1.5% to 4.0%), but a decrease in prevalence of prediabetes from 16.7% to 8.4% (49.7% decrease) during the 11-year period. Age, male sex, BMI, formal education, occupations other than agriculture, family history of diabetes, and systolic blood pressure were significant predictors of diabetes.

Conclusions

The prevalence of diabetes among adults in rural south India has dramatically increased while that of prediabetes, has decreased, over a 11-year period. The decrease in prevalence of prediabetes might suggest a future slowing down of the epidemic.

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Data Availability

The dataset will be available upon request unless there are legal or ethical reasons for not doing so.

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Acknowledgements

We thank the community leaders and the participants for their cooperation.

Funding

The CRDPP was supported by a grant from the World Diabetes Foundation, Denmark, and the satellite link for telemedicine services was donated by the Indian Space Research Organization, Bangalore, India. The TREND study was funded by National Institute for Health Research (NIHR) (INSPIRED 16/136/102) using UK aid from the UK Government to support global health research.

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Authors and Affiliations

  1. Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes and Dr.Mohan’s Diabetes Specialties Centre, No 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India

    Natarajan Lakshmi, Rajendra Pradeepa, Ranjit Mohan Anjana, Hari Rakesh, Radhakrishnan Subashini, Ulagamathesan Venkatesan, Mohan Deepa & Viswanathan Mohan

  2. University of Madras, Chennai, India

    Natarajan Lakshmi

  3. Women’s Christian College, Chennai, India

    Nora Vigasini

  4. Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK

    Moneeza Kalhan Siddiqui, Ewan R. Pearson & Colin N. A. Palmer

Authors
  1. Natarajan Lakshmi
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Contributions

VM, CP, RMA and RP conceived the study and provided scientific inputs and reviewed the manuscript critically for important intellectual content. RP and NL were involved data acquisition and execution of the field work. NL conducted the literature search and was involved in manuscript preparation, editing and revision of the drafts. HR, DM, VN reviewed article and provided inputs wherever necessary. RS and UV helped in statistical analysis of the data. MKS, ERP provided substantial contributions to the interpretation of data and revision of the manuscript. VM and RP are the guarantors of this work and had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors read the final draft of the article and contributed to it.

Corresponding author

Correspondence to Rajendra Pradeepa.

Ethics declarations

Ethical approval

This study was approved by the Institutional Ethics Committee of the Madras Diabetes Research Foundation, Chennai, India.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013.

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

Conflict of interest

The authors hereby declare there is no potential conflict of interest.

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Natarajan Lakshmi and Rajendra Pradeepa joint first author.

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Lakshmi, N., Pradeepa, R., Anjana, R.M. et al. Secular trends in the prevalence of diabetes and prediabetes among the rural population of South India. Int J Diabetes Dev Ctries 43, 883–891 (2023). https://doi.org/10.1007/s13410-023-01204-5

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