All Title Author
Keywords Abstract


Prevalence of Diabetes Mellitus and Its Risk Factors among Permanently Settled Tribal Individuals in Tribal and Urban Areas in Northern State of Sub-Himalayan Region of India

DOI: 10.1155/2014/380597

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background. Effect of urban environment on the development of DM and its risk factors is studied with an ecological fallacy due to their study designs that formulate the background for the present study. Objective. To study the prevalence of DM and associated lifestyle related risk factors in traditional tribal individuals residing in tribal area and migrating persons of the same tribe to urban area of sub-Himalayan northern state of India. Methodology. Population based cross-sectional study. Results. A total of 8000 individuals (tribal: 4000; urban: 4000) were recruited. Overall, among urban tribes the prevalence of central obesity (59.0%), overweight (29.3%), stage 1 (22.8%) and stage 2 (5.3%) hypertension, and DM (fasting: 7.8%; OGTT: 8.5%) was significantly higher than the tribes of tribal area. Based on OGTT, the prevalence of DM was found to be 9.2% among central obese tribes of urban area and 6.7% of tribal area . DM showed a significant high prevalence among urban tribes with prehypertension (urban: 8.3%; tribal: 2.9%; ), and stage 1 (urban: 14.1%; tribal: 8.7%; ) and stage 2 (urban: 17.5%; tribal: 13.9%; ) hypertension. Conclusion. Urban environment showed a changing lifestyle and high prevalence of DM among tribal migrating urban tribes as compared to traditional tribes. 1. Introduction Emerging trend of diabetes mellitus (DM) is observed worldwide, as by 2025, its prevalence is projected to be 6.3%, which is a 24.0% increase compared with 2003. There will be 333 million (a 72.0% increase) diabetics by 2030 in individuals of 20 to 79 years of age. The developing world (mainly central Asia and Sub-Saharan Africa) accounted for 141 million people with diabetes (72.5% of the world total) in 2003 [1]. Environmental factors like obesity (central or general), physical inactivity, and diet (saturated fats and transfatty acids) and socioeconomic factors are responsible for development of DM [2–6]. Diet rich in polyunsaturated fats and long chain omega-3 fatty acids reduces the risk for DM [7]. Along with the rising trend of DM, rapid urbanization has been observed as from 2008 to 2030 the global urban population will increase by 1.6 billion people (from 3.3 billion to 4.9 billion). While during the same period the rural population is going to reduce by 28 million. This demographic transition will largely take place in developing countries (particularly in Asia and Africa), as by 2030, the developing world population will constitute more than 80% of the world’s urban population [2, 3]. United Nations (UN) recognized that urbanization has health

References

[1]  K. M. Venkat Narayan, P. Zhang, A. M. Kanaya et al., “Diabetes: the pandemic and potential solutions,” in Disease Control Priorities in Developing Countries, D. T. Jamison, J. G. Breman, A. R. Measham et al., Eds., Oxford University Press, New York, NY, USA, 2nd edition, 2006.
[2]  Q. Qiao, D. E. Williams, G. Imperatore, K. M. Venkat Narayan, and J. Tuomilehto, “Epidemiology and geography of type 2 diabetes mellitus,” in International Textbook of Diabetes Mellitus, R. A. de Fronzo, E. Ferrannini, H. Keen, and P. Zimmet, Eds., pp. 33–56, John Wiley & Sons, Chichester, UK, 3rd edition, 2007.
[3]  UNFPA, State of World Population: Unleashing the Potential of Urban Growth, The United Nations Free Peoples Association, New York, NY, USA, 2007.
[4]  E. S. Ford, D. F. Williamson, and S. Liu, “Weight change and diabetes incidence: findings from a national cohort of US adults,” American Journal of Epidemiology, vol. 146, no. 3, pp. 214–222, 1997.
[5]  C. S. Yajnik, “The insulin resistance epidemic in India: fetal origins later lifestyle, or both?” Nutrition Reviews, vol. 59, no. 1, pp. 1–9, 2001.
[6]  F. B. Hu, T. Y. Li, G. A. Colditz, W. C. Willett, and J. E. Manson, “Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women,” Journal of the American Medical Association, vol. 289, no. 14, pp. 1785–1791, 2003.
[7]  A. I. Adler, E. J. Boyko, C. D. Schraer, and N. J. Murphy, “Lower prevalence of impaired glucose tolerance and diabetes associated with daily seal oil or salmon consumption among Alaska natives,” Diabetes Care, vol. 17, no. 12, pp. 1498–1501, 1994.
[8]  R. B. Patel and T. F. Burke, “Global health: urbanization—an emerging humanitarian disaster,” New England Journal of Medicine, vol. 361, no. 8, pp. 741–743, 2009.
[9]  L. K. Fezeu, F. K. Assah, B. Balkau et al., “Ten-year changes in central obesity and BMI in rural and urban Cameroon,” Obesity, vol. 16, no. 5, pp. 1144–1147, 2008.
[10]  S. A. Everson, S. C. Maty, J. W. Lynch, and G. A. Kaplan, “Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes,” Journal of Psychosomatic Research, vol. 53, no. 4, pp. 891–895, 2002.
[11]  S. Paeratakul, J. C. Lovejoy, D. H. Ryan, and G. A. Bray, “The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults,” International Journal of Obesity, vol. 26, no. 9, pp. 1205–1210, 2002.
[12]  B. M. Popkin, “Urbanization, lifestyle changes and the nutrition transition,” World Development, vol. 27, no. 11, pp. 1905–1916, 1999.
[13]  S. Allender, C. Foster, L. Hutchinson, and C. Arambepola, “Quantification of urbanization in relation to chronic diseases in developing countries: a systematic review,” Journal of Urban Health, vol. 85, no. 6, pp. 938–951, 2008.
[14]  D. L. Dahly and L. S. Adair, “Quantifying the urban environment: a scale measure of urbanicity outperforms the urban-rural dichotomy,” Social Science and Medicine, vol. 64, no. 7, pp. 1407–1419, 2007.
[15]  M. A. Mendez and B. M. Popkin, “Globalization, urbanization and nutritional change in the developing world,” The Electronic Journal of Agricultural and Development Economics, vol. 1, pp. 220–241, 2004.
[16]  C. S. Cockram, “Diabetes mellitus: perspective from the Asia-Pacific region,” Diabetes Research and Clinical Practice, vol. 2, pp. S3–S7, 2000.
[17]  V. M. de Azeredo Passos, S. M. Barreto, L. M. Diniz, and M. F. Lima-Costa, “Type 2 diabetes: prevalence and associated factors in Brazilian community—the Bambuí health and aging study,” Sao Paulo Medical Journal, vol. 123, no. 2, pp. 66–71, 2005.
[18]  E. Sobngwi, J.-C. Mbanya, N. C. Unwin et al., “Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon,” International Journal of Epidemiology, vol. 33, no. 4, pp. 769–776, 2004.
[19]  J. M. van Rooyen, H. S. Kruger, H. W. Huisman et al., “An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study,” Journal of Human Hypertension, vol. 14, no. 12, pp. 779–787, 2000.
[20]  V. Mohan, P. Mathur, R. Deepa et al., “Urban rural differences in prevalence of self-reported diabetes in India—the WHO-ICMR Indian NCD risk factor surveillance,” Diabetes Research and Clinical Practice, vol. 80, no. 1, pp. 159–168, 2008.
[21]  G. Danaei, M. M. Finucane, Y. Lu et al., “National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants,” The Lancet, vol. 378, no. 9785, pp. 31–40, 2011.
[22]  A. Ramachandran and C. Snehalatha, “Current scenario of diabetes in India,” Journal of diabetes, vol. 1, no. 1, pp. 18–28, 2009.
[23]  R. P. Upadhyay, P. Misra, V. G. Chellaiyan et al., “Burden of diabetes mellitus and prediabetes in tribal population of India: a systematic review,” Diabetes Research and Clinical Practice, vol. 102, no. 1, pp. 1–7, 2013.
[24]  A. Ramachandran, C. Snehalatha, A. Kapur et al., “High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey,” Diabetologia, vol. 44, no. 9, pp. 1094–1101, 2001.
[25]  A. Ramachandran, S. Mary, A. Yamuna, N. Murugesan, and C. Snehalatha, “High prevalence of diabetes and cardiovascular risk factors associated with urbanization in india,” Diabetes Care, vol. 31, no. 5, pp. 893–898, 2008.
[26]  P. Raghupathy, B. Antonisamy, C. H. D. Fall et al., “High prevalence of glucose intolerance even among young adults in south India,” Diabetes Research and Clinical Practice, vol. 77, no. 2, pp. 269–279, 2007.
[27]  A. Ramachandran, C. Snehalatha, and V. Vijay, “Low risk threshold for acquired diabetogenic factors in Asian Indians,” Diabetes Research and Clinical Practice, vol. 65, no. 3, pp. 189–195, 2004.
[28]  The DECODE-DECODA Study Group, “Age, body mass index and type2 diabetes association modified by ethnicity,” Diabetologia, vol. 46, no. 8, pp. 1063–1070, 2003.
[29]  World Health Organization, World Health Report 2004: Changing History, World Health Organization, Geneva, Switzerland, 2004.
[30]  M. Chandalia, N. Abate, A. Garg, J. Stray-Gundersen, and S. M. Grundy, “Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men,” Journal of Clinical Endocrinology and Metabolism, vol. 84, no. 7, pp. 2329–2335, 1999.
[31]  A. Misra, R. M. Pandey, J. Rama Devi, R. Sharma, N. K. Vikram, and N. Khanna, “High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India,” International Journal of Obesity, vol. 25, no. 11, pp. 1722–1729, 2001.
[32]  World Health Organization, “Obesity: preventing and managing the global epidemic,” World Health Organization Technical Report Series, vol. 894, pp. 1–253, 2000.
[33]  C. Snehalatha, A. Ramachandran, K. Satyavani, M. Yezhisai Vallabi, and V. Viswanathan, “Computed axial tomographic scan measurement of abdominal fat distribution and its correlation with anthropometry and insulin secretion in healthy Asian Indians,” Metabolism: Clinical and Experimental, vol. 46, no. 10, pp. 1220–1224, 1997.
[34]  A. Ramachandran, C. Snehalatha, D. Dharmaraj, and M. Viswanathan, “Prevalence of glucose intolerance in Asian Indians: urban-rural difference and significance of upper body adiposity,” Diabetes Care, vol. 15, no. 10, pp. 1348–1355, 1992.
[35]  E. Kabakov, C. Norymberg, E. Osher et al., “Prevalence of hypertension in type 2 diabetes mellitus: impact of the tightening definition of high blood pressure and association with confounding risk factors,” Journal of the Cardiometabolic Syndrome, vol. 1, no. 2, pp. 95–101, 2006.
[36]  W. V. Moore, D. Fredrickson, A. Brenner et al., “Prevalence of hypertension in patients with type II diabetes in referral versus primary care clinics,” Journal of Diabetes and its Complications, vol. 12, no. 6, pp. 302–306, 1998.
[37]  S. R. Joshi, B. Saboo, M. Vadivale et al., “Prevalence of diagnosed and undiagnosed diabetes and hypertension in India-results from the screening India's twin epidemic (SITE) study,” Diabetes Technology and Therapeutics, vol. 14, no. 1, pp. 8–15, 2012.
[38]  S. Tharkar, K. Satyavani, and V. Viswanathan, “Cost of medical care among type 2 diabetic patients with a co-morbid condition-Hypertension in India,” Diabetes Research and Clinical Practice, vol. 83, no. 2, pp. 263–267, 2009.
[39]  C. P. Wen, T. Y. D. Cheng, S. P. Tsai, H. L. Hsu, H. T. Chan, and C. C. Hsu, “Exploring the relationships between diabetes and smoking: with the development of “glucose equivalent” concept for diabetes management,” Diabetes Research and Clinical Practice, vol. 73, no. 1, pp. 70–76, 2006.
[40]  R. I. J. Dierkx, W. van de Hoek, J. B. L. Hoekstra, and D. W. Erkelens, “Smoking and diabetes mellitus,” Netherlands Journal of Medicine, vol. 48, no. 4, pp. 150–162, 1996.
[41]  F. Beziaud, J. M. Halimi, P. Lecomte, S. Vol, and J. Tichet, “Cigarette smoking and diabetes mellitus,” Diabetes and Metabolism, vol. 30, no. 2, pp. 161–166, 2004.
[42]  T. L. Holbrook, E. Barrett-Connor, and D. L. Wingard, “A prospective population-based study of alcohol use and non-insulin-dependent diabetes mellitus,” American Journal of Epidemiology, vol. 132, no. 5, pp. 902–909, 1990.
[43]  N. N. Zein, A. S. Abdulkarim, R. H. Wiesner, K. S. Egan, and D. H. Persing, “Prevalence of diabetes mellitus in patients with end-stage liver cirrhosis due to hepatitis C, alcohol, or cholestatic disease,” Journal of Hepatology, vol. 32, no. 2, pp. 209–217, 2000.
[44]  A. M. Hodge, G. K. Dowse, V. R. Collins, and P. Z. Zimmet, “Abnormal glucose tolerance and alcohol consumption in three populations at high risk of non-insulin-dependent diabetes mellitus,” American Journal of Epidemiology, vol. 137, no. 2, pp. 178–189, 1993.
[45]  N. Seike, M. Noda, and T. Kadowaki, “Alcohol consumption and risk of type 2 diabetes mellitus in Japanese: a systematic review,” Asia Pacific Journal of Clinical Nutrition, vol. 17, no. 4, pp. 545–551, 2008.
[46]  K. M. Conigrave and E. B. Rimm, “Alcohol for the prevention of type 2 diabetes mellitus?” Treatments in Endocrinology, vol. 2, no. 3, pp. 145–152, 2003.
[47]  L. L. J. Koppes, J. M. Dekker, H. F. J. Hendriks, L. M. Bouter, and R. J. Heine, “Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies,” Diabetes Care, vol. 28, no. 3, pp. 719–725, 2005.
[48]  J. A. Rivera, S. Barquera, T. González-Cossío, G. Olaiz, and J. Sepúlveda, “Nutrition transition in Mexico and in other Latin American countries,” Nutrition Reviews, vol. 62, pp. S149–S157, 2004.
[49]  H. H. Vorster, “The emergence of cardiovascular disease during urbanisation of Africans,” Public Health Nutrition, vol. 5, no. 1, pp. 239–243, 2002.
[50]  M. I. Noor, “The nutrition and health transition in Malaysia,” Public Health Nutrition, vol. 5, no. 1, pp. 191–195, 2002.
[51]  V. Kosulwat, “The nutrition and health transition in Thailand,” Public Health Nutrition, vol. 5, no. 1, pp. 183–189, 2002.
[52]  P. S. Shetty, “Nutrition transition in India,” Public Health Nutrition, vol. 5, no. 1, pp. 175–182, 2002.
[53]  T. N. Maletnlema, “A Tanzanian perspective on the nutrition transition and its implications for health,” Public Health Nutrition, vol. 5, no. 1, pp. 163–168, 2002.
[54]  A. Drewnowski and B. M. Popkin, “The nutrition transition: new trends in the global diet,” Nutrition Reviews, vol. 55, no. 2, pp. 31–43, 1997.
[55]  A. Astrup, J. Dyerberg, M. Selleck, and S. Stender, “Nutrition transition and its relationship to the development of obesity and related chronic diseases,” Obesity Reviews, vol. 9, no. 1, pp. 48–52, 2008.
[56]  M. Ezzati, S. Vander Hoorn, C. M. M. Lawes et al., “Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development,” PLoS Medicine, vol. 2, no. 5, article e133, 2005.

Full-Text

comments powered by Disqus