Risk Factors of Diabetes Mellitus in Rural Puducherry

Majgi, SM and Soudarssanane, BM and Roy, G and Das, AK (2012) Risk Factors of Diabetes Mellitus in Rural Puducherry. [Journal (On-line/Unpaginated)]

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Purpose: Prevalence of type 2 diabetes is increasing in India. Rural area constitutes 80% of India. Hence it is essential to understand the epidemiology for appropriate interventions. Objectives: to identify risk factors of type 2 diabetes mellitus in rural Puducherry. Methodology: Cross sectional study in two villages of Puducherry, India. 1403 subjects above 25 years from 2 villages. Study measured demographic variables, Body Mass Index (BMI), physical activity, family history of Diabetes Mellitus, smoking and alcohol consumption. Fasting blood glucose was measured for study subjects. Further, those with >126 mg/dl were subjected for Oral Glucose Tolerance Test. Univariate and multivariate analysis was done. Receiver Operating characteristic Curve was plotted to find out cut off for Diabetic Risk Score. Findings: The prevalence of type 2 Diabetes Mellitus (DM) was 5.8%. The response rate was (88%). In univariate analysis age, occupation, Socio Economic Status, BMI, physical activity, family history were significant for DM. In multivariate analysis age, BMI, family history of diabetes and occupation were significant for type 2 DM. The ‘diabetes risk score’ generated by the study using age, BMI and family history of DM, had specificity, sensitivity and accuracy of 54%, 77% and 76.2% respectively. The area under curve for scoring system was 0.784 (<0.05). Conclusions: Identified risk factors are useful for early diagnosis by using ‘diabetes risk score’ – thus uncovering the iceberg of disease.

Item Type:Journal (On-line/Unpaginated)
Keywords:Type 2 Diabetes; Risk factors; Diabetes risk scoring.
JOURNALS > Online Journal of Health and Allied Sciences
ID Code:8867
Deposited By: Kakkilaya Bevinje, Dr. Srinivas
Deposited On:04 May 2013 23:04
Last Modified:04 May 2013 23:04

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. World Health Statistics 2008. Future trends in global mortality:Major shifts in cause of death patterns.Geneva: World Health Organization;2008.

2. Preventing chronic diseases: a vital investment. Geneva, World Health Organization. 2005.

3. Mohan V, Mathur P, Deepa R et al. Urban rural differences in prevalence of self-reported diabetes in India - the WHO-ICMR Indian NCD risk factor surveillance.Diabetes Research Clinical Practice.2008;80:159-168.

4. Park K. Park's text Book of Preventive and Social Medicine. 19 ed. 2007; 301-345.

5. World Health Organization. Diet, nutrition and prevention of chronic diseases. TRS 916. Geneva: World Health Organization;2003.

6. National Health Policy 2002. New Delhi. Government of India. 2002.

7. Govindaraj V, Das A, Chandrasekhar S. Prevalence of diabetes mellitus in a rural population of Pondicherry. Journal of Diabetes Association of India.1984;24:20.

8. Ramachandran A, Mary S, Yamuna A et al. High Prevalence of Diabetes and Cardiovascular Risk Factors Associated With Urbanization in India. Diabetes Care. 2008;31(5):893-898.

9. Ramachandran A, Snehalatha C, Baskar A et al. Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India. Diabetologia. 2003;47:860-865.

10. Non-communicable Diseases and Mental Health. STEPS Field Manual Appendices. Geneva: World Health Organization;2003. pp1-31.

11. UNESCO. International Standard Classification of Education ISCED 1997.1997.

12. Directorate General of Employment & Training. National Classification of Occupations - 2004. 2004. Ministry of Labour, Government of India.

13. International Physical Activity Questionnaire. 2008 Available from URL:

14. Reddy S, Shaik Hyder Ali K. Estimation of Nicotine content in popular Indian brands of smoking and chewing products. Indian Journal of Dental Research.2008;19(2):88-91.

15. Bak S, Sindrup H, Alselv T et al. Cessation of Smoking After First- Ever Stroke: A Follow-Up Study. Stroke. 2002;33:2263-9.

16. Rhem J, Room R, Monteiro M et al. Alochol use. In: Ezzati M, Lopez A, Rodgers A, Murray C, editors. Comparative quantification of health risk: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Geneva, World Health Organization; 2004. pp959-1108.

17. Obesity: Preventing and managing global epidemic. TRS 894. Geneva: World Health Organization; 2000

18. World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Geneva: Department of Non-communicable Disease Surveillance, World Health Organization;1999

19. National Human Development Report 2001. Planning Commission of India. New Delhi: Government of India; 2002.

20. Thiruselvakumar D, Soudarssanane M. Epidemiological study of obesity in rural Pondicherry [dissertation of M.D. Community Medicine], Pondicherry: Pondicherry University; 2007.

21. Basavanagowdappa H, Prabhakar A, Prasannaraj P et al. Study of prevalence of diabetes mellitus and impaired fasting glucose in a rural population.International Journal of Diabetes in Developing Countries. 2005;25:98-101.

22. Chow C, Raju P, Raju R et al. The prevalence and management of diabetes in rural India. Diabetes Care. 2006;29:1717-1718.

23. Deo S, Zantye A, Mokal R et al. To identify the risk factors for high prevalence of diabetes and impaired glucose tolerance in Indian rural population.International Journal of Diabetes in Developing Countries. 2006;26:19-23.

24. Kokiwar P, Gupta S, Durge P. Prevalence of diabetes in a rural area of central India. International Journal of Diabetes in Developing Countries. 2007;27(1):8-10.

25. Raghupathy P, Antonisamy B, Fall C et al. High prevalence of glucose intolerance even among young adults in south India. Diabetes Research Clinical Practice.2007;77(2):269-79.

26. Prabhakaran D, Chaturvedi V, Ramakrishnan L et al. Risk factors related to the development of diabetes in men working in a north Indian industry. National Medical Journal of India. 2005;20(1):4-10.

27. Sadikot S, Nigam A, Das S et al. The burden of diabetes and impaired fasting glucose in India using the ADA1997 criteria: prevalence of diabetes in India study (PODIS). Diabetes Research Clinical Practice. 2004;66:293-300.

28. Chaturvedi N, Stephenson J, Fuller J. The relationship between socioeconomic status and diabetes control and complications in the EURODIAB IDDM Complications Study. Diabetes Care. 1996:19:423-430.

29. Robbins J, Vaccarino V, Zhang H et al. Socioeconomic status and diagnosed diabetes incidence. Diabetes Research Clinical Practice. 2004:68:230-238.

30. Menon V, Vinodkumar K, Gilchrist A et al. Prevalence of known and undetected diabetes and associated risk factors in central Kerala. Diabetes Research Clinical Practice. 2006;74:289-294.

31. Patadin S, Bots L, Abel R et al. Impaired glucose tolerance and diabetes mellitus in a rural population in south India. Diabetes Research Clinical Practice.1994;24:47-53.

32. Warram J, Krolewski A. Epidemiology of Diabetes Mellitus. In: Kahn C, Weir G, King G, Jacobson A, Moses A, Smith R, editors. Joslin's Diabetes Mellitus. 14 ed. Lippincott Williams & Wilkins; 2005. pp342-354.

33. Dunstan D, Zimmet P, Welborn T et al. The rising prevalence of diabetes and impaired glucose tolerance. Diabetes Care. 2002;25:829-834

34. Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian Adults. Diabetes Care. 2003;26:1380-1384.

35. Sayeed M, Banu A, Khan A et al. Prevalence of diabetes and hypertension in a rural population of Bangladesh. Diabetes Care. 1995;18(4):555-558.

36. Zargar A, Khan A, Masoodi S et al. Prevalence of Type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent.Diabetes Research Clinical Practice. 2000;7:135-146.

37. Khan S, Hull R, Utzschneider K. Review Article Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840-846.

38. Irwin M, Mayer-Davis E, Addy C et al. Moderrate- intensity physical activity and fasting insulin levels in women. Diabetes Care. 2000;23(4):449-54.

39. Jeon C, Lokken R, Hu F et al. Physical activity of moderate intensity and risk of type 2 diabetes - A systematic Review. Diabetes Care. 2007;30[3]:744-752.

40. Meigs J, Cupples L, Wilson P. Parental transmission of type 2 diabetes: the Framingham Offspring Study. Diabetes Care. 2000;49(12):2201-2207.

41. Viswanathan M, McCarthy M, Snehalatha C et al. Familial aggregation of Type 2 (non-insulin-dependent) diabetes mellitus in south India: absence of excess maternal transmission. Diabetic Medicine. 1996;13:232-237.

42. Velho G, Froguel P. Type 2 diabetes: genetic factors. In: Ekoe J, Zimmet P, Williams R, editors. The epidemiology of diabetes mellitus: an international perspective. 1 ed. John wily and sons, Ltd; 2001.

43. Dutt D, Roy G, Chatterjee P. Risk Factor Assessment for Type II Diabetes Mellitus in a Tertiary Hospital in Kolkata. Indian Journal of Community Medicine.2004;29(4):169-170.

44. Houston T, Person S, Pletcher M et al. Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study. British Medical Journal. 2006;332(7549):1064-9.

45. Nakanishi N, Nakamura K, Matsuo Y et al. Cigarette Smoking and Risk for Impaired Fasting Glucose and Type 2 Diabetes in Middle-Aged Japanese Men. Annals of Internal Medicine. 2000;133:183-191.

46. Kim S, Lee J, Lee J et al. Prevalence of Diabetes and Impaired Fasting Glucose in Korea. Diabetes Care 2006;29:226-231.

47. Sakai Y, Yamaji T, Tabata S et al. Relation of alcohol use and smoking to glucose tolerance status in Japanese men. Diabetes Research Clinical Practice.2006;73:83-88.

48. Wei M, Gibbons L, Mitchell T et al. Alcohol intake and incidence of type 2 Diabetes in men. Diabetes Care. 2000;23(1):18-22.

49. Howard A, Arnsten J, Gourevitch M. Effect of alcohol consumption on diabetes mellitus. Annals of Internal Medicine. 2004;140:211-219.

50. Ajani U, Gaziano J, Lotuf P et al. Alcohol Consumption and Risk of Coronary Heart Disease by Diabetes Status. Circulation. 2000;102:500-505.

51. Vegt F, Dekker J, Groeneveld W et al. Moderate alcohol consumption is associated with lower risk for incident diabetes and mortality: the Hoorn Study.Diabetes Research Clinical Practice. 2002;57:53-60.

52. Mohan V, Deepa R, Somannavar S et al. A simplified Indian Diabetes Risk Score for screening for undiagnosed Diabetic subjects. Journal of Association of Physicians of India. 2005;53:759-763.

53. Al-Lawati J, Tuomilehto J. Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East. Diabetes Research Clinical Practice. 2007;77(3):438-444.

54. Lindstrom J, Tuomilehto J. The Diabetes Risk Score: A practical tool to predict type 2 diabetes risk. Diabetes Care 2003;26:725-731


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