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- Title
Identification of the risk factors for the high prevalence of type 2 diabetes and its complications in a Punjabi population: North Indian Diabetes Study: A case-control study.
- Authors
Bhatti, Jasvinder S.; Bhatti, Gurjit K.; Joshi, Amit; Rai, Seema; Mastana, Sarabjit S.; Ralhan, Sarju K.; Bansal, Devi D.; Tewari, Rupinder
- Abstract
AIM: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is rising at alarming rates in India. The North Indian Diabetes Study was launched to investigate the relative contributions of the risk factors to the susceptibility to T2DM among the Punjabi population in North India. METHODOLOGY: In this study, 563 T2DM patients (313 male, 250 female) and 413 nondiabetic controls (189 male and 224 female) were recruited from North India. A standardized questionnaire was used to collect information about age, onset of diabetes, sex, smoking, alcohol, diet, physical activity, migration history, household information and family history of diabetes. Standard anthropometric measurements including height, weight and waist and hip circumferences were performed. All individuals were clinically diagnosed using standard procedures and information on medication use and associated diabetic complications was compiled. RESULTS: The mean age of diagnosis of T2DM was 48.6 ± 10.3 years. The average duration of diabetes was longer in males than in females (8.9 ± 0.7 vs. 6.9 ± 0.8 years; P < 0.05). The mean BMI values did not vary among diabetic and nondiabetic subjects (27.4 ± 4.7 vs. 26.9 ± 4.5; P = 0.172) but female diabetics had significantly higher BMI. Patients had pronounced abdominal adiposity, which was reflected by their significantly higher waist circumference (37.0 ± 4.3 in patients vs. 35.2 ± 4.3 in controls; P = 0.000) and higher waist-to-hip ratio (WHR) (0.97 ± 0.07 in patients vs. 0.94 ± 0.08 in controls; P = 0.000). Insulin resistance syndrome (HOMA-IR) with low levels of HDL-C and high levels of TG, VLDL-C and HbA1c were observed in T2DM cases as compared with controls (P < 0.05). Diabetic complications were significantly higher in T2DM subjects than in controls (CHD: 18% vs. 9.7%; hypertension: 61.3% vs. 38%; neuropathy: 52.3% vs. 31.1%; and ocular complications: 43.8% vs. 32.7%). CONCLUSIONS: This study documents that the North Indian Punjabi population is at high risk for developing diabetes and its complications in comparison with other Asian communities which, in part, is contributed to by morphological/biological attributes like physical inactivity, upper-body adiposity (as assessed by the WHR), body fat percent, dyslipidemia and insulin resistance (HOMA-IR).
- Subjects
OBESITY; INSULIN resistance; TYPE 2 diabetes; INDIGENOUS peoples of the Americas; PANJABIS (South Asian people)
- Publication
International Journal of Diabetes in Developing Countries, 2007, Vol 27, Issue 4, p108
- ISSN
0973-3930
- Publication type
Article