The Rising Prevalence of Type 2 Diabetes Among the Youth in Southern India-An Ancillary Analysis of the Secular TRends in DiabEtes in India (STRiDE-I) Study

Overview

Journal J Diabetes

Specialty Endocrinology

Date 2024 Jun 26

PMID 38923743

Authors

Arun Nanditha

Priscilla Susairaj

Krishnamoorthy Satheesh

Arun Raghavan

Chamukuttan Snehalatha

Ambady Ramachandran

Affiliations

Soon will be listed here.

Abstract

Background: We studied the prevalence and incidence of type 2 diabetes (T2DM) and its associated risk factors in younger (20 and 39 years) and older individuals (≥40 years) over a 10-year period.

Methods: Epidemiological surveys in 2006 (n = 7066) and 2016 (n = 9848) were conducted in similar urban and rural locations of southern India among people aged ≥20 years. Diagnosis of T2DM was made using World Health Organization criteria. Self-reported diabetes was verified from medical records. Age and gender standardized prevalence and incidence rates, percentage change in obesity, hypertension, and dyslipidemia were calculated. Prevalence ratios (PR) were calculated using Poisson regression analyses. Primary study was registered on www.

Clinicaltrials: gov. Identifier: NCT03490136.

Results: In 10 years, the prevalence of T2DM increased in younger (7.8% vs. 4.5%, p < 0.0001) and older individuals (34% vs. 28.4%, p < 0.0001). After adjusting for age, family history of diabetes, and waist circumference, younger individuals showed a higher percentage increase in prevalence than the older group (PR = 1.36 [95% confidence interval [CI], 1.14-1.62], p = 0.001) versus (PR = 1.11 [95% CI, 1.02-1.20], p = 0.02). Increase in rates of obesity and dyslipidemia was also higher in the younger than in the older individuals. In 10 years, incidence of T2DM increased by 120% (1.1% vs. 0.5%, p < 0.0001) and 150% (5% vs. 2%, p < 0.0001) in the younger and older individuals, respectively.

Conclusions: Higher percentage increase in prevalence of T2DM was seen among younger individuals over a 10-year period. Obesity and family history of diabetes were shown to be the primary contributing factors for the rise in prevalence.

Citing Articles

Global, regional, and national burden of childhood cardiovascular disease: trends from 1990 to 2021.

Wang M, Yi J, Chen Z Front Pediatr. 2024; 12:1495238.

PMID: 39722769 PMC: 11668807. DOI: 10.3389/fped.2024.1495238.

References

Mohan V, Misra A, Bloomgarden Z . Type 2 diabetes in the young in South Asia: Clinical heterogeneity and need for aggressive public health measures. J Diabetes. 2021; 13(8):610-612. DOI: 10.1111/1753-0407.13201. View

Yeung R, Zhang Y, Luk A, Yang W, Sobrepena L, Yoon K . Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort. Lancet Diabetes Endocrinol. 2014; 2(12):935-43. DOI: 10.1016/S2213-8587(14)70137-8. View

Luhar S, Kondal D, Jones R, Anjana R, Patel S, Kinra S . Lifetime risk of diabetes in metropolitan cities in India. Diabetologia. 2020; 64(3):521-529. PMC: 7864818. DOI: 10.1007/s00125-020-05330-1. View

Sattar N, Rawshani A, Franzen S, Rawshani A, Svensson A, Rosengren A . Age at Diagnosis of Type 2 Diabetes Mellitus and Associations With Cardiovascular and Mortality Risks. Circulation. 2019; 139(19):2228-2237. DOI: 10.1161/CIRCULATIONAHA.118.037885. View

Jali M, Kambar S, Jali S, Gowda S . Familial early onset of type-2 diabetes mellitus and its complications. N Am J Med Sci. 2012; 1(7):377-80. PMC: 3364686. DOI: 10.4297/najms.2009.7377. View

Kim K, Oh H, Kim J, Lee Y, Kim S, Park S . The clinical characteristics of the newly diagnosed early onset (< 40 years old) diabetes in outpatients' clinic. Korean Diabetes J. 2010; 34(2):119-25. PMC: 2883350. DOI: 10.4093/kdj.2010.34.2.119. View

Chan J, Lim L, Wareham N, Shaw J, Orchard T, Zhang P . The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2020; 396(10267):2019-2082. DOI: 10.1016/S0140-6736(20)32374-6. View

Wilmot E, Idris I . Early onset type 2 diabetes: risk factors, clinical impact and management. Ther Adv Chronic Dis. 2014; 5(6):234-44. PMC: 4205573. DOI: 10.1177/2040622314548679. View

Ramachandran A, Snehalatha C, Baskar A, MARY S, Kumar C, Selvam S . Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India. Diabetologia. 2004; 47(5):860-5. DOI: 10.1007/s00125-004-1387-6. View

10.

Narayan K, Kanaya A . Why are South Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways. Diabetologia. 2020; 63(6):1103-1109. PMC: 7531132. DOI: 10.1007/s00125-020-05132-5. View

11.

Lascar N, Brown J, Pattison H, Barnett A, Bailey C, Bellary S . Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol. 2017; 6(1):69-80. DOI: 10.1016/S2213-8587(17)30186-9. View

12.

Holden S, Barnett A, Peters J, Jenkins-Jones S, Poole C, Morgan C . The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010. Diabetes Obes Metab. 2013; 15(9):844-52. DOI: 10.1111/dom.12123. View

13.

Siddiqui M, Anjana R, Dawed A, Martoeau C, Srinivasan S, Saravanan J . Young-onset diabetes in Asian Indians is associated with lower measured and genetically determined beta cell function. Diabetologia. 2022; 65(6):973-983. PMC: 9076730. DOI: 10.1007/s00125-022-05671-z. View

14.

Nanditha A, Susairaj P, Raghavan A, Satheesh K, Vinitha R, Snehalatha C . Secular trends in cardiovascular risk factors among urban and rural populations in Tamil Nadu, India - An ancillary analysis of the STRiDE-I study. Diabetes Res Clin Pract. 2021; 178:108930. DOI: 10.1016/j.diabres.2021.108930. View

15.

McCarthy M, Hitman G, Shields D, Morton N, Snehalatha C, Mohan V . Family studies of non-insulin-dependent diabetes mellitus in South Indians. Diabetologia. 1994; 37(12):1221-30. DOI: 10.1007/BF00399796. View

16.

Ramachandran A, Snehalatha C, Latha E, Manoharan M, Vijay V . Impacts of urbanisation on the lifestyle and on the prevalence of diabetes in native Asian Indian population. Diabetes Res Clin Pract. 1999; 44(3):207-13. DOI: 10.1016/s0168-8227(99)00024-8. View

17.

Jensen E, Dabelea D, Praveen P, Amutha A, Hockett C, Isom S . Comparison of the incidence of diabetes in United States and Indian youth: An international harmonization of youth diabetes registries. Pediatr Diabetes. 2020; 22(1):8-14. PMC: 7748376. DOI: 10.1111/pedi.13009. View

18.

Ramachandran A, Snehalatha C, Shaw J, Susairaj P, Simon M, Vijaya L . Response to Comment on Nanditha et al. Secular TRends in DiabEtes in India (STRiDE-I): Change in Prevalence in 10 Years Among Urban and Rural Populations in Tamil Nadu. Diabetes Care 2019;42:476-485. Diabetes Care. 2019; 42(8):e139-e140. DOI: 10.2337/dci19-0027. View

19.

Ramachandran A, Snehalatha C, MARY S, Mukesh B, Bhaskar A, Vijay V . The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006; 49(2):289-97. DOI: 10.1007/s00125-005-0097-z. View

20.

Gungor N, Bacha F, Saad R, Janosky J, Arslanian S . Youth type 2 diabetes: insulin resistance, beta-cell failure, or both?. Diabetes Care. 2005; 28(3):638-44. PMC: 3428068. DOI: 10.2337/diacare.28.3.638. View