Mortality rates due to diabetes in a selected urban south Indian population--the Chennai Urban Population Study [CUPS--16].
OBJECTIVE
The aim of this study was to determine the mortality rate in diabetic and non-diabetic subjects in urban south India.


METHODS
The Chennai Urban Population Study is an ongoing epidemiological study in Chennai [formerly Madras, in south India]. All individuals > or = 20 years of age living in two residential colonies in Chennai were invited to participate in the study. Of the total 1399 eligible subjects, 1262 individuals responded [90.2%] at baseline, and of these, 1140 individuals [90.3%] could be followed annually from 1997 to 2003-04. Mortality rates and causes of death were the main outcome measures.


RESULTS
The median follow up period was six years. The overall mortality rate was higher in diabetic compared to non-diabetic subjects [18.9 vs.5.3 per 1000 person-years, p=0.004]. Mortality due to cardiovascular [diabetic subjects, 52.9%; non-diabetic subjects, 24.2%,p=0.042] and renal causes[diabetic subjects, 23.5%; non-diabetic subjects, 6.1%,p=0.072] was higher among diabetic subjects whereas mortality due to gastrointestinal 112.1%], respiratory [9.1%], lifestyle related [6.1%] and unnatural causes [18.2%] were observed only among non-diabetic subjects. Hazards ratio [HR] for all cause mortality for diabetes was 3.6, [95% Confidence Interval [CI]: 2.02-6.53, p<0.001] and this remained significant even after adjusting for age [HR:1.9, 95% CI:1.04-3.45, p=0.038]. Light grade physical activity was associated with higher mortality rate [p=0.008], but the significance disappeared when adjusted for age. Smoking was also associated with increased mortality.


CONCLUSIONS
In urban India, mortality rates are two fold higher in people with diabetes compared to nondiabetic subjects. Cardiovascular and renal diseases are the commonest causes of death among diabetic subjects.
Mohan
V
V
Diabetes Specialities Centre and Madras Diabetes Research Foundation, Gopalapuram, Chennai, India.
Shanthirani
C S
CS
Deepa
M
M
Deepa
R
R
Unnikrishnan
R I
RI
Datta
M
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D016016:Proportional Hazards Models; D014504:Urban Health / Q000706:statistics & numerical data*; D014505:Urban Population