Risk factors related to the development of diabetes in men working in a north Indian industry.
BACKGROUND
Epidemiological and lifestyle changes have been implicated in the high burden of diabetes in urban India. However, longitudinal data on the determinants for the development of diabetes in this population are not available. We investigated the determinants for the development of diabetes in workers in an Indian industrial organization.


METHODS
Two cross-sectional surveys were done, using similar methodology (Survey 1 during 1995-98 [n=2548] and Survey 2 during 2002-03 [n=2800]) among all employees (age 20-59 years) of an industrial organization. A large majority of these were men (89.5% in Survey 1 and 92.8% in Survey 2). Men with no diabetes at baseline, who participated in both the surveys (n=942), constituted the study population. Development of new-onset diabetes was defined using history and fasting glucose concentrations > or =7 mmol/L.


RESULTS
The mean (SD) age of the participants at baseline was 40 (2) years. Diabetes developed in 8% of the study population over 6.8 (1.7) years. Individuals who developed diabetes had significantly higher age, blood pressure, body mass index, waist circumference, fasting and post-prandial glucose, post-prandial insulin and fasting triglyceride levels at baseline. On multivariate regression analysis, only impaired glucose tolerance (OR 3.8, 95% CI: 2.1-6.8) and waist circumference (OR 1.09, 95% CI: 1.02-1.16) predicted the development of diabetes. Presence of the metabolic syndrome, as defined by the modified National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III and WHO criteria, increased the odds (95% CI) of developing diabetes by 2.2 (1.3-3.6) and 4.5 (2.7-7.4) times, respectively.


CONCLUSIONS
Impaired glucose tolerance, high waist circumference and the metabolic syndrome are powerful predictors for the development of diabetes among urban Indian men.
Prabhakaran
D
D
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Chaturvedi
V
V
Ramakrishnan
L
L
Jeemon
P
P
Shah
P
P
Snehi
U
U
Reddy
K S
KS
D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005843:Geography; D018149:Glucose Intolerance; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D007221:Industry; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors; D014504:Urban Health