title: Urban rural differences in prevalence of self-reported diabetes in India--the WHO-ICMR Indian NCD risk factor surveillance.
abstract: Recent reports show strikingly high prevalence of diabetes among urban Asian Indians; however, there are very few studies comparing urban, peri-urban and rural prevalence rates of diabetes and their risk factors at the national level. This study is a part of the national non-communicable diseases (NCD) risk factor surveillance conducted in different geographical locations (North, South, East, West/Central) in India between April 2003 and March 2005. A total of 44,523 individuals (age: 15-64 years) inclusive of 15,239 from urban, 15,760 from peri-urban/slum and 13,524 from rural areas were recruited. Major risk factors were studied using modified WHO STEPS approach. Diabetes was diagnosed based on self-reported diabetes diagnosed by a physician. The lowest prevalence of self-reported diabetes was recorded in rural (3.1%) followed by peri-urban/slum (3.2%) and the highest in urban areas (7.3%, odds ratio (OR) for urban areas: 2.48, 95% confidence interval (CI): 2.21-2.79, p<0.001). Urban residents with abdominal obesity and sedentary activity had the highest prevalence of self-reported diabetes (11.3%) while rural residents without abdominal obesity performing vigorous activity had the lowest prevalence (0.7%). In conclusion, this nation-wide NCD risk factor surveillance study shows that the prevalence of self-reported diabetes is higher in urban, intermediate in peri-urban and lowest in rural areas. Urban residence, abdominal obesity and physical inactivity are the risk factors associated with diabetes in this study.
authors.affiliation: Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, 4 Conran Smith Road, Gopalapuram, Chennai 600086, India. drmohans@vsnl.net
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
authors.forename: Prashant
authors.initials: P
authors.lastname: Mathur
authors.forename: Raj
authors.initials: R
authors.lastname: Deepa
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.forename: D K
authors.initials: DK
authors.lastname: Shukla
authors.forename: Geetha R
authors.initials: GR
authors.lastname: Menon
authors.forename: Krishnan
authors.initials: K
authors.lastname: Anand
authors.forename: Nimesh G
authors.initials: NG
authors.lastname: Desai
authors.forename: Prashant P
authors.initials: PP
authors.lastname: Joshi
authors.forename: J
authors.initials: J
authors.lastname: Mahanta
authors.forename: K R
authors.initials: KR
authors.lastname: Thankappan
authors.forename: Bela
authors.initials: B
authors.lastname: Shah
mesh_terms: D050153:Abdominal Fat; D017677:Age Distribution; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D014944:World Health Organization