title: Prevalence of diabetes and cardiovascular risk factors in middle-class urban participants in India.
abstract: OBJECTIVE
  To determine the prevalence of diabetes and awareness, treatment and control of cardiovascular risk factors in population-based participants in India.
  
  
  METHODS
  A study was conducted in 11 cities in different regions of India using cluster sampling. Participants were evaluated for demographic, biophysical, and biochemical risk factors. 6198 participants were recruited, and in 5359 participants (86.4%, men 55%), details of diabetes (known or fasting glucose >126 mg/dL), hypertension (known or blood pressure >140/>90 mm Hg), hypercholesterolemia (cholesterol >200 mg/dL), low high-density lipoprotein (HDL) cholesterol (men <40, women <50 mg/dL), hypertriglyceridemia (>150 mg/dL), and smoking/tobacco use were available. Details of awareness, treatment, and control of hypertension and hypercholesterolemia were also obtained.
  
  
  RESULTS
  The age-adjusted prevalence (%) of diabetes was 15.7 (95% CI 14.8 to 16.6; men 16.7, women 14.4) and that of impaired fasting glucose was 17.8 (16.8 to 18.7; men 17.7, women 18.0). In participants with diabetes, 27.6% were undiagnosed, drug treatment was in 54.1% and control (fasting glucose ≤130 mg/dL) in 39.6%. Among participants with diabetes versus those without, prevalence of hypertension was 73.1 (67.2 to 75.0) vs 26.5 (25.2 to 27.8), hypercholesterolemia 41.4 (38.3 to 44.5) vs 14.7 (13.7 to 15.7), hypertriglyceridemia 71.0 (68.1 to 73.8) vs 30.2 (28.8 to 31.5), low HDL cholesterol 78.5 (75.9 to 80.1) vs 37.1 (35.7 to 38.5), and smoking/smokeless tobacco use in 26.6 (23.8 to 29.4) vs 14.4 (13.4 to 15.4; p<0.001). Awareness, treatment, and control, respectively, of hypertension were 79.9%, 48.7%, and 40.7% and those of hypercholesterolemia were 61.0%, 19.1%, and 45.9%, respectively.
  
  
  CONCLUSIONS
  In the urban Indian middle class, more than a quarter of patients with diabetes are undiagnosed and the status of control is low. Cardiovascular risk factors-hypertension, hypercholesterolemia, low HDL cholesterol, hypertriglyceridemia, and smoking/smokeless tobacco use-are highly prevalent. There is low awareness, treatment, and control of hypertension and hypercholesterolemia in patients with diabetes.
authors.affiliation: Department of Diabetes , Jaipur Diabetes Research Centre , Jaipur, Rajasthan , India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Departments of Medicine and Endocrinology , Fortis Escorts Hospital , Jaipur, Rajasthan , India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Pharmacy , SMS Medical College, Rajasthan University of Health Sciences , Jaipur, Rajasthan , India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Sharma
authors.affiliation: Departments of Medicine and Endocrinology , Fortis Escorts Hospital , Jaipur, Rajasthan , India.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Lodha
authors.affiliation: Department of Medicine , Patna Medical College , Patna, Bihar , India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Achari
authors.affiliation: Department of Medicine , Government Medical College , Madurai, Tamil Nadu , India.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Asirvatham
authors.affiliation: Department of Endocrinology , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
authors.affiliation: Department of Medicine , SP Medical College , Bikaner, Rajasthan , India.
authors.forename: Balkishan
authors.initials: B
authors.lastname: Gupta
authors.affiliation: Department of Diabetes , Diabetes Care and Research Centre , Nagpur, Maharashtra , India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Medicine , JN Medical College , Belgaum, Karnataka , India.
authors.forename: Mallikarjuna V
authors.initials: MV
authors.lastname: Jali
authors.affiliation: Department of Community Medicine , Assam Medical College , Dibrugarh, Assam , India.
authors.forename: Tulika G
authors.initials: TG
authors.lastname: Mahanta
authors.affiliation: Department of Medicine , BBD College of Dental Sciences , Lucknow, Uttar Pradesh , India.
authors.forename: Anuj
authors.initials: A
authors.lastname: Maheshwari
authors.affiliation: Department of Diabetes , DiaCare and Research , Ahmadabad, Gujarat , India.
authors.forename: Banshi
authors.initials: B
authors.lastname: Saboo
authors.affiliation: Department of Medicine , Government Medical College , Jammu, Jammu and Kashmir , India.
authors.forename: Jitendra
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Cardiology , University of California San Francisco VA Medical Center , Fresno, California , USA.
authors.forename: Prakash C
authors.initials: PC
authors.lastname: Deedwania
keywords: Cardiovascular; Hypercholesterolemia; Hypertension