title: Comparing Type 2 Diabetes, Prediabetes, and Their Associated Risk Factors in Asian Indians in India and in the U.S.: The CARRS and MASALA Studies.
abstract: OBJECTIVE
  To assess the prevalence of diabetes and prediabetes and the associated risk factors in two Asian Indian populations living in different environments.
  
  
  METHODS
  We performed cross-sectional analyses, using representative samples of 2,305 Asian Indians aged 40-84 years living in Chennai, India, from the Centre for cArdiometabolic Risk Reduction in South-Asia study (CARRS) (2010-2011), and 757 Asian Indians aged 40-84 years living in the greater San Francisco and Chicago areas from the U.S. Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (2010-2013). Diabetes was defined as self-reported use of glucose-lowering medication, fasting glucose ≥126 mg/dL, or 2-h glucose ≥200 mg/dL. Prediabetes was defined as fasting glucose 100-125 mg/dL and/or 2-h glucose 140-199 mg/dL.
  
  
  RESULTS
  Age-adjusted diabetes prevalence was higher in India (38% [95% CI 36-40]) than in the U.S. (24% [95% CI 21-27]). Age-adjusted prediabetes prevalence was lower in India (24% [95% CI 22-26]) than in the U.S. (33% [95% CI 30-36]). After adjustment for age, sex, waist circumference, and systolic blood pressure, living in the U.S. was associated with an increased odds for prediabetes (odds ratio 1.2 [95% CI 0.9-1.5]) and a decreased odds for diabetes (odds ratio 0.5 [95% CI 0.4-0.6]).
  
  
  CONCLUSIONS
  These findings indicate possible changes in the relationship between migration and diabetes risk and highlight the growing burden of disease in urban India. Additionally, these results call for longitudinal studies to better identify the gene-environment-lifestyle exposures that underlie the elevated risk for type 2 diabetes development in Asian Indians.
authors: Nutrition and Health Sciences Program, Graduate Division of Biomedical and Biological Sciences, Laney Graduate School, Emory University, Atlanta, GA ugujral@emory.edu.
authors: Unjali P
authors: UP
authors: Gujral
authors: Nutrition and Health Sciences Program, Graduate Division of Biomedical and Biological Sciences, Laney Graduate School, Emory University, Atlanta, GA Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA Department of Medicine, School of Medicine, Emory University, Atlanta, GA.
authors: K M Venkat
authors: KM
authors: Narayan
authors: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, International Diabetes Federation Centre of Education, Chennai, India.
authors: R Ghua
authors: RG
authors: Pradeepa
authors: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, International Diabetes Federation Centre of Education, Chennai, India.
authors: Mohan
authors: M
authors: Deepa
authors: Nutrition and Health Sciences Program, Graduate Division of Biomedical and Biological Sciences, Laney Graduate School, Emory University, Atlanta, GA Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
authors: Mohammed K
authors: MK
authors: Ali
authors: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, International Diabetes Federation Centre of Education, Chennai, India.
authors: Ranjit M
authors: RM
authors: Anjana
authors: Department of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors: Namratha R
authors: NR
authors: Kandula
authors: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, International Diabetes Federation Centre of Education, Chennai, India.
authors: Viswanathan
authors: V
authors: Mohan
authors: Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA.
authors: Alka M
authors: AM
authors: Kanaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000208:ethnology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference