title: Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES).
abstract: OBJECTIVE
  There are few data on the incidence rates of diabetes and prediabetes (dysglycemia) in Asian Indians. This article presents the incidence of diabetes and prediabetes and the predictors of progression in a population-based Asian Indian cohort.
  
  
  METHODS
  Data on progression to diabetes and prediabetes from 1,376 individuals, a subset of 2,207 of the Chennai Urban Rural Epidemiology Study (CURES) cohort (phase 3) with normal glucose tolerance (NGT) or prediabetes at baseline, who were followed for a median of 9.1 years (11,629 person-years), are presented. During follow-up, 534 died and 1,077 with NGT and 299 with prediabetes at baseline were reinvestigated in a 10-year follow-up study. Diabetes and prediabetes were diagnosed based on the American Diabetes Association criteria. Incidence rates were calculated and predictors of progression to prediabetes and/or diabetes were estimated using the Cox proportional hazards model.
  
  
  RESULTS
  The incidence rates of diabetes, prediabetes, and "any dysglycemia" were 22.2, 29.5, and 51.7 per 1,000 person-years, respectively. Among those with NGT, 19.4% converted to diabetes and 25.7% to prediabetes, giving an overall conversion rate to dysglycemia of 45.1%. Among those with prediabetes, 58.9% converted to diabetes. Predictors of progression to dysglycemia were advancing age, family history of diabetes, 2-h plasma glucose, glycated hemoglobin (HbA1c), low HDL cholesterol, and physical inactivity.
  
  
  CONCLUSIONS
  Asian Indians have one of the highest incidence rates of diabetes, with rapid conversion from normoglycemia to dysglycemia. Public health interventions should target modifiable risk factors to slow down the diabetes epidemic in this population.
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India dranjana@drmohans.com.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Coimbatore Subramanian
authors.initials: CS
authors.lastname: Shanthi Rani
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pradeepa
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Vasudevan
authors.initials: V
authors.lastname: Sudha
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Haridas
authors.initials: H
authors.lastname: Divya Nair
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Lakshmipriya
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Subhashini
authors.affiliation: Manipal University, Manipal, India.
authors.forename: Valsalakumari Sreekumarannair
authors.initials: VS
authors.lastname: Binu
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and International Diabetes Federation Centre of Education, Chennai, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D044466:Asian People / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D011236:Prediabetic State / Q000208:ethnology*; D012307:Risk Factors; D012423:Rural Health; D014504:Urban Health
chemical_list: D006442:Glycated Hemoglobin