title: Factors associated with glucose tolerance, pre-diabetes, and type 2 diabetes in a rural community of south India: a cross-sectional study.
abstract: BACKGROUND
  India's national rural prevalence of type 2 diabetes has quadrupled in the past 25 years. Despite the growing rural burden, few studies have examined putative risk factors and their relationship with glucose intolerance and diabetes in rural areas. We undertook a cross-sectional study to determine the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes in a rural area of south India. In addition, we determined which factors were associated with type 2 diabetes.
  
  
  METHODS
  We sampled 2 % of the adult population from 17 villages using a randomized household-level sampling technique. Each participant undertook a questionnaire that included basic descriptive information and an assessment of socioeconomic status, physical activity, and dietary intake. Height, weight, waist and hip circumference, and blood pressure measurements were taken. An oral glucose tolerance test was used to determine diabetes status. We used stepwise logistic model building techniques to determine associations between several putative factors and type 2 diabetes.
  
  
  RESULTS
  753 participants were included in the study. The age- and sex-standardized prevalence of IFG was 3.9 %, IGT was 5.6 %, and type 2 diabetes was 10.8 %. Factors associated with type 2 diabetes after adjusting for confounders included physical activity [OR 0.81], rurality [OR 0.76], polyunsaturated fat intake [OR 0.94], body mass index [OR 1.85], waist to hip ratio [OR 1.62], and tobacco consumption [OR 2.82].
  
  
  CONCLUSIONS
  Our study contributes to the growing body of research suggesting that diabetes is a significant concern in rural south India. Associated risk factors should be considered as potential targets for reducing health burdens in India.
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, ON Canada.
authors.forename: Matthew
authors.identifier: 0000-0001-6644-2336
authors.initials: M
authors.lastname: Little
authors.affiliation: Department of Sociology and Anthropology, University of Guelph, Guelph, ON Canada.
authors.forename: Sally
authors.initials: S
authors.lastname: Humphries
authors.affiliation: Department of International Development Studies, Menno Simons College, University of Winnipeg, Winnipeg, MB Canada.
authors.forename: Kirit
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, ON Canada.
authors.forename: Warren
authors.initials: W
authors.lastname: Dodd
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, ON Canada.
authors.forename: Cate
authors.initials: C
authors.lastname: Dewey
keywords: Body mass index; Cross-sectional; Diet; Impaired fasting glucose; Impaired glucose tolerance; India; Rural; Tobacco; Type 2 diabetes; Waist to hip ratio