Diabetes is a growing global health care problem and it causes a severe economic burden to the patients and to society at large. The International Diabetes Federation (IDF) and the World Health Organization (WHO) have estimated that globally there are 463 million with diabetes in 2019 and by 2030 it is predicted to increase to 578 million. People with type 2 diabetes are increasing in every country, but 80% of diabetes live in low and middle-income countries.

It is estimated that nearly 50% of diabetes is undiagnosed. India has 77.0 million diabetes and it is expected to rise to 101.0 million by 2030. In India, Tamil Nadu is one of the states with the largest number of people, approximately 35.2 lakh with diabetes. This may be attributed to the higher rates of urbanization and modernization.

Series of urban and rural epidemiological studies conducted by IDRF has resulted in a wealth of knowledge on various aspects, the pathogenesis, risk factors, and temporal changes in the prevalence of diabetes, pre-diabetes, and cardiovascular risk factors in India.

Insulin Resistance and Clustering of Cardiometabolic Risk Factors in Urban Teenagers in Southern India.

The occurrence of cardiometabolic risk variables, their clustering, and their association with insulin resistance among 2640 healthy adolescents in urban south India was studied. Cardiometabolic abnormalities were present in nearly 68% of young healthy Asian-Indian adolescents. Insulin resistance is associated with individual cardiometabolic factors, and plasma insulin showed an association with the clustering of some variables.

Plasma Adiponectin Does Not Correlate With Insulin Resistance and Cardiometabolic Variables in Nondiabetic Asian Indian Teenagers.

The objectives of this study were to determine age- and sex-specific concentrations of adiponectin in 196 Asian Indian teenagers and adults and to assess whether its blood levels correlated with insulin resistance and other cardiometabolic parameters. It was found that in Asian Indian adults and teenagers, adiponectin did not correlate directly with measures of insulin sensitivity, overweight, and other cardiometabolic variables.

Awareness about diabetes and its complications in the general and diabetic population in a city in southern India.

The study was done to find out the levels of awareness of diabetes in the urban adult Indian population and to identify factors that influenced the awareness, including the presence of diabetes. Knowledge regarding the causes of diabetes, its prevention, and the methods to improve health was significantly low among the general population. Diabetic subjects had better knowledge about symptoms of diabetes and the preventive aspects. Awareness was low especially in women and subjects with low education. The study highlights the urgent need to spread awareness about diabetes in the general population.

High Prevalence of Diabetes and Cardiovascular Risk Factors Associated With Urbanization in India.

Prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and cardiovascular risk factors between a city (n= 2192), a town (n=2290), and periurban villages (PUVs) (n=2584) in southern India were compared and temporal changes in the city and PUVs were also looked into. Present and previous data in the city and the PUVs were compared. Overweight, elevated waist circumference, hypertension, and dyslipidemia were more prevalent in the city. Diabetes increased from 13.9% to 18.6% in 6 years and IGT decreased significantly in the city. The town and city had a similar prevalence; in the PUVs diabetes prevalence, had increased compared with that in a previous survey. Cardiometabolic abnormalities were more prevalent in urban populations.

Cardiovascular risk factors in the normoglycaemic Asian-Indian population-influence of urbanization.

The aim of this study was to investigate the prevalence of cardiovascular risk factors in normoglycaemic Asian-Indians and its association with urbanization and plasma glucose. The study revealed a high prevalence of cardiovascular risk factors even among normoglycemic individuals, and this is highest in urban areas. Fasting plasma glucose levels showed an association with dyslipidemia but not hypertension.

Multifaceted Determinants for Achieving Glycemic Control The International Diabetes Management Practice Study (IDMPS).

The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. The analysis of the first phase showed that both in type 1 and type 2 diabetes patients, in Latin America, Eastern Europe, and Asia including India, Korea, China, Indonesia, Hong Kong, Taiwan, Malaysia, and Thailand, only about one-third of the patients achieved the desired goal of glycaemic and lipid control. It was observed that in developing countries, factors pertinent to patients, doctors, and health care systems all impact on glycemic control.

Relationship Between A1C and Fasting Plasma Glucose in Dysglycemia or Type 2 Diabetes- An analysis of baseline data from the ORIGIN trial.

Baseline A1C and FPG data from the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial participants (n=12,527) were analyzed to 1) elucidate the relationship between A1C and FPG in people with moderate dysglycemia (A1C 5.6–9.0% [38–75 mmol/mol]) and additional risk factors for cardiovascular disease, 2) determine whether this relationship is altered by use of an OAD, and 3) study whether geographic and ethnic differences exist. A strong relationship between FPG and the corresponding A1C was seen across different geographic regions and ethnic groups. A smaller increase in A1C per unit increase in FPG occurred for persons taking an OAD versus those not taking an OAD.

PHS Study

A Study of Secular Trends in the Prevalence of Glucose Intolerance and Cardiovascular Risk Factors among Populations in Southern India.

Start Date: Jul 2016

End Date: Jan 2018

CV Burden

Secular trends in cardiometabolic risk factors among the urban and rural populations in Tamil Nadu.

Start Date: Sep 2018

End Date: Ongoing