The results of an Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study published recently in The Lancet show concerning levels of diabetes, hypertension, abdominal obesity and hypertriglyceridemia in India. More importantly, such high levels of disease prevalence were observed across the rural and urban regions of many States.
It must be noted that the burden of the above-mentioned non-communicable diseases and adverse health conditions is not equally high across all States. For instance, the prevalence of diseases such as diabetes was relatively low in rural Uttar Pradesh (0-4.9%). However, the region saw a relatively high prevalence of hypertriglyceridemia (≥25%) and abdominal obesity (≥25%). Similarly, in rural Gujarat, diabetes prevalence was relatively low (5-7.4%) whereas hypertension prevalence was relatively high (≥30%).
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What is more worrying is that in some States (Kerala, West Bengal, Sikkim and Goa), the burden of all four — the two diseases and the two adverse conditions — was alarmingly high. In these States, there was a relatively high prevalence of diabetes (>10%), hypertension (≥30%), abdominal obesity (≥25%) and hypertriglyceridemia (≥20%). The authors of the paper have cited the wide variations among States in disease burden and have called for State-specific policies and interventions rather than a blanket approach.
The survey was conducted between November 2008 and December 2020 across 31 States and Union Territories among 1,19,022 individuals who were 20 years or older. Some States such as Tamil Nadu and Maharashtra were surveyed between 2008 and 2010, while others such as West Bengal and Odisha were surveyed between 2019 and 2020.
Map 1 | The map shows the prevalence of diabetes
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Map 2 | The map shows the prevalence of hypertension
In the survey, abdominal obesity is defined as a waist circumference of 90 cm or higher for men and 80 cm or higher for women. Abdominal obesity or visceral fat has been linked to metabolic disturbances and increased risk for cardiovascular disease and type 2 diabetes. In women, it is also associated with breast cancer and the need for gallbladder surgery
Map 3 | The map shows the prevalence of abdominal obesity
Hypertriglyceridemia is defined as serum triglyceride concentrations of 150 mg/dL (1.7 mmol/L) or higher in the blood. According to the Harvard Medical School’s blog, high levels of triglycerides can be one of the signs of metabolic syndrome, which increases the risk of having a heart attack or stroke. Extremely high levels (1,000 mg/dL or more) of triglycerides can lead to acute pancreatitis.
Map 4 | The map shows the prevalence of hypertriglyceridemia.
The maps show the rural-urban prevalence of the two diseases and the two adverse health conditions across States. In general, the prevalence of both the diseases and conditions was much higher in urban areas than in rural. For instance, diabetes prevalence was >10% in 28 States/UTs if only urban areas were considered, whereas such a high share was recorded in only nine States/UTs if only rural areas were considered. Such a divide was seen across all diseases and conditions considered for this analysis.
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Overall, the study found that 11.4% of Indians had diabetes while 35.5% were hypertensive. Abdominal obesity was observed in 39.5% of individuals while hypertriglyceridemia was recorded in 32.1% of them. A slightly higher share of men (12.1%) had diabetes than women (10.7%). More men were hypertensive (38.7%) than women (32.6%). Hypertriglyceridemia was observed among more men (37.5%) than women (27.1%). But more women (49.6%) had abdominal obesity than men (28.8%).
Source: The Lancet report titled “Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17)“
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