Prevalence and risk factors of diabetes among adult men and women in India Sutapa Agrawal1, Shah Ebrahim1,2 1 South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India 2 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine Introduction Prevalence of diabetes in India by state Prevalence of diabetes by socioeconomic and demographic characteristics and risk factors Results Type 2 diabetes has become a major health challenge worldwide (King et al 1998). In 2000, there were an estimated 175 million people with diabetes worldwide and by 2030, the projected estimate of diabetes is 354 million (Wild et al 2004). The greatest relative rise is predicted in the developing countries of the Middle Eastern Crescent, Sub Saharan Africa and the Indian subcontinent. In India alone, the prevalence of diabetes is expected to increase from 31.7 million in 2000 to 79.4 million in 2030 (Wild et al 2004). The rise in diabetes in India and other low and middle income countries has been attributed to increased consumption of saturated fats, sugars, and sedentary behavior associated with urbanization and westernization (Gopalan 1997; WHO 2000; Fall 2001; Hu 2001; Juliana et al 2009). Other modifiable risk factors for reducing risk of diabetes include high fruit and vegetable consumption (Justin et al 2009); moderate alcohol intake (Rimm et al 1995) mostly in men (Kao et al 1998); avoiding smoking (Perry et al 1995); and, increased physical activity (Hu et al, 2001). Nationally representative studies from India on these risk factors at a national level are not available. This study gives the prevalence of diabetes among Indian women and men and examined the effect of risk factors such as dietary, nutritional, behavioural and socio-economic status on diabetes. Adjusted effect of consumption of Non-vegetarian food items on diabetes A marked country-wide variation in diabetes prevalence is found in India with urban rates as high as 5% and as low as 0.3%. Urban rates tend to be highest in the Southern region but high urban rates are found in most regions. Regular consumption of animal products was independently associated with diabetes but not milk consumption. Overweight and obesity were also independently associated with diabetes but watching TV was not. Wealth was independently associated with diabetes but educational attainment was not. No strong evidence for associations with smoking tobacco or alcohol were found. Findings were broadly similar for men and women. Prevalence of diabetes among Men and Women Nationally, there is a wide variation in prevalence of diabetes. Strong associations with modifiable lifestyle risk factors and positive associations with wealth were observed. Certain cultural factors in India may facilitate changes for better health-related behaviour. Intervention strategies like “Eat less, Eat on time and Walk more” to improve health literacy have to be inculcated. Changes in lifestyle and distribution of resources are needed at a micro and macro level. Prevention of diabetes should focus on lifestyle and target specific socio-economic groups. Discussion Data and Methods Prevalence of diabetes in rural and urban India The analysis used information on 1,24,385 ever-married women (15-49 years), and 74,369 ever married men (15-54 years) included in India’s third National Family Health Survey (NFHS-3) conducted during 2005-06. Prevalence of diabetes was computed as number of diabetes cases per 100,000 populations. Both bi-variate and multivariate analysis is done. Chi-square analysis was used to test for homogeneity in the risk factors and socioeconomic and demographic factors. Trend test were also carried out scoring the variables in different categories and using likelihood ratio tests. Multivariate logistic regression was used to estimate the odds ratios for diabetes of risk factors after controlling for socio-economic and demographic factors and for examining the independent effects of risk factors. Conclusion References Fall CH. 2001. The genesis of ‘Fetal origins of adult disease’. Int J Diab Dev Ctries. 21:3-8. Gopalan C. 1997. Diet related non-communicable diseases in South and South East Asia. In: Shetty PS, McPherson K, eds. Diet, Nutrition and Chronic Disease: Lessons from Contrasting Worlds. London: John Wiley & Sons.10–23. King et al. 1998. Global burden of diabetes, 1995 – 2025: prevalence, numerical estimates, and projections. Diabetes Care. 21: 1414 – 1431.  Hu FB. 2001. Diet, lifestyle, and risk of type 2 diabetes mellitus in women. New England Journal of Medicine. 345: 790–7.  Juliana et al. 2009. 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