Aims/hypothesis This study reports the results of the first phase of a national study to determine the prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in India. Methods A total of 363 primary sampling units (188 urban, 175 rural), in three states (Tamilnadu, Maharashtra and Jharkhand) and one union territory (Chandigarh) of India were sampled using a stratified multistage sampling design to survey individuals aged ≥20 years. The prevalence rates of diabetes and prediabetes were assessed by measurement of fasting and 2 h post glucose load capillary blood glucose. Results Of the 16,607 individuals selected for the study, 14,277 (86%) participated, of whom 13,055 gave blood samples. The weighted prevalence of diabetes (both known and newly diagnosed) was 10.4% in Tamilnadu, 8.4% in Maharashtra, 5.3% in Jharkhand, and 13.6% in Chandigarh. The prevalences of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were 8.3%, 12.8%, 8.1% and 14.6% respectively. Multiple logistic regression analysis showed that age, male sex, family history of diabetes, urban residence, abdominal obesity, generalised obesity, hypertension and income status were significantly associated with diabetes. Significant risk factors for prediabetes were age, family history of diabetes, abdominal obesity, hypertension and income status.
Aim To compare the prevalence of metabolic syndrome (MS) using the World Health Organisation (WHO), Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria of MS in an urban south Indian population, and their ability to identify coronary artery disease (CAD) in males and females.Methods Chennai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, in which 26 001 individuals aged ≥20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3, and the response rate was 90.4%. An oral glucose tolerance test (OGTT) was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects and the prevalence of MS estimated using the three criteria. Diagnosis of CAD, made by resting 12 lead ECG, was compared by the three criteria of MS.Results MS was identified in 546 subjects (23.2%) by WHO criteria, 430 subjects (18.3%) by ATPIII criteria and 607 subjects (25.8%) by IDF criteria. Only 224 of these subjects were identified by all the three criteria. There was an increased risk of probable CAD in MS subjects diagnosed by WHO criteria (odds ratio (OR) 3.86, 95% Confidence Interval (CI), 2.37-6.29, p < 0.001), compared to ATPIII criteria (OR 2.19, p < 0.05) and IDF criteria (OR 1.90, p < 0.05). The WHO criteria marked out a much higher population for CAD risk compared to ATPIII and IDF criteria in males, but not in females.
ConclusionIn Asian Indians, the WHO, ATPIII and IDF criteria of MS identify different individuals. The WHO criteria identify a greater number of CAD subjects in males, but not in females.
* P-value for K-W test. ANOVA, analysis of variance; BMI, body mass index; CI, confidence interval; K-W, Kruskal-Wallis; SD, standard deviation. a Agaram, Chennai, Chunampet, Illeedu, Pudupattu, Puthiram Kottai and Vanniyanallur. b Means were compared using one-way ANOVA or the K-W test when assumptions for ANOVA were not met.
OBJECTIVE -To determine random capillary blood glucose (RCBG) cut points that discriminate diabetic and pre-diabetic subjects from normal individuals.RESEARCH DESIGN AND METHODS -RCBG was performed in 1,333 individuals randomly chosen from 63,305 individuals who had participated in an opportunistic screening program. An oral glucose tolerance test was also performed by venous plasma glucose on an autoanalyzer. RCBG cut points that discriminate diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were determined using receiver operating characteristic curves.RESULTS -Using 2-h plasma glucose Ն200 mg/dl (11.1 mmol/l) criterion, the RCBG cut point of 140 mg/dl (7.7 mmol/l) gave the highest sensitivity and specificity. For 2-h plasma glucose Ն200 mg/dl (11.1 mmol/l) and fasting plasma glucose (FPG) Ն126 mg/dl (7.0 mmol/l) criteria, either 2-h plasma glucose Ն200 mg/dl (11.1 mmol/l) or FPG Ն126 mg/dl (7.0 mmol/l) criterion, and the FPG Ն126 mg/dl (7.0 mmol/l) criterion, RCBG cut point was 143 mg/dl (7.9 mmol/l). RCBG cut points for IGT, IFG according to World Health Organization criterion, and IFG according to American Diabetes Association criterion were 119 mg/dl (6.6 mmol/l), 118 mg/dl (6.6 mmol/l), and 113 mg/dl (6.3 mmol/l), respectively.CONCLUSIONS -Asian Indians with RCBG Ͼ110 mg/dl at screening can be recommended to undergo definitive testing.
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