Kalra Sanjay, Anjana Ranjit Mohan, Verma Madhur, Pradeepa Rajendra, Sharma Nikita, Deepa Mohan, Singh Omna, Venkatesan Ulagamadesan, Elangovan Nirmal, Aggarwal Sameer, Kakkar Rakesh, Mohan Viswanathan
Department of Endocrinology, Bharti Hospital, Karnal, India.
University Centre for Research and Development, Chandigarh University, Mohali, India.
Diabetes Ther. 2024 Jul;15(7):1597-1613. doi: 10.1007/s13300-024-01602-w. Epub 2024 May 21.
Diabetes is a multifactorial disease with far-reaching consequences. Environmental factors, such as urban or rural residence, influence its prevalence and associated comorbidities. Haryana-a north Indian state-has undergone rapid urbanisation, and part of it is included in the National Capital Region (NCR). The primary aim of the study is to estimate the prevalence of diabetes in Haryana with urban-rural, NCR and non-NCR regional stratification and assess the factors affecting the likelihood of having diabetes among adults.
This sub-group analysis of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study (a nationally representative cross-sectional population-based survey) was done for Haryana using data from 3722 participants. The dependent variable was diabetes, while residence in NCR/non-NCR and urban-rural areas were prime independent variables. Weighted prevalence was estimated using state-specific sampling weights and standardized using National Family Health Survey-5 (NFHS-5) study weights. Associations were depicted using bivariate analysis, and factors describing the likelihood of living with diabetes were explored using a multivariable binary logistic regression analysis approach.
Overall, the weighted prevalence of diabetes in Haryana was higher than the national average (12.4% vs. 11.4%). The prevalence was higher in urban (17.9%) than in rural areas (9.5%). The prevalence of diabetes in rural areas was higher in the NCR region, while that of prediabetes was higher in rural non-NCR region. Urban-rural participants' anthropometric measurements and biochemical profiles depicted non-significant differences. Urban-rural status, age and physical activity levels were the most significant factors that affected the likelihood of living with diabetes.
The current analysis provides robust prevalence estimates highlighting the urban-rural disparities. Urban areas continue to have a high prevalence of diabetes and prediabetes; rural areas depict a much higher prevalence of prediabetes than diabetes. With the economic transition rapidly bridging the gap between urban and rural populations, health policymakers should plan efficient strategies to tackle the diabetes epidemic.
糖尿病是一种具有深远影响的多因素疾病。环境因素，如城乡居住情况，会影响其患病率及相关合并症。哈里亚纳邦——印度北部的一个邦——经历了快速城市化，其部分地区被纳入国家首都地区（NCR）。本研究的主要目的是按城乡、NCR和非NCR区域分层估算哈里亚纳邦糖尿病的患病率，并评估影响成年人患糖尿病可能性的因素。
本研究是对印度医学研究理事会 - 印度糖尿病（ICMR - INDIAB）研究（一项具有全国代表性的基于人群的横断面调查）进行的亚组分析，使用了来自哈里亚纳邦3722名参与者的数据。因变量是糖尿病，而在NCR/非NCR以及城乡地区的居住情况是主要自变量。使用特定邦的抽样权重估算加权患病率，并使用全国家庭健康调查 - 5（NFHS - 5）研究权重进行标准化。使用双变量分析描述关联，并使用多变量二元逻辑回归分析方法探索描述患糖尿病可能性的因素。
总体而言，哈里亚纳邦糖尿病的加权患病率高于全国平均水平（12.4%对11.4%）。城市地区的患病率（17.9%）高于农村地区（9.5%）。农村地区中，NCR区域的糖尿病患病率较高，而农村非NCR区域的糖尿病前期患病率较高。城乡参与者的人体测量指标和生化指标差异不显著。城乡状况、年龄和身体活动水平是影响患糖尿病可能性的最显著因素。
当前分析提供了有力的患病率估计，突出了城乡差异。城市地区糖尿病和糖尿病前期的患病率持续较高；农村地区糖尿病前期的患病率远高于糖尿病。随着经济转型迅速缩小城乡人口差距，卫生政策制定者应制定有效的策略来应对糖尿病流行。
