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Aims: To study changes in cardiovascular (CV) risk factors; hypertension (HTN), dysglycaemia (DG) and dyslipidaemia (DL) and their interrelationship, in urban and rural Southern India, in a decade., Methods: Epidemiological data of a city (Chennai, n = 2192(2006), n = 3850(2016)) and peri-urban villages (Panruti, n = 2584 (2006), n = 2468 (2016)) among persons aged ≥ 20 years in 2006 and in 2016 were analysed. Age-standardized prevalence, prevalence ratios and interrelationships of HTN, DG and DL and effect of time in years, age, gender and obesity were calculated using Poisson regression analyses., Results: Response rates in urban and rural areas were 86.5% and 87.6% respectively. Mean age, general obesity (GO), abdominal obesity (AO), total calories and carbohydrate intake increased in both populations (p < 0.0001). Rural population had lower BMI than the urban but had higher AO, particularly among women. Physical activity decreased only in the urban population. HTN increased in urban population; in both, proportion of known HTN decreased, DG and DL increased., Conclusions: In both populations, GO, AO, DG and DL increased; AO and DL were more common among rural women. HTN did not increase in the rural population. The risk factors increased rapidly even in rural areas projecting the impact of urbanisation on the CV burden., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Aims: The aim of the study was to evaluate the effect of text messaging as a tool to improve glycaemic control among newly diagnosed T2D patients in a 2 year period., Methods: This is a multicentric, randomised controlled trial conducted in 2 states of India. The primary outcome was improvement in glycaemia measured by an HbA1c value of ≤7% (53 mmol/mol) with intervention. The secondary outcomes were changes in biochemical, dietary parameters and physical activity. Acceptability of text messages was assessed. Persons having HbA1c value of ≥6.5% (48 mmol/mol) at diagnosis were enrolled. A total of 248 participants with a mean age of 43.3 ± 8.7 years were recruited. Participants in the control group (n = 122) received standard care, the intervention group (n = 126) received customized text messages thrice a week. Both groups received personal advice at the beginning of the study., Results: Baseline characteristics were similar in both groups. At 24 months, both groups showed significant reduction in blood pressure and glycaemic variables in comparison to the baseline values. The intervention group showed significant lowering of LDLc also. Multivariate analysis showed that reduction in HbA1c was associated with intervention., Conclusion: Text messaging can lead to improvement in glycaemic control through personal empowerment and sustained behavioural changes., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aims: We had shown that mobile phone based text messaging was an effective tool to deliver lifestyle changes among Asian Indian men with a 36% relative risk reduction in incident diabetes over two years. The present analysis investigated whether beneficial effects of intervention on diabetes prevention persisted for an additional three years after withdrawal of active intervention., Methods: The primary two year randomized controlled trial (2010-2012) compared lifestyle changes with use of automated text messaging reminders in the intervention (n = 271) versus standard care advice (n = 266) at baseline. At the end of the study, both groups received additional advice on lifestyle changes by a trained dietician. Participants free of diabetes (n = 394) were invited three years later to ascertain the sustained effect of intervention. The primary outcome was incidence of type 2 diabetes. This trial is registered with ClinicalTrials.gov,number NCT02848547., Results: During the mean follow-up of 5 years, 346 out of 394 (87.8%) men were reviewed. Incidence of diabetes was reduced by 30% in the intervention group, with declining gap between-group differences over time (Kaplan-Meier analysis). Significant improvement in dietary adherence occurred in the intervention group at 2nd and 5th year follow up (trend χ 2  = 21.35, p < 0.0001). Cox regression analysis showed that the 5th year incidence of diabetes was significantly reduced in the intervention group. Higher body mass index and 2 h plasma glucose at 24 months increased the incidence of diabetes., Conclusions: Sustained reduction in incident diabetes was apparent after cessation of active lifestyle intervention. This was possibly associated with continuing practice of improved lifestyle., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Aims: The aims of this study were: (1) to assess the association of adiponectin, leptin and interleukin-6 (IL-6) with incidence of type 2 diabetes (T2DM) in Asian Indian men with impaired glucose tolerance (IGT) and (2) to evaluate the additional contribution of these with the well-established glycaemic marker HbA1c., Methods: This is an ancillary analyses of a nested case-control study derived from a prospective, prevention trial in India. All the participants had IGT at baseline. For this subanalysis a total of 147 (T2DM: 71; nondiabetic: 76) participants were selected based on the final glycemic outcomes. Association of these selected adipokines with T2DM were assessed using logistic regression analyses. Clinical usefulness of adding adipokine markers with HbA1c on prediction of T2DM was assessed using the area under the curve (AUC) of the receiver operating characteristics., Results: Baseline levels of adiponectin were lower and the levels of IL-6 were higher in T2DM cases when compared with non-diabetic cases (P<0.05). Levels of leptin were similar in both groups. In fully adjusted models, adiponectin (odds ratio (OR): 0.55 [95%CI: 0.33-0.91]; P=0.019) and IL-6 (OR: 2.27 [95%CI: 1.40-3.691]; P=0.001) were associated with diabetes. Addition of adiponectin to HbA1c improved the AUC (ΔAUC: 0.0619; P=0.0251), whereas addition of IL-6 did not improve the predictive power of HbA1c alone., Conclusions: Adiponectin and IL-6 are independently associated with incident diabetes. However, they are unlikely to serve as simple tools to predict future risk of diabetes but may have a role in understanding the pathogenesis., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

The prevalence of diabetes mellitus (DM) and cardiovascular disease (CVD) is increasing in urban India. Overweight in adolescence is a marker of overweight in adult age, and it shows an association with the above diseases. There have been meagre data from India on the prevalence of childhood obesity. The objective of the study was to quantify the prevalence of overweight and its risk factors in adolescent children in urban India. School students in the age group of 13-18 years (n = 4700, M:F 2382:2318) were studied. Body mass index (BMI) was measured. Data on physical activity, food habits, occupation of parents and their economic status, birth weight of the children and age at menarche in girls were obtained by questionnaire. Age-adjusted prevalence of overweight was 17.8% for boys and 15.8% for girls. It increased with age and was higher in lower tertiles of physical activity and in higher socio-economic group. Birth weight and current BMI were positively associated. The study highlighted the high prevalence of overweight in adolescent children in urban India. Life style factors influenced BMI in adolescent age.