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Introduction: Diabetes mellitus (DM) is a major public health challenge around the world. It is crucial to understand the geographic distribution of the disease in order to pinpoint high-priority locations and focus intervention on the target populations. Hence, this study was carried out to determine the spatial pattern and determinants of type-2 DM in an Indian population using National Family Health Survey-4 (NFHS-4) and Longitudinal Aging Survey in India (LASI). Methods: We have adopted an ecological approach, wherein geospatial analysis was performed using aggregated district-level data from NFHS-4 (613 districts) and LASI survey datasets (632 districts). Moran's I statistic was determined and Local Indicators of Spatial Association (LISA) maps were created to understand the spatial clustering pattern of DM. Spatial regression models were run to determine the spatial factors associated with DM. Results: Prevalence of self-reported DM among males (15–50 years) and females (15–49 years) was 2.1% [95% confidence interval (CI) 2.0–2.3%] and 1.7% (95% CI 1.6–1.8%), respectively. Prevalence of self-reported DM among males and females aged 45 years and above was 12.5% (95% CI 11.5–13.5%) and 10.9% (95% CI 9.8–12%). Positive spatial autocorrelation with significant Moran's I was found for both males and females in both NFHS-4 and LASI data. High-prevalence clustering (hotspots) was maximum among the districts belonging to southern states such as Kerala, Tamil Nadu, Karnataka, and Andhra Pradesh. Northern and central states like Madhya Pradesh, Chhattisgarh, and Haryana mostly had clustering of cold spots (i.e., lower prevalence clustered in the neighboring regions). Conclusion: DM burden in India is spatially clustered. Southern states had the highest level of spatial clustering. Targeted interventions with intersectoral coordination are necessary across the geographically clustered hotspots of DM. [ABSTRACT FROM AUTHOR]

To study the association and possible predictive role of visfatin, resistin, fetuin-A and chemerin with incident type 2 diabetes (T2DM) among Asian Indians with prediabetes. Their association with insulin resistance, β-cell function, glycaemia and anthropometry were also studied. This is a nested case–control study of a large 2-year prospective prevention trial in persons at high risk of developing T2DM. Baseline HbA1c values between 6.0% (42 mmol/mol) and 6.2% (44 mmol/mol) were chosen for this analysis (n = 144). At follow-up, persons with incident T2DM (HbA1c ≥ 6.5%, 48 mmol/mol) were grouped as cases (n = 72) and those reverted to normoglycaemia, (HbA1c < 5.7% (39 mmol/mol) as controls (n = 72). Insulin resistance showed the strongest association with incident T2DM ((Odds Ratio (OR): 23.22 [95%CI 6.36–84.77]; p < 0.0001). Baseline visfatin (OR: 6.56 [95%CI 2.21–19.5]; p < 0.001) and fetuin-A (OR: 1.01 [95%CI (1.01–1.04)]; p < 0.0001) independently contributed to the conversion of prediabetes to T2DM. The contribution was significantly higher when their elevated levels coexisted (OR: 12.63 [95%CI 3.57–44.63]; p < 0.0001). The area under the curve was 0.77 ± SE 0.4 (95%CI 0.69–0.85) and 0.80 ± SE 0.04 (95%CI 0.73–0.88) for visfatin (median 17.7 ng/ml, sensitivity and specificity: 75%, p < 0.0001) and fetuin-A (mean 236.2 µg/ml, sensitivity: 71%, specificity: 75%, p < 0.0001) respectively. Higher baseline visfatin and fetuin-A concentrations are strongly associated with incident T2DM and are predictive of future diabetes. [ABSTRACT FROM AUTHOR]

Introduction: We present a new diabetes risk score developed and validated in a multi-ethnic population in Guyana, South America. Measurement of in-country diabetes prevalence is a vital epidemiologic tool to combat the pandemic. It is believed that for every person diagnosed with type 2 diabetes there is another undiagnosed. The International Diabetes Federation (IDF) recommends a two-step detection programme using a risk score questionnaire to identify high-risk individuals followed by glycaemic measure. Methods: Data on 798 persons from the 2016 STEPwise Approach to Chronic Disease Risk Factor Surveillance (STEPS) were used to correlate responses to 36 questions with glycated haemoglobin (HbA1C) and fasting plasma glucose (FPG) results. Bootstrapping was used to internally validate the derived seven-variable model. This model with the addition of family history questions was tested in a convenience sample of 659 Guyanese adults and externally validated in a cohort of another 528. Results: An 8-item Guyana Diabetes Risk Score (GDRS) was derived. The final model performed with an area under the curve (AUC) of 0.812 Conclusions: The validated eight-item Guyana Diabetes Risk Score will be extremely useful in identifying individuals at high risk of having diabetes in Caribbean, Black or East Indian populations. [ABSTRACT FROM AUTHOR]

The article discusses the study on the glycemic and insulinemic responses of healthy East Indians after consumption of maltitol. It offers information on maltitol which is a bulk sweetener that exhibit a low glycemic response. The results reportedly revealed that maltitol glycemic response in healthy people is low.

Background: The prevalence of diabetes mellitus (DM) and periodontal disease / periodontitis (PD) is high, and the association of these two as risk factors influencing each other has been recognized and is extensively documented. However, a majority of these association studies have been done in developed countries and / or in developing countries other than India. Objective: To review, quantify and qualify the status of the published indexed scientific literature regarding the bidirectional association of DM and PD in India. Method: An internet search of the literature was conducted to examine relevant association studies of DM and PD in India. As a matter of interest, the related articles were searched manually from one non-indexed national (India) publication of periodontology until October 2008. Specific focus was on indexed literature and only these were considered for the review. Result: Eleven pertinent indexed publications addressing the concern with regard to population in India were identified. Most of them were in agreement with the accepted mechanisms involving these two diseases, but more supported a unidirectional view of interaction, that is, advocating the role of DM in a worsened periodontal condition. One study with an opposite view was recognised. Conclusion: The paucity of such research in India, which will be a hub of diabetics in the near future, reflects the need to make available a strong body of evidence in the indexed literature relating not only to DM and its 'sixth complication', PD, but also the strong influence of PD on DM. [ABSTRACT FROM AUTHOR]

The article discusses the cross-sectional study on the use of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) to assess the risk of developing diabetes. The study reportedly involved adults from a rural area in Jammu and Kashmir, India who were evaluated for their health status and surveyed using a protocol with MDRF-IDRS. The results revealed that MDRF-IDRS can effectively identify people who are at high risk of developing diabetes mellitus.

Adiponectin is an adipose tissue specific protein that is decreased in subjects with obesity and type 2 diabetes. The objective of the present study was to examine whether variants in the regulatory regions of the adiponectin gene contribute to type 2 diabetes in Asian Indians. The study comprised of 2,000 normal glucose tolerant (NGT) and 2,000 type 2 diabetic, unrelated subjects randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), in southern India. Fasting serum adiponectin levels were measured by radioimmunoassay. We identified two proximal promoter SNPs (−11377C→G and −11282T→C), one intronic SNP (+10211T→G) and one exonic SNP (+45T→G) by SSCP and direct sequencing in a pilot study ( n = 500). The +10211T→G SNP alone was genotyped using PCR-RFLP in 4,000 study subjects. Logistic regression analysis revealed that subjects with TG genotype of +10211T→G had significantly higher risk for diabetes compared to TT genotype [Odds ratio 1.28; 95% Confidence Interval (CI) 1.07–1.54; P = 0.008]. However, no association with diabetes was observed with GG genotype ( P = 0.22). Stratification of the study subjects based on BMI showed that the odds ratio for obesity for the TG genotype was 1.53 (95%CI 1.3–1.8; P < 10−7) and that for GG genotype, 2.10 (95% CI 1.3–3.3; P = 0.002). Among NGT subjects, the mean serum adiponectin levels were significantly lower among the GG ( P = 0.007) and TG ( P = 0.001) genotypes compared to TT genotype. Among Asian Indians there is an association of +10211T→G polymorphism in the first intron of the adiponectin gene with type 2 diabetes, obesity and hypoadiponectinemia. [ABSTRACT FROM AUTHOR]

Objective:To investigate the association of insulin receptor substrate-2 (IRS-2) G1057D polymorphism with type 2 diabetes and obesity in Asian Indians.Methods:The study comprised of 1193 normal glucose tolerant (NGT) subjects and 1018 subjects with type 2 diabetes, aged 20 years with an average body mass index of 23.7±4.6 and 25.3±4.2 kg/m2, respectively. The subjects were unrelated and randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), a population-based study in Chennai in southern India. The G1057D polymorphism of the IRS-2 gene was genotyped using PCR-RFLP assay.Results:The genotype frequency of the IRS-2 G1057D polymorphism was significantly different between the NGT and type 2 diabetic groups (P=0.0007) in the total study subjects and among the obese subjects (P=0.00007). Logistic regression analysis showed that the DD genotype showed an increased susceptibility to diabetes with an odds ratio (adjusted for age and sex) of 2.19 (95% CI: 1.34–3.57, P=0.002) when compared to the GG+GD genotype, among the obese subjects, but not in non obese subjects. In order to explore possible interaction with obesity, logistic regression analysis was performed and the coefficient corresponding to the interaction parameter (genotype × obesity) was significant (P=0.0001).Conclusion:In Asian Indians, the DD genotype increases susceptibility to type 2 diabetes by interacting with obesity.International Journal of Obesity (2007) 31, 97–102. doi:10.1038/sj.ijo.0803356; published online 25 April 2006 [ABSTRACT FROM AUTHOR]

Objective:To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians.Design:Analysis of data from multisite cross-sectional epidemiological studies in north India.Subjects:In all, 2050 adult subjects >18 years of age (883 male and 1167 female subjects).Measurements:Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol.Results:In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI >21 kg/m2. WC levels of 90 and 80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of 25 kg/m2. The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study.Conclusion:We propose the following WC action levels for adult Asian Indians: action level 1: men, 78 cm, women, 72 cm; and action level 2: men, 90 cm, women, 80 cm.International Journal of Obesity (2006) 30, 106–111. doi:10.1038/sj.ijo.0803111; published online 27 September 2005 [ABSTRACT FROM AUTHOR]

Context: Studies, mostly from outside the United States, have found high prevalence of diabetes, coronary heart disease (CHD), and hypertension among Asian Indians, despite low rates of associated risk factors.Objective: To analyze the prevalence of obesity, diabetes, CHD, hypertension, and other associated risk factors among Asian Indians in the United States compared to non-Hispanic whites.Design, Setting, and Subjects: Cross-sectional study using data from the National Health Interview Survey (NHIS) for 1997, 1998, 1999, and 2000. We analyzed 87,846 non-Hispanic whites and 555 Asian Indians.Main Outcome Measures: Whether a subject reported having diabetes, CHD, or hypertension.Results: Asian Indians had lower average body mass indices (BMIs) than non-Hispanic whites and lower rates of tobacco use, but were less physically active. In multivariate analysis controlling for age and BMI, Asian Indians had significantly higher odds of borderline or overt diabetes (adjusted OR [AOR], 2.70; 95% confidence interval [CI], 1.72 to 4.23). Multivariate analysis also showed that Asian Indians had nonsignificantly lower odds ratios for CHD (AOR, 0.58; 95% CI, 0.25 to 1.35) and significantly lower odds of reporting hypertension (AOR, 0.58; 95% CI, 0.42 to 0.82) compared to non-Hispanic whites.Conclusion: Asian Indians in the United States have higher odds of being diabetic despite lower rates of obesity. Unlike studies on Asian Indians in India and the United Kingdom, we found no evidence of an elevated risk of CHD or hypertension. We need more reliable national data on Asian Indians to understand their particular health behaviors and cardiovascular risks. Research and preventive efforts should focus on reducing diabetes among Asian Indians. [ABSTRACT FROM AUTHOR]

The article observes that India's embrace of the worst of both Eastern and Western ways is causing the increase in rapid lifestyle diseases such as obesity and diabetes. Topics discussed include statistics on diabetes prevalence from the International Diabetes Foundation (IDF) and the Madras Diabetes Research Foundation as well as thrifty genotypes being tagged as a culprit. Also mentioned are the problem of the thrifty genotype beginning in the womb and screening for gestational diabetes.

The original version of this article contained a mistake in Phase IV: establishing validity and development of norms under Participants section. The below text For establishing validity and norm of DMKT, data were gathered from 300 patients suffering with type 2 diabetes. [ABSTRACT FROM AUTHOR]