Lifetime risk of diabetes in metropolitan cities in India
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Lifetime risk of diabetes in metropolitan cities in India Shammi Luhar 1,2 & Dimple Kondal 3 & Rebecca Jones 4 & Ranjit M. Anjana 5 & Shivani A. Patel 6 & Sanjay Kinra 7 Lynda Clarke 2 & Mohammed K. Ali 6 & Dorairaj Prabhakaran 3,8 & M. Masood Kadir 9 & Nikhil Tandon 10 & Viswanathan Mohan 5 & K. M. Venkat Narayan 6
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Received: 29 July 2020 / Accepted: 5 October 2020 # The Author(s) 2020
Abstract Aims/hypothesis We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI. Methods A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010–2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008–2015). Results Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI. Conclusions/interpretation Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country. Keywords Body mass index . Diabetes . Diabetes-free life expectancy . India . Lifetime risk . Metropolitan cities . Urban
Abbreviations CARRS CBG FPG HIC
ICMR-INDIAB cArdiometabolic Risk Reduction in South Asia study Capillary blood glucose Fasting venous plasma glucose High-income country
* Shammi Luhar [email protected] 1
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
2
Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
3
Centre for Chronic Disease Control (CCDC), New Delhi, India
4
Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
5
Madras Diabetes Research Foundation, Chennai, India
LMIC SAGE SRS
Indian Council of Medical Research–INdia DIABetes Low- to middle-income country Study on global AGEing and adult health Sample Registration System
6
Hubert Department of Global Health, Emory University, Atlanta,
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