Spatial pattern and determinants of diagnosed diabetes in southern India: evidence from a 2012-13 population-based survey.

The diabetes epidemic is expanding rapidly in India, with 69.2 million people living with diabetes in 2015. This study assessed the spatial pattern and determinants of diagnosed diabetes prevalence in the districts of six states and one union territory (UT) in southern India - a region that has a high prevalence of diabetes. Using cross-sectional population-based survey data from the 2012-13 District Level Household and Facility Survey-4, the prevalence and magnitude of diagnosed diabetes at district level for the population aged 18 years and above were computed. Moran's I was calculated to explore the spatial clustering of diagnosed diabetes prevalence. Ordinary Least Square (OLS) and Spatial Lag (SL) regression models were carried out to investigate the spatial determinants of diagnosed diabetes prevalence. The prevalence of diagnosed diabetes was found to be substantially higher than that of self-reported diabetes in southern India (7.64% vs 2.38%). Diagnosed diabetes prevalence in the study area varied from 10.52% in Goa to 4.89% in Telangana. The Moran's I values signified positive moderate autocorrelation. Southern India had 14.15 million individuals with diagnosed diabetes in 2012-13. Bangalore had the highest number of persons with diagnosed diabetes, and Palakkad had the smallest number. In the OLS and SL models, the proportion of people with secondary education and above, wealthy and Christian populations were found to be significant determinants of diagnosed diabetes prevalence. In addition, in the OLS model, the proportion of Scheduled Tribe population showed a negative relationship with diagnosed diabetes prevalence. In order to prevent or postpone the onset age for diabetes, there is a need to raise awareness about diabetes in India.