Shammi Luhar1,2, Dimple Kondal3, Rebecca Jones4, Ranjit M Anjana5, Shivani A Patel6, Sanjay Kinra7, Lynda Clarke8, Mohammed K Ali6, Dorairaj Prabhakaran3,9, M Masood Kadir10, Nikhil Tandon11, Viswanathan Mohan5, K M Venkat Narayan6. 1. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. sl989@medschl.cam.ac.uk. 2. Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK. sl989@medschl.cam.ac.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. 6. Hubert Department of Global Health, Emory University, Atlanta, GA, USA. 7. Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 8. Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK. 9. Public Health Foundation of India, Gurgaon, India. 10. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. 11. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
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. Graphical 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. Graphical abstract.
Entities:
Keywords:
Body mass index; Diabetes; Diabetes-free life expectancy; India; Lifetime risk; Metropolitan cities; Urban
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