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WHAT IS DRIVING THE DIABETES EPIDEMIC IN INDIA?

CHAIRMAN & CHIEF OF DIABETOLOGY Dr.Mohan’s DIABETES SPECIALITIES CENTRE . &. DIRECTOR MADRAS DIABETES RESEARCH FOUNDATION . Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Gopalapuram, Chennai. Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Anna Nagar, Chennai. India. Hyderabad.

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WHAT IS DRIVING THE DIABETES EPIDEMIC IN INDIA?

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  1. CHAIRMAN & CHIEF OF DIABETOLOGY Dr.Mohan’sDIABETES SPECIALITIES CENTRE & DIRECTOR MADRAS DIABETES RESEARCH FOUNDATION Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Gopalapuram, Chennai Dr. Mohan’sDIABETES SPECIALITIES CENTRE, Anna Nagar, Chennai India Hyderabad Chennai (Formerly Madras) MADRAS DIABETES RESEARCH FOUNDATION, Gopalapuram, Chennai Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Jubilee Hills, Hyderabad WHAT IS DRIVING THE DIABETES EPIDEMIC IN INDIA? Dr.V.Mohan., M.D., F.R.C.P (UK)., F.R.C.P (Glasg)., Ph.D., D.Sc., FNASc.,

  2. DIABETES: TOP 10 COUNTRIES Wild S et al, WHO Report, Diabetes Care, 2004

  3. Genetic factors? Environmental [Diet / physical activity] factors? Gene – Environment Interaction? QUESTION : IS THIS DIABETES EPIDEMIC DUE TO… OR

  4. PPAR-g GENE: PRO12ALA POLYMORPHISM p=0.006 South Indians in Chennai South Asians in Dallas Caucasians in Dallas Radha V et al, Diabetes Care, 2006 [in press]

  5. CHANGING FACE OF INDIA • Demographic transition • Epidemiological transition • Rapid Urbanization • Industrialization • Increasing income levels • Changing lifestyles, values and culture

  6. DEMOGRAPHIC TRANSITION IN INDIA Expectation of life at birth in the year : 1951 – 41 years; 2000 – 64 years

  7. URBANIZATION IN INDIA       Number of metropolitan cities 1901 1 1951 5 1991 23 2001 40 URBANIZATION AND ECONOMIC GROWTH In 15 years from now > 50% of Indians will be in Urban cities Source:http//urbanindia.nic/scene.htm

  8. VISIBLE FAT CONSUMPTION AND PREVALENCE OF NEWLY DIAGNOSED DIABETES AND IGT * * * p<0.05 for the trend Saroja Raghavan et al, Chennai Urban Population Study, 2006

  9. PREVALENCE OF DIABETES IN RELATION TO PHYSICAL ACTIVITY Mohan V et al, Diabet Med. 2005,22:1206-11

  10. SYNERGISTIC EFFECT OF HERITABILITY AND PHYSICAL ACTIVITY ON GLUCOSE INTOLERANCE Chennai Urban Population Study Family history negative + Physical active Reference Family history positive + Physical active 2.5 times higher risk Family history negative + Sedentary 2.0 times higher risk Family history Positive + Sedentary 3.0 times higher risk Mohan V et al, J Assoc Physicians India, 51:771-777, 2003

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