Prevalence of Diabetes Mellitus and Its Risk Factors among Permanently Settled Tribal Individuals in Tribal and Urban Areas in Northern State of Sub-Himalayan Region of India
Background. Effect of urban environment on the development of DM and its risk factors is studied with an ecological fallacy due to their study designs that formulate the background for the present study. Objective. To study the prevalence of DM and associated lifestyle related risk factors in traditional tribal individuals residing in tribal area and migrating persons of the same tribe to urban area of sub-Himalayan northern state of India. Methodology. Population based cross-sectional study. Results. A total of 8000 individuals (tribal: 4000; urban: 4000) were recruited. Overall, among urban tribes the prevalence of central obesity (59.0%), overweight (29.3%), stage 1 (22.8%) and stage 2 (5.3%) hypertension, and DM (fasting: 7.8%; OGTT: 8.5%) was significantly higher than the tribes of tribal area. Based on OGTT, the prevalence of DM was found to be 9.2% among central obese tribes of urban area and 6.7% of tribal area . DM showed a significant high prevalence among urban tribes with prehypertension (urban: 8.3%; tribal: 2.9%; ), and stage 1 (urban: 14.1%; tribal: 8.7%; ) and stage 2 (urban: 17.5%; tribal: 13.9%; ) hypertension. Conclusion. Urban environment showed a changing lifestyle and high prevalence of DM among tribal migrating urban tribes as compared to traditional tribes. 1. Introduction Emerging trend of diabetes mellitus (DM) is observed worldwide, as by 2025, its prevalence is projected to be 6.3%, which is a 24.0% increase compared with 2003. There will be 333 million (a 72.0% increase) diabetics by 2030 in individuals of 20 to 79 years of age. The developing world (mainly central Asia and Sub-Saharan Africa) accounted for 141 million people with diabetes (72.5% of the world total) in 2003 [1]. Environmental factors like obesity (central or general), physical inactivity, and diet (saturated fats and transfatty acids) and socioeconomic factors are responsible for development of DM [2–6]. Diet rich in polyunsaturated fats and long chain omega-3 fatty acids reduces the risk for DM [7]. Along with the rising trend of DM, rapid urbanization has been observed as from 2008 to 2030 the global urban population will increase by 1.6 billion people (from 3.3 billion to 4.9 billion). While during the same period the rural population is going to reduce by 28 million. This demographic transition will largely take place in developing countries (particularly in Asia and Africa), as by 2030, the developing world population will constitute more than 80% of the world’s urban population [2, 3]. United Nations (UN) recognized that urbanization has health
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