Incidence of diabetes in south Asian young adults compared to Pima Indians

Authors

K M Venkat Narayan, Rollins School of Public Health, Atlanta, Georgia, USA
Dimple Kondal, Public Health Foundation of India, New Delhi, Delhi, India
Sayuko Kobes, National Institute of Diabetes and Digestive and Kidney Diseases Phoenix Epidemiology and Clinical Research Branch, USA.
Lisa R. Staimez, Rollins School of Public Health, Atlanta, Georgia, USA.
Deepa Mohan, Madras Diabetes Research Foundation, Tamil Nadu, India
Unjali P. Gujral, Rollins School of Public Health, Georgia, USA.
Shivani A. Patel, Rollins School of Public Health, Georgia, USA.
Ranjit Mohan Anjana, Madras Diabetes Research Foundation, Tamil Nadu, India
Roopa Shivashankar, Public Health Foundation of India, New Delhi, Delhi, India
Muhammad Masood Kadir, Aga Khan UnviversityFollow

Document Type

Article

Department

Community Health Sciences

Abstract

Introduction: South Asians (SA) and Pima Indians have high prevalence of diabetes but differ markedly in body size. We hypothesize that young SA will have higher diabetes incidence than Pima Indians at comparable body mass index (BMI) levels.
Research design and methods: We used prospective cohort data to estimate age-specific, sex, and BMI-specific diabetes incidence in SA aged 20-44 years living in India and Pakistan from the Center for Cardiometabolic Risk Reduction in South Asia Study (n=6676), and compared with Pima Indians, from Pima Indian Study (n=1852).
Results: At baseline, SA were considerably less obese than Pima Indians (BMI (kg/m²): 24.4 vs 33.8; waist circumference (cm): 82.5 vs 107.0). Age-standardized diabetes incidence (cases/1000 person-years, 95% CI) was lower in SA than in Pima Indians (men: 14.2, 12.2-16.2 vs 37.3, 31.8-42.8; women: 14.8, 13.0-16.5 vs 46.1, 41.2-51.1). Risk of incident diabetes among 20-24-year-old Pima men and women was six times (relative risk (RR), 95% CI: 6.04, 3.30 to 12.0) and seven times (RR, 95% CI: 7.64, 3.73 to 18.2) higher as compared with SA men and women, respectively. In those with BMI <25 kg/m², however, the risk of diabetes was over five times in SA men than in Pima Indian men. Among those with BMI ≥30 kg/m², diabetes incidence in SA men was nearly as high as in Pima men. SA and Pima Indians had similar magnitude of association between age, sex, BMI, and insulin secretion with diabetes. The effect of family history was larger in SA, whereas that of insulin resistance was larger in Pima Indians CONCLUSIONS: In the background of relatively low insulin resistance, higher diabetes incidence in SA is driven by poor insulin secretion in SA men. The findings call for research to improve insulin secretion in early natural history of diabetes.

Comments

Pagination are not provided by the author/publisher

Publication (Name of Journal)

BMJ Open Diabetes Research & Care

Recommended Citation

Narayan, K. V., Kondal, D., Kobes, S., Staimez, L. R., Mohan, D., Gujral, U. P., Patel, S. A., Anjana, R. M., Shivashankar, R., Kadir, M. (2021). Incidence of diabetes in south Asian young adults compared to Pima Indians. BMJ Open Diabetes Research & Care, 9(1), e001988.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/866