Incidence of diabetes rising in rural areas of Tamil Nadu: Study

CHENNAI: It is usually believed that people in rural areas adhere to a traditional lifestyle that includes more physical activity and access to a diet that is more nutrient-rich and contains fewer processed foods, one would anticipate a low prevalence of diabetes. However, recent research shows that the frequency of diabetes is rapidly growing in rural areas, especially in low and middle-income countries.

In India, this is particularly prominent in the more socio economically developed states such as Tamil Nadu residents appear to be particularly affected. A recent expert study found that, when compared to its cities, the incidence of diabetes is rising rapidly among the poor in Tamil Nadu's villages. Adult obesity rates in Tamil Nadu have also increased from 5.6 per cent in 2010 to 6.9 per cent in 2016.

It is derived that the prevalence rate of diabetes in cities has reached 25 percent, close to saturation point at which, essentially, all those who are prone to diabetes would have got it; therefore, any further rise in prevalence would be unlikely. On the other hand, villages are steadily getting more urbanised especially in States like Tamil Nadu. Lifestyles are gradually changing to resemble those in the urban areas, and better education and awareness levels imply that most cases of diabetes will be identified and fewer will remain undetected.

The Madras Diabetes Research Foundation (MDRF), in collaboration with the University of Dundee in Scotland has conducted a study called Telemedicine Project for Screening Diabetes and Its Complications in Rural Tamil Nadu (TREND). Using laboratory tests, retinal images, and questionnaires, researchers have screened more than 8,000 people over the age of 18 from approximately 25 villages in the Cheyyur taluk of the Kancheepuram district since 2018.

The preliminary findings of this study show that the prevalence of diabetes in a village in Kancheepuram district increased from 4.9 per cent in 2006 to 13.5 per cent this year. The prevalence of diabetes in Chennai also increased during the same time period, but the pace of increase was much slower (from 16 per cent to 25 per cent.)

At least 18.2 per cent of those who were screened in the most recent study had pre-diabetes, up from 14.6 per cent in 2006. About a third of the people screened either had diabetes or were at risk for developing it. Due to a lack of awareness, people with pre-diabetes in rural areas are more likely to progress to diabetes, say experts.

There are a number of factors contributing to the rise in diabetes in rural areas. Chief Diabetologist Dr V Mohan says that people do not know enough about the disease and what causes it. "People do not take preventive measures to avoid getting the disease because of this. In the farming community, diabetes may also be caused by a high carbohydrate intake, a lack of adherence to diet guidelines, medications, and decreased physical activity as a result of the introduction of agricultural machinery. Regular medical check-up is not done."

He added that one of the fears that people have is that they will have to take their medication for the rest of their lives. Moreover, there is less access to healthcare facilities in rural areas. People have a harder time getting the disease diagnosed and treated because of this.

Dr Ranjit Unnikrishnan, Vice Chairman - Consultant Diabetologist at Dr. Mohan's Diabetes Specialities Centre pointed out that people in rural areas are rapidly transitioning from a vigorously active to a sedentary lifestyle.

"Availability and affordability of tractors and other agricultural machinery have reduced occupational physical activity in the villages. Rural diets frequently contain a lot of sugar and refined carbohydrates, which can also cause diabetes. People's diets are shifting away from nutritious home-cooked meals and toward processed and junk food as rural areas become increasingly urbanised. People are now eating more polished white rice and refined sugar, both of which raise blood glucose levels, in place of traditional foods," he said