Prevalence of known diabetes in Chennai City.

AIM: To determine prevalence of known diabetes in those more than 20 years of age in Chennai city. METHODOLOGY: Urban population was selected for the survey. Assuming the prevalence of known diabetes as 5.0% in those aged > 20 years, the cluster sample size calculated to estimate it with 95% CI and +/- 10% precision, was 25800 individuals of all ages. This population obtained from 200 households in each of 30 randomly selected corporation divisions of the city, was surveyed by social workers by house to house enquiry. General information and health status of every member of the household were recorded on prescribed forms. This survey was conducted during January-July, 1998. RESULTS: Among 26,066 individuals of all ages 779 had known diabetes and 99.4% of them had type 2 diabetes. The prevalence of known diabetes was 2.9% for all ages and both sexes combined. Crude and age-standardized prevalence was 4.9% (95% CI 4.6-5.2) for those aged > 20 years. The standardized prevalence was 10.5% (95% CI 9.8 - 11.2) in those aged > or = 40 years. The prevalence was significantly high (P < 0.05) in females. CONCLUSION: The prevalence of known diabetes was low in total population but increased in those aged > 20 and further increased in those aged > or = 40 years. The causes for high prevalence in > or = 40 year age group needs to be explored in this population.

Prevalence and incidence of type-2 diabetes and impaired glucose tolerance in a selected Indian urban population.

AIM: To study the impact of diabetes mellitus on a selected Indian urban population. METHODS: The staff of Indian Institute of Technology in Chennai and their relatives were screened for diabetes by oral glucose tolerance test (OGTT) in 1992. But those on treatment for diabetes were not screened by OGTT. All those found to have diabetes during initial screening were excluded from further follow-up. Those without diabetes were followed with repeat OGTT one year later in 1993. RESULTS: A total of 1198 persons, 455 (38.0%) females and 743 (62.0%) males, participated in this study. While 116 (9.7%), 80 (69.0%) males and 36 (31.0%) females, suffering from diabetes were exempted from OGTT, the remaining 1082 (90.3%), 663 (61.3%) males and 419 (38.7%) females, were screened by OGTT. Among the 663 males, 450 (67.9%) were normal, 155 (23.4%) had impaired glucose tolerance (IGT) and 58 (8.7%) had diabetes. Among the 419 females, 275 (65.6%) were normal, 120 (28.6%) had IGT and 24 (5.7%) had diabetes. Out of 1000 persons without diabetes, 696 (69.6%), 444 (63.8%) with normal glucose tolerance and 252 (36.2%) with IGT had participated in the repeat screening by OGTT after one year. One (0.7%) normal person and 14 (5.5%) with IGT, progressed to diabetes in one year. All had type-2 diabetes and non type-1 diabetes. Of 444 normal persons 34 (7.7%) developed IGT during one year. CONCLUSIONS: The prevalence of 9.7% and 7.7% for known and newly detected type-2 diabetes respectively and the annual incidence of 2.2% indicate the magnitude of impact of diabetes mellitus on this population. Though IGT was found to be a risk factor, factors leading to its progression to diabetic state could not be identified in this study.

Prevalence of diabetes in the young in south India.

Students from nine schools and one college in Madras city, were screened for diabetes by oral glucose tolerance test. The criteria recommended by the World Health Organization was adopted to classify glucose tolerance. Among 3,515 students, between 5 and 19 years of age, participated in this survey, 1982 (56.4%) were males and 1.533 were (43.6%) females. Family history of diabetes was positive in 302 (8.6%) students. There was no overt case of diabetes of any type. Three (0.09%) males had renal glycosuria. It is therefore concluded that insulin-dependent diabetes, non-insulin dependent diabetes or any other type of diabetes in the young is rare in South India.

Glycosuria and diabetes mellitus in children and adolescents in south India.

In Madras city (India) 10,513 school students between 3 and 20 yr of age were investigated for glycosuria and its causes. While no previously known cases of diabetes mellitus of any type were encountered, four students (0.038%) in the survey population were found to have glycosuria. One (0.009%) had renal glycosuria, two (0.019%) were possibly NIDDY (MODY) and one (0.009%) had transient glycosuria while receiving anti-tuberculous chemotherapy. It is therefore concluded that neither diabetes mellitus nor glycosuria of non-diabetic causes is a crucial health problem in Indian children and adolescents. While the reasons for this are not known, further research in this field could be of global interest.

The effect of consanguinity on the gestation period and anthropometric traits of the new-born in Southern India.

The effect of consanguinity on the period of gestation and the anthropometric characteristics at birth was studied in a southern Indian population. A total of 1000 new-born babies, born without undue birth trauma, developmental anomalies or acute illness were measured on the first day of their life. They were divided into four groups according to the relationship of their parents as uncle-niece, first cousins, beyond first cousins and unrelated. Birth weight, length and head and chest circumferences of both male and female infants were almost equal in consanguineous and non-consanguineous groups. Neither was the period of gestation significantly different. It is therefore concluded that in this population there is no significant effect of consanguinity on the anthropometric characteristics at birth as well as on the gestation period.

Reproductive wastage and developmental disorders in relation to consanguinity in south India.

The effect of consanguinity on fertility, reproductive loss and developmental disorders were studied in 156 consanguineous marriages in comparison with 221 non-consanguineous marriages. Although fertility was greater (P less than 0.05) in consanguineous than in non-consanguineous marriages, the number of living children were approximately equal in both groups, on account of increased child mortality in the former (P less than 0.05). The frequencies of abortion and stillbirth were (also) approximately equal in both groups. Developmental anomalies were significantly more frequent (P less than 0.001) among the offspring of consanguineous parents. These results indicate the continued presence of deleterious genes in this population, in spite of the practice of consanguinity over many generations.

PIP: The effect of consanguinity on fertility, reproductive loss, and development disorders were studied in South India. The population investigated included 377 unselected mothers who, along with their children, were followed up longitudinally. Each mother was interviewed regarding consanguinity, details of reproductive performance, and death of any offspring. Marriages were classified as unrelated or between uncle and niece, between first cousins, between first cousins once removed, between second cousins, between second cousins once removed, and between third cousins. Among the 377 marriages, 156 (41.4%) were consanguineous and 221 (58.6%) were nonconsanguineous. Consanguinity was more prevalent among Hindus than among Muslims or Christians. The mean and standard deviation in the age of women were similar in all age categories at the time of the study, but the numbers of pregnancies and live births were higher in consanguineous than in nonconsanguineous unions. The mean number of living children were not significantly different in the 2 groups. Although the intrauterine wastage showed no significant difference between the 2 groups, extrauterine loss of life, especially the death rate of children, was higher in the consanguineous marriages. The causes of death in the nonconsanguineous group were diptheria, tuberculosis meningitis, acute nephritis, convulsive disorder, and brain abscess. The causes of death in the consanguineous group were measles with complications, gastroenteritis, pyogenic meningitis, whooping cough, convulsive disorder, undiagnosed fever, burns, and undiagnosed illness with persistent vomiting. In regard to developmental anomalies, in only 1 instance was the condition unequivocally due to autosomal recessive inheritance. In the majority of the remaining cases the disorders were polygenic or multifactorial in origin. The frequency of developmental anomalies was significantly more frequent among the children of consanguineous parents.

Adequacy of breast milk for optimal growth of infants.

The weights and heights of 384 breast-fed and bottle-fed infants were studied during the first year of life. The growth of breast-fed infants was superior to that of bottle-fed infants in both sexes. The mean weights and heights of breast-fed male infants were similar to the Harvard standard up to 28 weeks of age. The growth of breast-fed female infants was only parallel to the Harvard standard up to 16 weeks of age, their measurements being lower than Harvard standard from birth, the differences increasing with increasing age. While none of the breast-fed infants suffered severe malnutrition 6% of bottle-fed infants were marasmic at one year of age. Breast milk fulfills the nutritional requirements of infants for four to six months after birth but supplementary feeding is necessary thereafter to maintain optimal growth. Bottle-fed babies are prone to undernutrition because of inadequate calories offered. This risk can be avoided by providing adequate nourishment.