Abstract
There has been a huge increase in diabetes and its associated cardiovascular complications over the last decade, predominantly in the middle- and low-income countries. In these countries, the majority live in rural areas. The Rural Epidemiology of Diabetes in South India (REDSI) study was aimed to analyze the prevalence of diabetes, cardiovascular risk factors, and its complications in rural farming and non-farming villages in Tamil Nadu, South India. A research survey on the prevalence of self-reported diabetes, cardiovascular risk factors (age, sex, obesity, hypertension, hypercholesterolemia, alcohol and tobacco use) and agricultural occupational exposure was executed among 106,111 people from 61 villages in the state of Tamil Nadu, South India, during 2015–2018. Overall, we observed a diabetes prevalence of 11.9% in rural South India. A nearly two-fold higher prevalence of diabetes was observed among the farming community (15.0%) compared to that among the non-farming population (8.7%). Logistic regression analyses revealed a strong association with agrochemical exposure (P < 0.0001) and diabetes prevalence among rural farming people. Our survey indicates a high prevalence of diabetes in rural South India particularly among the farming community. This survey in conjunction with other epidemiological and experimental studies raises the need for understanding the etiology of diabetes and other cardiovascular risk factors in rural communities.
Highlights
The world has witnessed a massive increase in the prevalence of diabetes and its complications during the period 1980–2014 [1]
We had equal representation of both sexes, and 32% of the population were below 35 years and 10% of the population were aged more than 65 years (Table 1)
51.7% are involved in farming activities, and they are sub-categorized into pesticide applicators, agrochemical handlers, and field workers based on their level of exposure to agrochemicals
Summary
The world has witnessed a massive increase in the prevalence of diabetes and its complications during the period 1980–2014 [1]. The epidemic of diabetes prevalence is of several orders of magnitude especially in middleand low-income countries, which are predominantly occupied by rural communities [2]. It has been generally thought that urbanization, westernization, and affluence have significant roles in the explosion of diabetes, but we believe that these factors alone could not explain the diabetes epidemic in middle- and low-income countries, especially in rural areas. Studies from different regions of the world indicated the increasing prevalence of diabetes and other metabolic diseases in rural communities [3,4,5,6,7,8]
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