Spatial clustering of diabetes among reproductive age women and its spatial determinants at the district level in southern India

Abstract

BackgroundFew recent studies have demonstrated that in India diabetes prevalence varies geographically. Differences in individual-level factors and socioeconomic status are common explanations for this variation. However, we have not come across any study on diabetes spatial clusters at the district-level among reproductive-age women in southern India. Therefore, the study was carried out to understand the spatial clustering of diabetes prevalence among reproductive-age women and its spatial determinants in southern India. MethodsNational Family Health Survey (2015–16) data was used to estimate High Blood Glucose (HBG) and Very High Blood Glucose (VHBG) prevalence for women aged 15–49 years in 99 districts of southern India. We adopted advanced spatial statistical analysis such as Moran's Index and spatial regression techniques to address the study objectives. ResultsRemarkable variations were found in HBG and VHBG prevalence among 99 districts in southern India. Spatial association of HBG was found in 4 districts, and VHBG was found in 7 districts, which were hotspots. The value of the bivariate Moran's I statistics confirmed the spatial dependence between HBG and VHBG with a set of independent variables. District-level prevalence of HBG and VHBG have shown significant spatial clustering across southern Indian districts. The adjusted coefficients from the spatial error model confirmed that district-level proportion of tobacco use, overweight, obese, and general caste had significant associations with HBG and VHBG prevalence. ConclusionThe study suggests that there is need for targeted intervention programs to address diabetes among reproductive-age women in high priority districts in southern India.