Incidence of Type-2 Diabetes among Industrial Workers in Kerala, India

Background

Kerala is the most advanced Indian State in epidemiological transition and the diabetes capital of the country.  However data on incidence of diabetes in Kerala are limited.  We studied the incidence of type 2 diabetes among industrial workers.    

Methodology

We measured fasting plasma glucose (FPG) among 326 workers (mean age 51 years, men 76%) from two major industries in Kerala in the year 2009 and 2011 using standard protocol. Individuals with FPG of >=126 mg/dl or on medications for diabetes were considered to have diabetes mellitus, FPG >=100 mg and <=125 mg as pre-diabetic and FPG <100 as normal. 

Results

Among the 326 workers 26.1% (95% CI 21.6-31.1) were diabetic, 32.8% (CI 28.7-37.2) were pre-diabetic and the remaining 41.1% were having normal FPG at baseline.   At the two year follow-up 30.4% were diabetic, 35.0% were pre-diabetic and 34.7% had normal FPG.  At year two, 13.3% of the 241 workers who were either normal or pre-diabetic at baseline developed diabetes providing an incidence rate of 6.65% per year.  Among the 134 workers with normal FPG at baseline 28.4% progressed to pre-diabetic stage, 5.2% developed diabetes and among the 107 pre-diabetics 23.4% developed diabetes at year two. The odds of progressing to diabetes from pre-diabetes was five times higher compared to those from normal FPG (OR 5.53; CI 2.28-13.37)     

Conclusion

Progression to pre-diabetes and diabetes occurred at a very fast rate in this population indicating the need for preventive measures to slow down this progression.