PREVALENCE OF DIABETIC RISK FACTORS IN MEDICAL STUDENTS

Dr SP Miital, Dr Kiranjeet Kaur

Abstract


Background: India prosperity associated with rise in altered lifestyle and dietary habits, so also the metabolic diseases. This prompted us to search risk factors in medical students.

 Material and Method: 450 medical students were studied.

Results: 421 students (182 male and 239 female) had completed the study. Mean age of male (M) and female (F) students was 19 ± 1.128. Diabetes mellitus (DM) was comparatively common in relatives of female students. 32.78% students had obese relatives, especially paternal diabetic, and both parental and maternal diabetic relatives, Hypertension (HTN) [M=13.74% & F= 18.41%] and coronary artery disease (CAD). Underweight students were 48 [M= 19 & F= 29] and overweight 191 [M= 91 & F= 100]. 31.61% male students had waist ≥ 90 cm and 32.42% female ≥ 80 cm, and  Waist – Hip Ratio (WHR) ≥0.90 in 38.06% male and ≥ 0.80 in 36.53% female. Low birthweight students were 26 (M= 7 & F= 19) and high birthweight 9 (M=5 & F=4). Systolic HTN was present in 31 (M=26 & F=5) and diastolic HTN in 32 (M=18 & F=14). One male was diabetic and 3 female had Glucose Intolerance and 4 had PCOD.

Conclusion: Students, particularly female and “normal-weight metabolically obese”, were at risk of developing DM, obesity, HTN and CAD. Parental DM determined high birth weight. Most of female students were underweight, suggesting DM in lean subjects may shift from male to female. “Obesity paradox” present in students because of “metabolically unhealthy normal-weight”.


Keywords


Obesity, physical inactivity, “obesity paradox”

Full Text:

PDF

References


Crozan Barba, Anura Kurpad, K Srinath Reddy, et al. Appropriate body–mass index for Asian population and its implications for policy and intervention strategies (WHO expert consultation). The Lancet 2004; 363: 157-63.

FrankB, Hu. Globalization of Diabetes. Diabetes Care 2011 Jun; 34(6):1249 -1257.

WHO Scientific Group on the Prevention and Management of Osteoporosis (2000: Geneva, Switzerland) (2003). “Prevention and Management of Osteoporosis: report of WHO scientific group”. Retrieved 2007 – 05-31.

Chan JC, Malik V, Jia W, et al. Diabetes in Asia epidemiology, risk factors and pathophysiology. JAMA 2009;301:2129-2140.

Yang W, Lu J, Weng J, et al. China National Diabetes and Metabolic Disorders Study Group: Prevalence of diabetes among men and women in China. N Eng J Med 2010; 361:1090-1101.

Ramachandran A, Mary S, Yamuna A, et al. High prevalence of diabetes and cardiovascular risk factors associated with urbanisation in India. Diabetes Care 2008;31:893-898.

Yoon KH, Lee JH, Kim JW, et al. Epidemic obesity and type 2 diabetes in Asia. Lancet 2006;368: 1681-1688.

Abdulbari Bener, Mohammad T Yousafzai, Abdulla OAA Al-Hamaq, et al. Parental transmission of type 2 diabetes mellitus in a highly endogamous population. World J Diabetes 2013 Apr 15; 4(2): 40–46.

B. Balkau, R. Roussel, S. Wagner, et al. Transmission of Type 2 diabetes to sons and daughters: the D.E.S.I.R. cohort. Diabetic Medicine 2017 (Research: Epidemiology); Volume 34, Issue 11.

Yang W, Lu J, Weng J, et al.Prevalence of diabetes among men and women in China. N Engl J Med 2010 Mar 25;362(12):1090-101.

Ramachandran A, Snehalatha C, Kapur A, et al. Diabetes Epidemiology Study Group in India (DESI): High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001; 44:1094–1101.

Mohan V, Vijayaprabha R, Rema M, et al.. Clinical profile of lean NIDDM in South India. Diabetes Res Clin Pract 1997;38:101–108.

S Krishnamoorthy, J Gridhar Muthu, S R Ramakrishna, et al. Clinical and Biochemical Profile of Lean Body Weight Type 2 Diabetics, Normal Weight and Obese Diabetes. Journal of Evolution of Medical and Dental Sciences 2015; Vol 4(71):12397 – 12413.

Sidharth Das. Low Bodyweight Type 2 Diabetes Mellitus. Journal of Nutritional & Environmental Medicine 1999; Vol 9(3):229-239.

T Aggarwal, RC Bhatia, D Singh, et al. Prevalence of Obesity and Overweight in Affluent Adolescents from Ludhiana, Punjab (Short Communication). J Indian Paediatrics 2008;45:500-502.

Thomas Harder, Elke Rodekamp, Karen Schellong, et al. Weight and Subsequent Risk of Type 2 Diabetes: A Meta-Analysis. American Journal of Epidemiology 2007; Vol 165(8): 849–857.

Barker DJ, Hales CN, Fall CH, et al. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 1993; Vol. 36: 62-67.

McCance DR, Pettitt DJ, Hanson RL, et al. Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype? BMJ 1994; Vol. 308:942-945.

Wei JN, Sung FC, Li CY, et al. Low birth weight and high birth weight—infants are both at an increased risk to have type 2 diabetes among schoolchildren in Taiwan. Diabetes Care 2003; Vol.26: 343-348.

Donghua Mi,, Hongjuan Fang, Yaqun Zhao, et al. Birth weight and type 2 diabetes: A meta-analysis. Exp Ther Med 2017; Vol14(6):5313-5320.

Lithell HO, McKeigue PM, Berglund L, et al. Relation of size at birth to non-insulin dependent diabetes and insulin concentrations in men aged 50–60 years. BMJ (Clinical research ed) 1996;312:406–410.

Phillips DI, Hirst S, Clark PM, et al. Fetal growth and insulin secretion in adult life. Diabetologia 1994;37:592–596.

Mooorthi MMS, Nadesan B, Ramalingam E, et al. A study of maternal factors influencing very low birth weight babies. Int J Contemp Pediatr 2017;4:1173–1178.

Mortensen B, Hingst JR, Frederiksen N, et al. Effect of birth weight and 12 weeks of exercise training on exercise-induced AMPK signaling in human skeletal muscle. Am J Physiol Endocrinol Metab 2013;304:E1379–E1390.

von Bonsdorff MB, Muller M, Aspelund T, et al. Persistence of the effect of birth size on dysglycaemia and type 2 diabetes in old age: AGES-Reykjavik study. Age (Dordr) 2013;35:1401–1409.

Taylor DJ, Thompson CH, Kemp GJ, et al. A relationship between impaired fetal growth and reduced muscle glycolysis revealed by 31P magnetic resonance spectroscopy. Diabetologia 1995;38:1205–1212.

Vejrazkova D, Lukasova P, Vankova M, et al. Gestational diabetes-metabolic risks of adult women with respect to birth weight. Physiol Res 2015;64(Suppl 2):S135–S145.

Ong KK, Ahmed ML, Emmett PM, et al. Association between postnatal catch-up growth and obesity in childhood: Prospective cohort study. BMJ (Clinical research ed) 2000;320:967–971.

Fowden AL, Forhead AJ. Endocrine interactions in the control of fetal growth. Nestle Nutr Inst Workshop Ser 2013;74:91–102.

Stocker C, O'Dowd J, Morton NM, et al. Modulation of susceptibility to weight gain and insulin resistance in low birth weight rats by treatment of their mothers with leptin during pregnancy and lactation. Int J Obes Relat Metab Disord 2004;28:129–136.

Amrutha Mary, George Amith, George Jacob, et al. Lean diabetes mellitus: An emerging entity in the era of obesity. World J Diabetes 2015 May 15; 6(4): 613–620.

Jung-Nan Wei, Fung-Chang Sung, Chung-Yi Li, et al. Low Birth Weight and High Birth Weight Infants Are Both at an Increases Risk to Have Type 2 Diabetes Among School children in Taiwan. Diabetes Care 2003; 26(2):343-348.

Viswanathan M, McCarthy MI, Snehalatha C, et al. Familial aggregation of type 2 (non-insulin-dependent) diabetes mellitus in South India; absence of excess maternal transmission. Diabet Med 1996;13:232–237.

Shera AS, Rafique G, Khawaja IA, et al. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in Baluchistan province. Diabetes Res Clin Pract 1999;44:49–58.

Karter AJ, Rowell SE, Ackerson LM, et al. Excess maternal transmission of type 2 diabetes: the Northern California Kaiser Permanente Diabetes Registry. Diabetes Care 1999; 22:938–943.

Johnsson IW, Haglund B, Ahlsson F, et al. A high birth weight is associated with increased risk of type 2 diabetes and obesity. Pediatr Obes 2015;10(2):77-83.

Carnethon MR, De Chavez PJ, Biggs ML, Lewis CE, Pankow JS, Bertoni AG, et al. Association of weight status with mortality in adults with incident diabetes. JAMA 2012;308:581–590.

NathalieEckel, KristinMühlenbruch, KarinaMeidtner, et al. Characterization of metabolically unhealthy normal-weight individuals: Risk factors and their associations with type 2 diabetes. Metabolism 2015;64(8):862-871.

Patrick T. Bradshaw, Keri L. Monda, and June Stevens. METABOLIC SYNDROME IN HEALTHY OBESE, OVERWEIGHT AND NORMAL WEIGHT INDIVIDUALS: THE ATHEROSCLEROSIS RISK IN COMMUNITIES STUDY. Obesity (Silver Spring) 2013; 21(1): 203–209.


Refbacks

  • There are currently no refbacks.