Objective: To describe the natural history of diabetes in Indians.
Research Design and Methods: Data are from CARRS longitudinal study participants aged ≥20 years. Glycemic states were defined per ADA criteria. Markov models estimated annual transition probabilities, and sojourn time through states.
Results: Among 2714 diabetes-free participants, 641 had isolated impaired fasting glucose (iIFG), and 341 had impaired glucose tolerance (IGT). The annual transition to diabetes for IGT was 13.9% (12.0%, 15.9%) vs 8.6% (7.3%, 9.8%) for iIFG. In the normoglycemia iIFG diabetes model, mean sojourn time in normoglycemia was (40.3; 34.6, 48.2 years) while sojourn time in iIFG was (9.7; 8.4, 11.4 years). For the normoglycemia IGT diabetes model, mean sojourn time in normoglycemia was 34.5 (29.5, 40.8) while sojourn time in IGT was (6.1;5.3, 7.1 years).
Conclusion: Individuals reside in normoglycemia for 35-40 years, however, progression from prediabetes to diabetes is rapid.
Funding
The CARRS Study was funded in part by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C and the United Health Group, Minneapolis, MN, USA, and by NHLBI Award Number PO1HL154996. KMVN, MKA, UPG, and SAP were funded in part by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK111024. KMVN was funded in part for “Worksite Lifestyle Program for Reducing Diabetes and Cardiovascular Risk in India project funded by NHLBI, NIH Department of Health and Human Services under Award number R01HL125442. SAP was funded in part by Department of Health and Human Services, National Institutes of Health, NHLBI under Award Number 5U01HL138635-02.
SAP, KMVN, MKA, NT, and DP were supported in part by the Institutes of Health (NIH), award number 5U01HL138635 under the Hypertension Outcomes for T4 Research within Lower Middle-Income Countries (Hy-TREC) program. DK has been supported by Fogarty International Center for PH leader Course, National Institutes of Health under grant number (D43TW009135).
