Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study

J Diabetes Complications. 2021 Dec;35(12):108051. doi: 10.1016/j.jdiacomp.2021.108051. Epub 2021 Sep 25.

Abstract

Aims: To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study.

Materials and methods: The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed.

Results: Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers.

Conclusions: Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.

Keywords: Diabetes; Hypertension; INDIAB; India; Migration; Obesity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Diabetes Mellitus* / epidemiology
  • Female
  • Humans
  • Hypertension* / epidemiology
  • India / epidemiology
  • Male
  • Middle Aged
  • Obesity* / epidemiology
  • Prevalence
  • Risk Factors
  • Rural Population / statistics & numerical data
  • Transients and Migrants* / statistics & numerical data
  • Urban Population* / statistics & numerical data