About this item:

24 Views | 15 Downloads

Author Notes:

Correspondence: Shammi Luhar, sl989@medschl.cam.ac.uk

Author contributions: SL, RJ, SK, LC and KMVN all helped develop the concept and design the study. The acquisition of data was done by DK, RMA, MKA, SAP, DP, MK, VM, NT and KMVN. Statistical analysis of the data was performed by SL.

All authors made substantial contributions to the interpretation of results. SL and KMVN drafted the manuscript and all authors contributed to the critical revision of the manuscript for important intellectual content.

SL had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final manuscript for publication.

Disclosures: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.


Research Funding:

This specific research was funded by the Economic and Social Research Council (https://esrc.ukri.org; grant no. ES/J500021/1 to SL).

CARRS 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.

KMVN, MKA and SAP were funded in part by the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH under award no. 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 no. R01HL125442.

SAP, KMVN, MKA, NT and DP were supported in part by the NHLBI of the NIH, award no. 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, NIH under grant no. D43TW009135.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Endocrinology & Metabolism
  • Body mass index
  • Diabetes
  • Diabetes-free life expectancy
  • India
  • Lifetime risk
  • Metropolitan cities
  • Urban
  • Body mass index
  • Progression
  • Prevalence
  • Mellitus
  • States

Lifetime risk of diabetes in metropolitan cities in India

Show all authors Show less authors


Journal Title:



Volume 64, Number 3


, Pages 521-529

Type of Work:

Article | Final Publisher PDF


Aims/hypothesis We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI. Methods A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010–2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008–2015). Results Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI. Conclusions/interpretation Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country.

Copyright information:

© The Author(s) 2020

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
Export to EndNote