Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2024; 13(4): 91638
Published online Dec 9, 2024. doi: 10.5409/wjcp.v13.i4.91638
Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India
Vansh Maheshwari, Saurav Basu
Vansh Maheshwari, Saurav Basu, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurugram 122102, Haryana, India
Author contributions: Maheshwari V contributed to the formal analysis and writing of the first draft; Basu S contributed to the concepts, methodology, writing, reviewing and editing of the manuscript; Both authors read and approved the final version of the manuscript.
Institutional review board statement: NFHS-5 was conducted in compliance with ethical guidelines and received approval from the ethics review board of the International Institute of Population Sciences, Mumbai, India.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Saurav Basu, MBBS, MD, Associate Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, 3rd Floor, Sohna Road, Mumbai Expressway, Bhondsi Near Maruti Kunj, Gurugram 122102, Haryana, India. saurav.basu1983@gmail.com
Received: January 1, 2024
Revised: August 30, 2024
Accepted: September 25, 2024
Published online: December 9, 2024
Processing time: 303 Days and 4.3 Hours
Abstract
BACKGROUND

Globally, obesity and diabetes mellitus (DM) are emergent public health concerns in the adolescent population. India, home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization, with accompanying unhealthy nutritional transition, and sedentary lifestyle.

AIM

To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents (15-19 years) in India.

METHODS

This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India (2019-2021). The survey employed stratified two-stage sampling, with systematic random sampling in rural and urban areas. Statistical analysis included descriptive statistics, bivariate, and multivariable logistic regression, employing generalized linear models.

RESULTS

The weighted prevalence of DM was 1.09% including 0.77% [95% confidence interval (CI): 0.72-0.83] previously diagnosed and 0.32% (95%CI: 0.29-0.35) newly diagnosed cases detected on survey screening. On adjusted analysis, increasing age, higher education levels, higher wealth index, and overweight/obesity were the factors significantly associated with presence of DM. Only 61% of the adolescents with previously diagnosed DM were on anti-diabetes treatment. The weighted prevalence of overweight/obesity among older adolescents was 6.9% with significantly higher odds in the male sex, having higher educational levels, urban residence, and those with a higher wealth index.

CONCLUSION

Nearly one in hundred older adolescents in India have diabetes, with one in three undiagnosed. Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

Keywords: Obesity; Hyperglycaemia; Adolescents; Diabetes; India

Core Tip: In resource-limited settings, 3 in 10 older adolescents with diabetes (DM) are undiagnosed due to lack of screening while only 6 in 10 older adolescents previously diagnosed with DM utilize anti-diabetes medication. Primary care physicians including paediatricians in outpatient settings should necessarily screen older adolescents with family history or those who are overweight or obese for DM. Furthermore, they should advise older adolescents to engage in regular physical activity and exercise to maintain normal body weight even in the absence of hyperglycaemia. Finally, medication adherence in older adolescents with DM should be assessed during each appointment accompanied with regular counselling.