Top

Journal of Immigrant and Minority Health

Published in:

01-04-2018 | Original Paper

Diabetes in Immigrant Tibetan Muslims in Kashmir, North India

Authors: Mirza Shohiab Ur Riyaz, Majid Khalil Rather, Parvaiz A. Koul

Published in: Journal of Immigrant and Minority Health | Issue 2/2018

Abstract

Tibetan Muslims have migrated from Lhasa (3000 m altitude) to Srinagar, India (altitude 1500 m) about 55 years back. We set out to study the prevalence of diabetes and prediabetes among this immigrant population. All consenting adults aged ≥18 years were questioned about a previous history of diabetes or any other medical history. Anthropometric data were recorded. Fasting blood glucose was measured in duplicate by Accu-check glucometer and HbA1C levels were measured. Of the 281 participants, 26 (9.25%) had diabetes whereas 46 (16.4%) had pre-diabetes; 24 reporting doctor-diagnosed diabetes. Participants with diabetes/pre-diabetes were more likely to be obese, smokers and hypertensive. Multiple logistic regression analysis revealed age to be significantly associated with a higher prevalence of diabetes. One in four adults ≥18 years among Tibetan Muslims have diabetes or prediabetes. Migration to lower altitude could have contributed to this high prevalence.

Kawate R, Yamakido M, Nishimoto Y, Bennett PH, Hamman RF, Knowler WC. Diabetes mellitus and its vascular complications in Japanese migrants on the island of Hawaii. Diabetes Care. 1979;2:161–70.CrossRefPubMed

Bennet PH, Rushforth NB, Miller M, LeCompte PM. Epidemiological studies on Diabetes mellitus in Pima Indians. Recent Prog Horm Res. 1976;32:333–76.

Mather HM, Keen H. The Southall diabetes survey; prevalence of known diabetes in Asians and Europeans. Br Med J. 1985;291:1081–4.CrossRef

Ramiya K L, Kodali V R, Alberti K. Epidemiology of diabetes in Asian of the Indian Subcontinent. Diabetes Metab. 1990;6:125–146.CrossRef

Abate N, Chandalia M. Ethnicity and type 2 diabetes: focus on Asian Indians. J Diabetes Complicat. 2001;15:320–7.CrossRefPubMed

Petousi N, Robbins PA. Human adaptation to hypoxia of high altitude: Tibetan Paradigm from pre genomic to post genomic era. J Appl Physiol. 2014;116(7):875–84.CrossRefPubMed

Aldenderfer M. Peopling the Tibetan Plateau: insight from archaeology. High Alt Med Biol. 2011;12:141–147.CrossRefPubMed

Shaopeng Xu, Zapei Jiayong, Bin Li, Hong Zhu, Hong Chang, Wei Shi, et al. Prevalence and clustering of cardiovascular risk factors among Tibetan adults in China. PLoS One. 2015;10(6):e0129966.CrossRef

Sherpa LY, Deji, Stigum H, Chongsuvivatwong V, Nafstad P, Bjertness E. Prevalence of metabolic syndrome and common metabolic components in high altitude farmers and herdsmen at 3700 m in Tibet. High Alt Med Biol. 2013;14:37–44.CrossRefPubMed

10.

Shah AR. Exploring ethnicities-a- sociological profile of Tibetan Muslim community in Kashmir valley; Eurasiareview.com/20122012.

11.

Ahmad J, Masoodi MA, Ashraf M, Rashid R, Ahmad A. Prevalence of diabetes and its associated risk factors in age group of 20 years and above in Kashmir, India. Al Ameen J Med Sci. 2011;4(1):38–44.

12.

Bhat SD, Tsegya D. The demographic and health surveillance of Tibetan refugee population in India. Dharamsala: Department of health Central Tibetan Administration, 1998

13.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011;34(1):S62–9.CrossRefPubMedCentral

14.

Siedell JC. Obesity, insulin resistance and diabetes-world epidemic. Br J Clin Nutr. 2000;183:5–8.

15.

Misra A, Pandey RM, Devi JR, Sharine R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidemia in urban slum population of North India. Int J Obes Relat Metab Disorders. 2001;25:1722–9.CrossRef

16.

Zargar AH, Bhat MH, Laway BA, Masoodi SR, Wani AI, Mir Ifthikar, et al. Clinical and aetiological profile of early onset diabetes: data from a tertiary care centre in Indian subcontinent. Diabetes Res Clin Pract. 2001;47(1):224–6.

17.

Castillo O, Woolcott OO, Gonzales E, Tello V, Tello L, Villarreal C, et al. Residents at high altitude show a lower glucose profile than sea-level residents throughout 12-hour blood continuous monitoring. High Alt Med Biol. 2007;8:307–11.CrossRefPubMed

18.

Picon-Reategui E. Effect of chronic hypoxia on the action of insulin in carbohydrate metabolism. J Appl Physiol. 1966;21:1177–80.CrossRefPubMed

19.

Calderon R, Llerena L, Munive L, Kruger F. Intravenous glucose tolerance test in pregnancy in women living in chronic hypoxia. Diabetes. 1966;15:130–2.CrossRefPubMed

20.

Krampl E, Kametas NA, Cacho Zegarra AM, Roden M, Nicolaides KH. Maternal plasma glucose at high altitude. Br J Obstet Gynaecol. 2001;108:254–7.

21.

Lindgarde F, Ercilla MB, Correa LR, Ahren B. Body adiposity, insulin, and leptin in subgroups of Peruvian Amerindians. High Alt Med Biol. 2004;5:27–31.CrossRefPubMed

22.

Calderon R, Llerena A. Carbohydrate metabolism in people living in chronic hypoxia. Diabetes. 1965;14:100–5.CrossRefPubMed

23.

Woolcott OO, Castillo OA, Gutierrez C, Elashoff RM, Stefanovski D, Bergman RN. Inverse association between diabetes and altitude: a cross sectional study in the adult population of the United States. Obesity. 2014;22(9):2080–90. doi:10.1002/oby.20800.CrossRefPubMedPubMedCentral

24.

Burke JP, Williams K, Haffner SM, Villalpando CG, Stern MP. Elevated incidence of type 2 diabetes in San Antonio, Texas, compared with that of Mexico City, Mexico. Diabetes Care. 2001;24:1573–8.CrossRefPubMed

25.

Zargar AH, Khan AK, Masoodi SR, Laway BA, Wani AI, Bashir MI, et al. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Kashmir valley of Indian subcontinent. Diabetes Res Clin Pract. 2000;47:135–46.CrossRefPubMed

26.

Harris MI, Hadden WC, Knowler WC, Bennett P. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20–74 years. Diabetes. 1987;36:523–34.CrossRefPubMed

27.

Novoa FJ, Boronat M, Saavedra P, Diaz Cremades JM, Varillas VF, La Roche F, et al. Difference in cardiovascular risk factors, insulin resistance, and insulin secretion in individuals with normal glucose tolerance and in subjects with impaired glucose regulation: the Telde study. Diabetes Care. 2005;28:2388–239.CrossRefPubMed

28.

Peterson JL, Mcguire DK. Impaired glucose tolerance and impaired fasting glucose a review of diagnosis, clinical implications and management. Diabetes Vasc Dis Res. 2005;2:9–15.CrossRef

29.

Ramachandran A, Snehalatha C, Kapur A, Vijaya V, Mohan V, Das AK, et al. Diabetes epidemiology study group in India. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44:1094–101.CrossRefPubMed

30.

Najeeb Q, Singh J, Pandey R, Mahajan R. A comparative study of fasting, post parandial glucose and glycated haemoglobin for diagnosing diabetes mellitus in staff members of MMIMSR, Mullana, Ambala. Med J DY Patil Univ. 2015;8:158–64.CrossRef

31.

Perry RC, Shankar RR, Fineberg N, Mc Gill J, Baron AD. Early Diabetes Intervention Program (EDIP). HbA1C measurement improves the detection of type 2 diabetes in high risk individuals with non diagnostic levels of fasting plasma glucose: the early diabetes intervention program. Diabetes Care. 2001;24:465–71.CrossRefPubMed

32.

Ge RL, Simonson TS, Cooksey RC, Tanna U, Qin G, Huff CD, et al. Metabolic insight into mechanism of high altitude adaptation in Tibetans. Mol Genet Metab. 2012;106(2):244–7.CrossRefPubMedPubMedCentral

33.

Lorenzo FR, Huff C, Myllymäki M, Olenchock B, Swierczek S, Tashi T, et al. A genetic mechanism for Tibetan high altitude adaptation. Nat Genet. 2014;46(9):951956. Doi:10.1038/ng.3067.CrossRef

34.

Tashi T, Feng T, Koul P, Amaru R, Hussey D, Lorenzo FR, RiLi G, Prchal JT. High altitude genetic adaptation in Tibetans: no role of increased hemoglobin-oxygen affinity. Blood Cells Mol Dis. 2014;53(0):27–9. Doi:10.1016/j.bcmd.2014.02.003.CrossRefPubMedPubMedCentral

35.

Contreras AV, Tarres N, Tovar AR. PPARα a key nutritional & environmental sensor for metabolic adaptation. Adv Nutr. 2001;4(4):439–52.CrossRef

36.

Ge RL, Simonson TS, Gordeuk V, Prchal JT, McClain DA. Metabolic aspects of high-altitude adaptation in Tibetans. Exp Physiol. 2015;100:1247–55. Doi:10.1113/EP085292.CrossRefPubMed

Title: Diabetes in Immigrant Tibetan Muslims in Kashmir, North India
Authors: Mirza Shohiab Ur Riyaz
Majid Khalil Rather
Parvaiz A. Koul
Publication date: 01-04-2018
Publisher: Springer US
Published in: Journal of Immigrant and Minority Health / Issue 2/2018
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI: https://doi.org/10.1007/s10903-017-0558-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diabetes in Immigrant Tibetan Muslims in Kashmir, North India

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2018

Increasing Cancer Screening Among Old Order Anabaptist Women Through Specialized Women’s Health and Integrated Cancer Screening Interventions

Impact of Length of Residence in the United States on Risk of Diabetes and Hypertension in Resettled Refugees

Sex Differences and Predictors of Changes in Body Weight and Noncommunicable Diseases in a Random, Newly-Arrived Group of Refugees Followed for Two Years

A Conceptual Model for Home Based Primary Care of Older Refugees

Characterization of Foreign-Born vs. Native-Born Worker Fatalities in Kentucky, 2001–2014

Erratum to: Sex Differences and Predictors of Changes in Body Weight and Noncommunicable Diseases in a Random, Newly-Arrived Group of Refugees Followed for Two Years