RESUMEN
Background: For India, the ‘diabetes capital’ of the world, it is essential to knowthe incidence of type 2 diabetes mellitus (T2DM) and its key determinants. Astwo thirds of Indians live in rural areas, a study was undertaken to assess theincidence and risk factors of T2DM in rural Pondicherry, India.Methods: In a population-based cohort study initiated in 2007, a sample of 1223adults > 25 years of age from two villages of Pondicherry were selected using clusterrandom sampling. Data on risk factor exposure were collected using a structuredquestionnaire, anthropometric tests and fasting blood glucose assessment. Duringhouse visits, 1223 of 1403 invited subjects participated. Of these, 71 (5.8%) werefound to have diabetes. In 2010–2011, 85% of the non-diabetics (979/1152) werefollowed up using the same protocol. We calculated the risk of T2DM per annumstandardized by age and sex. Population estimates of the risk factors associatedwith T2DM were analysed using the Generalized Estimating Equation model andthe Population Attributable Risk (PAR) for T2DM calculated.Results: During 2937 person-years (PY) of follow-up, 63 new cases of T2DMoccurred, giving an incidence rate of 21.5/1000 PY. Almost one third (31.7%)of cases occurred in people aged below 40 years. The incidence was doubleamong males (28.7/1000 PY; 95% confidence interval (CI): 21.0–38.7) comparedwith females (14.6/1000 PY; 95% CI: 9.4–21.7). Applying these rates to ruralpopulations, it is estimated that each year 8.7 million people develop T2DM inrural India. Nearly half of the T2DM incidence was attributed to overweight/obesityand alcohol usage.Conclusion: T2DM incidence was 2% per year in adults in rural Pondicherry,India, with the rate increasing twice as fast in men. Increasing age, obesity, alcoholuse and a family history of T2DM independently predicted the development ofdiabetes. As half of T2DM incidence was attributed to overweight/obesity andalcohol use, health promotion interventions focusing on maintaining an optimalweight and decreasing