OCCURRENCE OF TYPE 2 DIABETES MELLITUS IN THE PARENTS OF JHARKHAND STATE'S TRIBAL MEDICAL STUDENTS STUDYING AT RAJENDRA INSTITUTE OF MEDICAL SCIENCES (RIMS), RANCHI: A COMPARISON WITH THEIR NON TRIBAL PEERS
Authors: Mahto Shishir Kumar , Sinha Rashmi , Sinha Mani Bhushan Kumar 
Published: December 2020

Background: Rapidly increasing toll of Diabetes Mellitus (DM) cases has become a great challenge for healthcare affecting almost all socioeconomic groups and according to the projections made in few studies, our country is standing on the verge of becoming world capital of DM by the year 2030. Studies have also shown that there is only a marginal difference in prevalence of diabetes among different states in India and the cases are increasing at a steady rate in all the states including in Jharkhand. Jharkhand is a land of 32 different types of indigenous scheduled tribe communities. The prevalence of DM in these marginalized and vulnerable groups of people has not been studied yet. As the ethnic and socio cultural practices are significantly different in every tribal community and they are mostly endogamous, it would be particularly important to study the traits and trends of DM in these groups. The data can be quite helpful in understanding the genetic bases of the disease pathogenesis.
Methods: We conceptualized this study aiming on to observe the occurrence of type 2 DM in the parents of tribal medical students in comparison with that in the parents of their non tribal peers studying at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand. We recruited 262 students for our study and a structured questionnaire was supplied to them.
Results: Out of 50 tribal students included in our study, 14 (28.00%) gave us the history of diabetes in either one or both of their parents whereas 53 (25.00%) out of 212 students from non tribal peer group responded with same answers (p value = 0.7190; no significant difference).
Discussion: Two important findings that we observed in our study are quite higher occurrence of type 2 DM both among the tribal and non tribal groups than the prevalence of the disease in general population and almost equal occurrence of type 2 DM in the subjects of both these groups. These findings can be attributed to the urban residency, affluent socioeconomic status and sedentary lifestyle of our subjects, as all these risk factors for type 2 DM were significantly prevalent in both groups. Slightly more occurrence of cases in tribal group in comparison to non tribal peers can be due to the concept of “thrifty genotype” for the pathogenesis of type 2 DM, which is more applicable to the tribal subjects.
Conclusion: We concluded from our study that urbanization, affluent socioeconomic condition and sedentary lifestyle are very important risk factors for the pathogenesis of type 2 DM due to which there was clustering of cases in our study groups. Furthermore, transition of tribal communities from rural to urban settings is making them prone for developing type 2 DM. therefore the disease spectrum of type 2 DM in these communities should be extensively studied. These data can be extremely important in formulating strategies for preventive and curative steps targeting the vulnerable tribal communities.