Prevalence and detecting spatial clustering of diabetes at the district level in India

  • Koustav Ghosh
  • Preeti DhillonEmail author
  • Gopal Agrawal
Original Article



Diabetes is increasingly becoming a prevalent disease in developing countries such as India. This has raised great concern among public health practitioners, researchers and policy makers. The present study aims to examine the geographical variations in the prevalence of diabetes and its contextual risk factors including production and consumption of different food groups in the districts of India.


We used state- and district-level data from multiple sources. These include National Family Health Survey-4 (2015–2016), socio-economic data from the census of India (2011), per capita crop production from the Ministry of Agriculture and Farmers and consumption of different food groups from the 68th round of the National Sample Survey. The study adopted advanced spatial statistical analysis including the Moran index and spatial regression to fulfil the objectives of the article.


The study reveals the remarkable geographical variations in diabetes risk in the districts of India. Districts from the coastal area have more diabetes prevalence. Per capita calorie consumption, calorie intake from sugar and production of sugar crops in districts are significantly positively related to diabetes prevalence. On the other hand, protein intake and calorie consumption from pulses and nuts and milk and dairy products reduce the risk of diabetes.


The study recommends that public health programmes target hot-spot districts with high prevalence of diabetes and encourage people to increase consumption of protein-rich diets including pulses, nuts and milk products to reduce diabetes prevalence.


Diabetes Spatial Dietary groups India Districts 



This research received no specific grant from any funding agency, commercial entity or not-for-profit organisation. We thank the reviewers from the journal for giving their useful comments for the improvement of this article.

Author contribution

Conceived and designed the experiments: KG, PD. Compiled the data: KG. Analysed the data: KG. Writing-original draft: KG, PD. Writing-review and editing: PD, GA.

Compliance with ethical standards

Competing interests

We declare that no competing interests exist.

Conflict of interests

The authors declare that they have no conflict of interest.

Ethical statement

The authors assert that all procedures contributing to this work fulfil the ethical standards of the National Family Health Survey. The protocol for the NFHS-4 survey, including the content of all the survey questionnaires, was approved by the IIPS Institutional Review Board and the ICF Institutional Review Board. The protocol was also reviewed by the US Centers for Disease Control and Prevention (CDC).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.International Institute for Population Sciences (IIPS)MumbaiIndia
  2. 2.Directorate of Census OperationsBhopalIndia

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