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Identifying spatial variation in the burden of diabetes among women across 640 districts in India: a cross-sectional study



Diabetes is one of the leading causes of mortality and morbidity among women in India. The burden of diabetes among women was found to increase with age and exposure to the post-partum period. The present study examines the spatial variation in the prevalence of diabetes among women in the late reproductive age-group of 35–49 years across 640 districts in India.


The study utilized data from the recent round of the National Family Health Survey, 2015–16. Age-standardized prevalence rates were calculated, followed by an examination of economic inequality using the poor-rich-ratio (PRR) and Wagstaff’s concentration index. Spatial variation in the prevalence of diabetes was explored with a series of quantile maps, univariate, and bivariate LISA cluster maps. Further, to explore the district-level diabetes prevalence among women in the country, Ordinary Least Square and Spatial Autoregressive (SAR) models were used.


The study findings affirm the presence of spatial clustering in the burden of diabetes among women. The burden is relatively higher among women from the Southern and Eastern parts of the country. Findings establish obesity, hypertension, and living in urban areas as major correlates of diabetes.


Program with an aim to lower the intensity of community-based prevalence of diabetes, especially among women in their late reproductive ages, should adopt differential approaches across different states/districts in the context of their lifestyle, dietary pattern, working pattern, and other socio-cultural practices.

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Data Availability

This study utilizes secondary data from a national survey conducted under the stewardship of the Ministry of Health & Family Welfare, Government of India, with the help of the International Institute for Population Sciences as the nodal agency. The data has been archived in a public repository. Therefore, the data is easily accessible for research purposes.



Body Mass Index


Diastolic Blood Pressure


Non-Communicable Diseases


National Family Health Survey


Systolic Blood Pressure


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The authors would like to acknowledge the research co-ordinators in Demographic and Health Surveys (DHS) India that developed the study’s research protocol. We would also like to acknowledge the helpful comments of the anonymous referees.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information




SKS apprehended the idea. PP designed the experiment, analyzed it, interpreted the results, and drafted the manuscript. SKS and SVS supervised the work. Authors take responsibility for the integrity of the work as a whole from inception to the published article. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Parul Puri.

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Singh, S., Puri, P. & Subramanian, S.V. Identifying spatial variation in the burden of diabetes among women across 640 districts in India: a cross-sectional study. J Diabetes Metab Disord 19, 523–533 (2020).

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  • India
  • Chronic diseases
  • Diabetes
  • Districts
  • Geospatial
  • Women