PMID- 32236106
OWN - NLM
STAT- MEDLINE
DCOM- 20200713
LR  - 20210219
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 4
DP  - 2020
TI  - Does a rise in BMI cause an increased risk of diabetes?: Evidence from India.
PG  - e0229716
LID - 10.1371/journal.pone.0229716 [doi]
LID - e0229716
AB  - BACKGROUND: Overnutrition increases the risk of diabetes. Evidence on the causal 
      impact of overnutrition on diabetes is scarce for India. Considering a 
      representative sample from India, this study examines the causal effect of a rise 
      in the Body Mass Index (BMI) of an individual on the likelihood of being diabetic 
      while addressing the issue of unobserved endogeneity between overnutrition and 
      diabetes. METHODS: The study considers individual level data from Demographic and 
      Health Surveys (DHS) of India, namely, National Family Health Survey (NFHS) for 
      the year 2015-16. The NFHS is a large-scale, multi-round survey conducted in a 
      representative sample of households throughout India. The survey covers females 
      having age 15-49 years and males having age 15-54 years. The instrument variable 
      approach is used to address the potential endogeneity in the relationship between 
      BMI and diabetes. We instrument BMI of an individual by BMI of a non-biologically 
      related household member. Ordered Probit, Probit and IV-Probit models are 
      estimated using two alternative definitions for measuring diabetes-self-reported 
      diabetes status and blood glucose levels (ordinal measure). RESULTS: The 
      coefficients obtained from the Ordered Probit and Probit models are much smaller 
      than those estimated by an IV-Probit model. The latter estimates the causal 
      impact of a rise in BMI on diabetes by taking into account the effect of the 
      unobserved genetic and other related factors. The likelihood of being diabetic is 
      twice or more among the overweight and obese individuals as compared to 
      non-overweight individuals in all the specifications. With a unit increase in BMI 
      the probability of being diabetic increases by about 1.5% among overweight and 
      obese individuals and by 0.5% among the non-overweight individuals in the 
      IV-Probit model. Similar results from the Ordered Probit model show that on 
      average, the overweight and obese individuals experience about 0.2% increase in 
      the probability of being diabetic and about 0.4% increase in the probability of 
      being prediabetic. CONCLUSION: Our study demonstrates that the likelihood of 
      being both prediabetic and diabetic is higher among the overweight and obese 
      individuals as compared to the non-overweight individuals. We also find that the 
      level of risk of being prediabetic or diabetic differs across gender, wealth 
      quintiles and regions and the effects are more severe among population in the 
      urban areas, belonging to the richest wealth quintile and men. Our findings have 
      significant implications for the policy formulation as diabetes has a substantial 
      health and economic burden associated with it. Future studies may investigate the 
      effect of abdominal obesity on diabetes.
FAU - Gupta, Shivani
AU  - Gupta S
AUID- ORCID: 0000-0001-9666-3981
AD  - Centre for International Trade and Development, School of International Studies, 
      Jawaharlal Nehru University, New Delhi, India.
FAU - Bansal, Sangeeta
AU  - Bansal S
AD  - Centre for International Trade and Development, School of International Studies, 
      Jawaharlal Nehru University, New Delhi, India.
LA  - eng
PT  - Journal Article
DEP - 20200401
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
EIN - PLoS One. 2021 Feb 19;16(2):e0247537. PMID: 33606811
MH  - Adolescent
MH  - Adult
MH  - *Body Mass Index
MH  - Female
MH  - Health Surveys
MH  - Humans
MH  - India/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Obesity/*epidemiology
MH  - Prediabetic State/*epidemiology
MH  - Risk Factors
MH  - Young Adult
PMC - PMC7112218
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/04/03 06:00
MHDA- 2020/07/14 06:00
PMCR- 2020/04/01
CRDT- 2020/04/03 06:00
PHST- 2019/09/03 00:00 [received]
PHST- 2020/02/06 00:00 [accepted]
PHST- 2020/04/03 06:00 [entrez]
PHST- 2020/04/03 06:00 [pubmed]
PHST- 2020/07/14 06:00 [medline]
PHST- 2020/04/01 00:00 [pmc-release]
AID - PONE-D-19-24183 [pii]
AID - 10.1371/journal.pone.0229716 [doi]
PST - epublish
SO  - PLoS One. 2020 Apr 1;15(4):e0229716. doi: 10.1371/journal.pone.0229716. 
      eCollection 2020.