Delayed onset of diabetes in children of low economic stratum — a study from Southern India

Influence of the socioeconomic status on the age at onset of insulin-dependent diabetes mellitus (IDDM) was analysed in 614 patients who developed diabetes ≤ 20 years. The peak occurrence was seen at 11 years in girls ( n = 293). The boys ( n = 321) showed multiple peaks between 11 and 18 years. In the urban patients ( n = 463), the peak was at 11 years in contrast to a delayed peak at 18 years in the rural group ( n = 151). When analysed with respect to the family income, the higher income group (HIG) (Rs. > 2000/month) showed a sharp peak at 11 years whereas the lower income group (LIG) showed a peak at 18 years ( χ 2 = 7.2, P = 0.007). The median body weight of the LIG was lower compared to the HIG. Although the exact cause for the delayed age at onset of IDDM in the rural or LIG is not known, it is likely to be a consequence of the lower socioeconomic and nutritional status (indicated by low body weight) and probably indicates the influence of environmental factors in the pathogenesis of the disease.