Abstract title	Association between socioeconomic status and risk of incident diabetes in adults residing in urban Delhi
Co-authors	K. Agarwal1, R. Shivshankar2, M.K. Ali3, K. Venkat Narayan3, D. Prabbhakaran2, R. Chadha1, N. Tandon4.
1Lady Irwin College, Food and Nutrition, New Delhi, India.
2Public Health Foundation of India, Gurugram, India.
3Emory University, Rollins School of Public Health, Atlanta, USA.
4All India Institute of Medical Sciences, Endocrinology and Metabolism, New Delhi, India.
Abstract body	Background
In developed countries, low socio economic status results in an increased risk of diabetes, while, in developing countries like India, it is reported that affluent people are at a higher risk of diabetes. However, with increase in urbanization, migration of people from rural to urban areas and change in lifestyle patterns like diet, physical inactivity, the risk of diabetes is increasing in the poor.
Aim
To assess the association between socioeconomic status and risk of incident diabetes in adults.
Method
Data from 100 adults newly diagnosed with diabetes (fasting blood glucose ≥126mg/dl or HbA1c ≥6.5%) and 200 age and gender matched controls (diabetes free individuals at baseline and at second evaluation), within Cardio-metabolic Risk Reduction in South Asia (CARRS), a prospective study among non-pregnant adults ≥ 20 years, representative of urban Delhi, were used for analysis. Socio economic status (SES) was assessed by educational qualifications, occupation and income of the participants. The association between SES and risk of diabetes was evaluated using conditional logistic regression adjusting for potential confounders: body mass index, family history of diabetes, physical activity score, duration of tobacco use and alcohol consumption.
Results
People who had a lower educational qualification had a higher risk of diabetes as compared to those who had college degrees or higher education. However, the results were not found to be statistically significant. Similarly, people in the middle income groups had a higher risk of diabetes as compared to people in the high income category. Semi or unskilled workers and skilled workers had twice the risk of diabetes when compared to people in white collar jobs. 
Table 1: Association between socioeconomic status and risk of incident diabetes
Variables 	OR (95% CI) 
Educational qualification 	
Primary school and below 	1.400 (  0.402,   4.871) 
High or secondary school 	1.561 (  0.630,   3.870) 
Graduate or higher 	1.000 
	
Income (Rs/month) 	
<10,000 	0.856 (  0.242,   3.029) 
10,000-30,000 	1.532 (  0.510,   4.606) 
30,000-50,000 	1.854 (  0.528,   6.510) 
≥50,000 	1.000 
	
Occupation 	
Not working 	1.407 ( 0.396, 4.996) 
Semi or unskilled worker 	2.444( 0.676, 8.835) 
Skilled worker 	2.217 ( 0.659, 7.458) 
White collar 	1.000 
Adjusted for body mass index (continuous), family history of diabetes (yes vs no), physical activity score (continuous), duration of tobacco use (continuous) and alcohol consumption (yes vs no)
Discussion
Our results show that low educational attainment and income (not statistically significant) can result in increasing the risk of diabetes. Earlier, the affluent in the country were thought to be at risk of diabetes but now even the poor are at a high risk. The health policies to prevent diabetes should focus on people with different SES backgrounds, and, pay attention to the social determinants of diabetes in the country. 
Conflict of Interest	I have no potential conflict of interest to disclose