Effect Of Educational Status On Fasting Glucose And Hba1c Concentrations Independent Of Income And Population Differences In Indian Populations

Higher education levels are known to be associated with better understanding and awareness of type 2 diabetes (T2D) and its complications. Given the diverse ethnic and socio-cultural characteristics of Indian populations, we aimed to study the effect of educational status on fasting glucose (FG) and HbA1c from three distinct Endogamous Ethnic Groups (EEGs) in India, which are part of the INDIGENIUS consortium, supported by an Indo-U.S. Collaborative Research Partnership on T2D. We obtained data from 1,548 individuals from 68 families (Mean age: 45.5(16)y, 51% men, BMI 26.7(5.2)), representing the communities of Chettiar (34%) from Tamil Nadu state, Agarwal (34%) from Rajasthan state, and Reddy (32%) from Andhra Pradesh state with different levels of income (Low, Middle, High) and education (Uneducated [UE], High School [HS], Graduate [GD], and Postgraduate [PG]). We rank-normalized FG and HbA1c by Van der Waerden's method and performed MANCOVA adjusting for covariates (age, sex, BMI, T2D and income). The main effects were EEG and education level. Data were standardized. Reddys exhibited the lowest value of FG [(-0.05 (SE: 0.06)] compared with Chettiars [0.48 (0.14)] and Agarwals [0.4 (0.04)] p<0.001; for HbA1c, Reddys [0.18 (0.14)] were different from Agarwals [0.35 (0.04)] p< 0.001, but not with Chettiars [0.18 (0.14)]. Once adjusted for confounders, education levels (UE, HS, GD, PG) showed association with FG as follows, respectively: 0.6 (0.1)a, 0.25 (0.06)b, 0.13 (0.06)c and 0.05 (0.08)c; and for HbA1c as follows: 0.37 (0.1)a, 0.23 (0.06)b, 0.1 (0.06)c and 0.1 (0.07)c. The letters a, b and c refer to homogenous groups p<0.1. Education had significant effect on FG (and HbA1c) (p< 0.003), but its interaction with sex was found only for FG (p<0.036). In conclusion, fasting glucose and HbA1c concentrations are influenced by education level independent of income status and population background in the ethnically diverse Indian populations. Disclosure T. Koshy: None. R. Arya: None. J.C. Lopez-Alvarenga: None. V. Venkatesan: None. U. Ravichandran: None. S. Sharma: None. S. Lodha: None. A.R. Ponnala: None. K.K. Sharma: None. M.V. Shaik: None. R.G. Resendez: None. D. Ramu: None. P. Venugopal: None. P. R.: None. N. S.: None. J.A. Ezeilo: None. C.A. Bejar: None. S. Mummidi: None. C. Natesan: None. J. Blangero: None. K.M. Medicherla: None. S. Thanikachalam: None. T. Sadras Panchatcharam: None. D. K.: None. R. Gupta: None. R. Duggirala: None. D.K. Sanghera: None. S.F. Paul: None. Funding Indian Council of Medical Research (55/6/2/Indo-US/2014-NCD-II); National Institute of Diabetes and Digestive and Kidney Diseases (R21DK105913)