Built Environment Factors, Psychosocial Factors and Diabetes Mellitus: A South Indian Study

Abstract

We assessed the contribution of selected built environment factors to body weight in a pilot study in urban Visakhapatnam, South India. Participants were 123 men and 60 women (age 16 to 69 years; BMI 17.3–30.5) who had lived in the area for at least 3 years. Individuals with lower BMI tended to be (a) working people (non-home based–-working away from home), (b) non-vegetarians, (c) physically active (activity mostly related to work), and (d) taking afternoon siestas. Psychological stress, quality of life and wellbeing data were used from an earlier study of individuals with diabetes mellitus. The measures included were depression, anxiety, energy, positive wellbeing, satisfaction, impact, and social worry and diabetes worry (Diabetes quality of life). Guttman's Smallest Space Analysis (SSA) suggested the relationships among the psychosocial measures can be accounted for by one facet with three axial sets of variables (a) positive wellbeing and energy, (b) satisfaction, impact, and social worry and diabetes worry, and (c) anxiety and depression. SSAs on male participants suggested that fasting blood glucose and weight were most closely associated with anxiety and energy levels. In female participants, weight and fasting glucose were most closely associated with energy and to a somewhat lesser extent with anxiety. In both sexes, age was closely associated with positive wellbeing. Also in both sexes, age, weight, and fasting glucose levels were closely associated with each other. The results support the importance of understanding the impact of built environment and psychosocial factors on body weight in diabetic individuals for designing prevention strategies.