191-LB: The Impact of Urbanization on the People of the Upper Amazon

Although it has gotten little attention, T2D has become a public health issue in the Peruvian Amazon, particularly among urban dwellers. The growing rate of T2D in the global south has been attributed to greater access to industrial foods and sedentary lifestyles ensuant of rapid urbanization. In Amazonia, people migrate from rural communities to urban hubs searching for socioeconomic opportunities. As a result, prevalence of T2D and obesity has rapidly increased in these cities. Our study compared the diabetes status of people living in Yurimaguas (YU) with those living in traditional rural villages in the Balsapuerto District (BD), Peru, to understand health differences between rural and urban Amazonians.

Methods Participants were recruited in YU (M/F = 114/52) and 11 rural villages in BD (F/M = 92/77). We collected blood pressure, glucose, insulin, glycosylated hemoglobin (A1c), lipids panels, and body measurements. T2D status was determined using ADA guidelines for A1c and glucose.

Results Mean age of participants was younger in BD (44.4 yrs) compared to YU (50.3 yrs; t₃₃₅ = 3.52, p < 0.01). After adjusting for age, we found participants in YU had greater A1c (F_{2, 328} = 49.14, p < 0.01), BMI (F_{2, 328} = 28.79, p < 0.01), glucose (F_{2, 328} = 8.85, p < 0.01), insulin (F_{2, 328} = 7.11, p < 0.01), triglycerides (F_{2, 328} = 3.84, p < 0.01), and systolic pressure (F_{2, 328} = 37.45, p < 0.01) compared to participants living in BD. The proportion of individuals with diabetes and prediabetes was greater in YU (37%, 34% respectively) compared to BD (4%, 12% respectively; χ² = 119.9, df =2, p < 0.01). The percentage of individuals with BMIs > 25 in YU was 68% (n = 112) and 29% (n = 49) in BD respectively (χ² = 51.8, df =1, p < 0.01).

Discussion Results suggest Peruvians living in YU generally had poor health profiles, higher incidence of diabetes, and higher BMIs compared to their rural counterparts 40km away. Given the stark differences between these communities, efforts should be made to understand the nutritional and lifestyle factors leading to this health decline.