BACKGROUND:
India is becoming a global hotspot for diabetes mellitus, driven by several socio-demographic, behavioural, and environmental factors that vary across different geographical regions. The north-eastern part of India is not an exception. This research aims to assess the influence of sociodemographic and environmental factors on the prevalence of diabetes mellitus in Northeast India, focusing on the effects of altitude and place of residence.

METHODS:
The study used the data from the National Family and Health Survey-5 (India, 2019-202) for all North-eastern states. Initially, district wise prevalence and spatial autocorrelation analysis was conducted to understand the spatial pattern, followed by logistic regression analysis to examine the association of various factors.

RESULTS:
People residing in rural areas have slightly lower odds (OR=.99, CI=.991-.991) of getting diabetes than urban residents, and people residing at higher altitudes have lower odds (OR=.71, CI=.706-.707) of getting diabetes than the people residing in lower altitude areas. The result reveals people residing in high-altitude urban areas have lower odds than others, whereas people residing in urban low-altitude areas have higher odds (CI=1.46, CI=1.457-1.458) than the rest of the areas.

CONCLUSIONS:
The study reveals that spatial variability exists across the region, and different environmental factors play a role in the variability of diabetes prevalence. People residing in high-altitude urban areas are less prone to getting diabetes than people residing in high-altitude rural areas, which is the inverse of the general trend. The study advocates specialized intervention and policy formulation for the high-altitude rural areas to manage diabetes.