Diabetes and Impaired Fasting Glycemia in a Rural Population of Bangladesh

Abstract

OBJECTIVE -To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a rural population of Bangladesh.RESEARCH DESIGN AND METHODS -A cluster sampling of 4,923 subjects Ն20 years old in a rural community were investigated. Fasting plasma glucose, blood pressure, height, weight, and girth of waist and hip were measured. BMI and waist-to-hip ratio (WHR) were calculated. Total cholesterol, triglycerides, and HDL cholesterol were also estimated. We used the 1997 American Diabetes Association diagnostic criteria.RESULTS -The crude prevalence of type 2 diabetes was 4.3% and IFG was 12.4%. The age-standardized prevalence of type 2 diabetes (95% CI) was 3.8% (3.12-4.49) and IFG was 13.0% (11.76 -14.16). The subjects with higher family income had significantly higher prevalence of type 2 diabetes (5.9 vs. 3.5%, P Ͻ 0.001) and IFG (15.6 vs. 10.8%, P Ͻ 0.001) than those with lower income. Employing logistic regression in different models, we found that wealthy class, family history of diabetes, reduced physical exercise, and increased age, BMI, and WHR were the important predictors of diabetes. Total cholesterol, triglycerides, and HDL cholesterol showed no association with diabetes and IFG.CONCLUSIONS -The prevalence of diabetes and IFG in the rural population was found to be on the increase compared with the previous reports of Bangladesh and other Asian studies. Older age, higher obesity, higher income, family history of diabetes, and reduced physical activity were proved significant risk factors for diabetes and IFG, whereas plasma lipids showed no association with diabetes and IFG. Further study may address whether diabetes is causally associated with insulin deficiency or insulin resistance.

Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India

“…Improvements in living conditions similar to those noted in our study were described in a neighbouring Bangladeshi population [11]. The prevalence of diabetes had increased from 2.23% to 3.8% in a period of 8 years.…”

“…Therefore, 60% of the diabetic cases had already been diagnosed. Similar demographic changes owing to modernisation had been reported in several studies [11,12,13].…”

Cardiovascular Disease in Bangladesh: A Review

“…The reported prevalence varies widely from 1.21% to 32%. 11,16,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Table 2). According to the Bangladesh NCD Risk Factor Survey 2010 27 , the prevalence of hypertension is 17.9% in general, 18.5% in men and 17.3% in women.…”

Rationale and methodology for a population-based study of diabetes and common eye diseases in a rural area in Bangladesh: Bangladesh Population based Diabetes and Eye Study (BPDES)

“…This is of particular concern given consistent findings across population based studies of diabetes in rural populations that patients belonging to higher socio-economic strata with higher family income had greater knowledge of diabetes 5 , yet also higher prevalence of diabetes compared to those with lower income. 28 Data from Bangladesh suggests that when comparing urban with urbanising 'rural' areas this paradox cannot be explained by differences in body mass index obesity, waist to hip ratio or hypertension.…”