Overweight and abdominal obesity as determinants of undiagnosed diabetes and pre-diabetes in Bangladesh

Dewan S. Alam, Shamim H. Talukder, Muhammad Ashique Haider Chowdhury, Ali Tanweer Siddiquee, Shyfuddin Ahmed, Sonia Pervin, Sushmita Khan, Khaled Hasan, Tracey L.P. Koehlmoos, Louis W. Niessen

Research output: Contribution to journalArticle

Abstract

Background: Type 2 diabetes and pre-diabetes are an increasing pandemic globally and often remain undiagnosed long after onset in low-income settings. The objective of this study is to assess the determinants and prevalence of undiagnosed diabetes and pre-diabetes among adults in Bangladesh. Methods: In an exploratory study, we performed oral glucose tolerance test on 1243 adults ≥20 years of age from urban Mirpur, Dhaka (n = 518) and rural Matlab, Chandpur (n = 725) who had never been diagnosed with diabetes or pre-diabetes. We collected data on socioeconomic, demographic, past medical history, physical activity, and measured weight, height, waist and hip circumferences, and blood pressure. Risk factors associated with undiagnosed diabetes and pre-diabetes were examined using a multiple logistic regression model. Results: Overall prevalence of diabetes and pre-diabetes was 6.6 % (95 % CI 5.3, 8.1) and 16.6 % (14.5, 18.7) respectively, with both being significantly higher in urban than rural populations (diabetes 12.2 % vs 2.6 % respectively, p < 0.000; pre-diabetes 21.2 % vs 13.2 %, p < 0.001). After adjustment the variables, urban residence (OR 2.5 [95 % CI 1.02, 5.9]), age group 40-59 y (2.9 [1.7-5.2]), ≥60 y (8.1 [2.8-23.8]), overweight (2.2 [1.3-3.9]), abdominal obesity (3.3 [1.8-6.0]) and high WHR 5.6 (2.7-11.9) were all significant predictors of diabetes. Significant predictors of pre-diabetes included age group 40-59 (1.6 [1.1-2.2]), female sex (1.5 [1.0-2.2]), abdominal obesity (1.7 [1.2-2.4]) and high WHR (1.6 [1.2-2.3]). Conclusion: Both overweight and abdominal obesity contribute to the hidden public health threat of undiagnosed diabetes and pre-diabetes. Awareness raising and screening of high risk groups combined with a tailored approach are essential for halting the epidemic of diabetes and pre-diabetes in Bangladesh.

Original languageEnglish (US)
Article number19
JournalBMC Obesity
Volume3
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Keywords

  • Bangladesh
  • Determinants
  • Diabetes
  • Pre-diabetes
  • Prevalance
  • Rural
  • Screening
  • Urban

ASJC Scopus subject areas

  • Epidemiology
  • Endocrinology, Diabetes and Metabolism
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Health Policy
  • Public Health, Environmental and Occupational Health

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  • Cite this

    Alam, D. S., Talukder, S. H., Chowdhury, M. A. H., Siddiquee, A. T., Ahmed, S., Pervin, S., Khan, S., Hasan, K., Koehlmoos, T. L. P., & Niessen, L. W. (2016). Overweight and abdominal obesity as determinants of undiagnosed diabetes and pre-diabetes in Bangladesh. BMC Obesity, 3(1), [19]. https://doi.org/10.1186/S40608-016-0099-Z