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

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Alam, Dewan S, Talukder, Shamim H, Chowdhury, Muhammad Ashique Haider, Siddiquee, Ali Tanweer, Ahmed, Shyfuddin, Pervin, Sonia, Khan, Sushmita, Hasan, Khaled, Koehlmoos, Tracey L P and Niessen, Louis ORCID: https://orcid.org/0000-0002-8639-5191 (2016) 'Overweight and abdominal obesity as determinants of undiagnosed diabetes and pre-diabetes in Bangladesh'. BMC Obesity, Vol 3, Issue 19.

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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.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WB Practice of Medicine > Diagnosis > General Diagnosis > WB 141 General works
WK Endocrine System > WK 810 Diabetes mellitus
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s40608-016-0099-z
Depositing User: Jessica Jones
Date Deposited: 29 Mar 2016 14:20
Last Modified: 06 Feb 2018 13:12
URI: http://archive.lstmed.ac.uk/id/eprint/5814

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