Abstract
It is important to prevent the increase in the prevalence of diabetes mellitus (DM) worldwide by efficiently managing its controllable risk factors. This study aimed to identify factors associated with the 4-year estimated incidence of type 2 DM (T2DM) by sex and provide basic data for a sex-specific strategic approach to lifestyle modification. We performed a secondary data analysis using raw data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES, 2016–2018). The KNHANES is a descriptive correlational survey designed to examine sex differences in the factors associated with the 4-year estimated incidence of T2DM. This study included 9,614 Korean adults (4,134 men and 5,480 women) aged 40–69 years without a diagnosis of T2DM. For the statistical analysis, a complex sample analysis was performed for sex comparison using the χ2-test or one-way analysis of variance; a multiple regression analysis was performed to analyze the sex-specific influencing variables of 4-year estimated T2DM incidence. The waist-to-height ratio, an indicator of central obesity in adults, showed the strongest association with the 4-year estimated incidence of T2DM in both groups (male: β = 0.33, p ≤ 0.001; female: β = 0.38, p ≤ 0.001). The influencing variables were the monthly drinking rate (β = 0.07, p ≤ 0.001) and sleep time (β = −0.03, p < 0.05) in men and the sedentary time in women (β = 0.03, p < 0.05). The overall explanatory power of these variables was 11.3% for men and 14.3% for women. Thus, significant sex differences were found in the 4-year estimated incidence of T2DM. Therefore, intervention programs need to be sex-specific to enhance the efficacy of the interventions in reducing the incidence of T2DM, and such intervention programs should be administered with a strategic approach differentiated by sex.
Highlights
Worldwide, the number of adult patients with diabetes mellitus (DM) nearly doubled between 2006 (246 million) and 2019 (463 million)
The main symptoms of type 2 DM (T2DM), which include polydipsia, polyuria, and weight loss, are slight initially, and the patient is often unaware of this disease. erefore, T2DM remains undiagnosed in one-third of such patients until a complication develops [5]. erefore, it is crucial to reduce the incidence of DM by identifying the factors associated with T2DM
A significant sex difference was observed in the variables associated with the 4-year estimated incidence of T2DM
Summary
The number of adult patients with diabetes mellitus (DM) nearly doubled between 2006 (246 million) and 2019 (463 million). E risk factors for T2DM include abdominal obesity, obesity, cardiovascular disease, family history of DM, previous history of impaired fasting glucose or impaired glucose tolerance, gestational DM, hypertension, insulin resistance, and alcohol consumption [3, 5,6,7,8]. In Korea, the obesity rate for men is 1.5 times higher than that for women [9]; the incidence of chronic diseases in women is increasing because of age-associated increases in abdominal. Is is important, as 54% of T2DM cases are associated with abdominal obesity [3]. Alcohol consumption is an important risk factor among the Korean adult population, with 75% of men drinking at least once a month and alcohol consumption steadily rising among women over the past 10 years [9]. Sleep deprivation has been reported to increase the risk of T2DM in some studies [12, 13]; in contrast, no association between sleep duration and DM was observed in another previous work [14]
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