Impaired fasting glucose and impaired glucose tolerance in rural population of Bangladesh

Abstract

The prevalence of type 2 diabetes is rapidly rising all over the world at an alarming rate. Over the past 30 years, the increase in prevalence is rising exponentially in South Asian region, data suggest a three fold increase (from 2.0 to 7.0%) in the urbanizing population of Bangladesh within 5 years. However, the prevalence of various degrees of glucose intolerance, i.e., type 2 diabetes, impaired glucose tolerance and impaired fasting glucose considered vital for prevention are still unknown in this population. The objective of the study was to estimate the prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) with their demographic and anthropometric characteristics in a reasonable large sample compare to other studies conducted in Bangladesh. A random sample of 5000 rural population aged > or =20 years was included in this cross sectional study. Fasting blood glucose (FBG) level was measured from 3981 individuals and 2-hr blood glucose (BG) was done on 3954 subjects, excluding known diabetic cases (n= 27). Height, weight, waist and hip circumference including blood pressure and demographic information was also collected. The prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly detected type 2 diabetes (T2DM) were 1.3%, 2.0% and 7.0% respectively. IFG, IGT, IFG+IGT were more prevalent in females than males. Age, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) were higher in glucose-intolerant subjects than in normal glucose tolerant (NGT) group. FBG and 2-hr BG values were correlated in NGT and DM subjects. Our data suggest that estimation of FBG value identifies more people with diabetes compared to 2-hr BG estimation. These findings need to be further examined in other settings with urban and rural populations for the justification of FBG for screening of diabetes in Bangladeshi population for development of intervention strategy for the prevention and management of abnormal glucose tolerance. The significance of IFG as a precursor of diabetes and CVD will become evident only from longitudinal studies in different ethnic groups.