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.
Highlights
The prevalence of type 2 diabetes is anticipated to increase drastically during the forthcoming decades in both developed and developing countries[1]
Increased body mass index (BMI) was observed among impaired glucose tolerance (IGT), impaired fasting glucose (IFG)+IGT and DM groups, and increased waist circumference was observed in IGT and DM groups (Table-I)
BMI, waist to hip ratio (WHR) and waist circumference were higher in glucose intolerant groups than in the normal glucose tolerant (NGT) group, while the highest mean values were found in diabetes group for both sex
Summary
The prevalence of type 2 diabetes is anticipated to increase drastically during the forthcoming decades in both developed and developing countries[1]. The prevalence of different stages of glucose intolerance, i.e. type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) differ distinctly between countries and populations. Bangladesh is a developing country with happening of recent rapid urbanization, rural to urban migration, and increase employment with some degree of economic development[3]. There are some population-based studies conducted in urban and rural areas of Bangladesh to estimate the prevalence of diabetes mellitus. These studies were conducted in different time points and have revealed a growing trend of diabetes prevalence ranging from 2.2 to 8.1%, both in rural and urban communities[5,6,7]. The IFG or IGT is considered as prediabetes and is suggested as a strong risk factor for cardiovascular diseases (CVD)[12]
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