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Diabetes and Pre-Diabetes among Persons Aged 35 to 60 Years in Eastern Uganda: Prevalence and Associated Factors
Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.
Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.
Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda.
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2013 (English)In: PLoS ONE, ISSN 1932-6203, Vol. 8, no 8, e72554- p.Article in journal (Refereed) Published
Abstract [en]

Background: Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and prediabetes) and its associated factors among people aged 35-60 years so as to clarify the relevance of targeted screening in rural Africa. Methods: A population-based survey of 1,497 people (786 women and 711 men) aged 35-60 years was conducted in a predominantly rural Demographic Surveillance Site in eastern Uganda. Participants responded to a lifestyle questionnaire, following which their Body Mass Index (BMI) and Blood Pressure (BP) were measured. Fasting plasma glucose (FPG) was measured from capillary blood using On-Call (R) Plus (Acon) rapid glucose meters, following overnight fasting. AGR was defined as FPG >= 6.1 mmol L-1 (World Health Organization (WHO) criteria or >= 5.6mmol L-1 (American Diabetes Association (ADA) criteria. Diabetes was defined as FPG >6.9mmol L-1, or being on diabetes treatment. Results: The mean age of participants was 45 years for men and 44 for women. Prevalence of diabetes was 7.4% (95% CI 6.1-8.8), while prevalence of pre-diabetes was 8.6% (95% CI 7.3-10.2) using WHO criteria and 20.2% (95% CI 17.5-22.9) with ADA criteria. Using WHO cut-offs, the prevalence of AGR was 2 times higher among obese persons compared with normal BMI persons (Adjusted Prevalence Rate Ratio (APRR) 1.9, 95% CI 1.3-2.8). Occupation as a mechanic, achieving the WHO recommended physical activity threshold, and higher dietary diversity were associated with lower likelihood of AGR (APRR 0.6, 95% CI 0.4-0.9; APRR 0.6, 95% CI 0.4-0.8; APRR 0.5, 95% CI 0.3-0.9 respectively). The direct medical cost of detecting one person with AGR was two US dollars with ADA and three point seven dollars with WHO cut-offs. Conclusions: There is a high prevalence of AGR among people aged 35-60 years in this setting. Screening for high risk persons and targeted health education to address obesity, insufficient physical activity and non-diverse diets are necessary.

Place, publisher, year, edition, pages
2013. Vol. 8, no 8, e72554- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-207529DOI: 10.1371/journal.pone.0072554ISI: 000323221500137OAI: oai:DiVA.org:uu-207529DiVA: diva2:648596
Available from: 2013-09-16 Created: 2013-09-16 Last updated: 2013-09-27Bibliographically approved

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