Prediabetes, diagnosed and undiagnosed diabetes, their risk factors and association with knowledge of diabetes in rural Bangladesh: The Bangladesh Population-based Diabetes and Eye Study.

BACKGROUND

The aim of the present study was to determine the prevalence and risk factors of prediabetes and diagnosed and undiagnosed diabetes mellitus (DM) in rural Bangladesh.

METHODS

Using a population-based cluster random sampling strategy, 3104 adults aged ≥30 years were recruited. Fasting capillary blood glucose, blood pressure, height, weight, waist circumference, and knowledge, attitudes, and practice related to diabetes were recorded. Diabetes was defined as fasting glucose (FG) ≥7.0 mmol/L or a self-reported diagnosis of diabetes; impaired FG (IFG) was defined as FG ≥ 6.1 and <7.0 mmol/L.

RESULTS

The overall crude prevalence of DM was 7.2% (95% confidence interval [CI] 6.3%-8.1%; n = 222), of which 55% (n = 123) was previously undiagnosed (UDM). The prevalence of IFG was 5.3% (95% CI 4.5%-6.1%; n = 163). The age-standardized prevalence of DM and IFG was 6.6% and 5.0%, respectively. The prevalence of UDM was higher in people of lower socioeconomic status (59% vs. 31%; P < 0.001). Of those with known DM, 56% had poor glycemic control (FG ≥ 7.0 mmol/L) and 37% were not on medication. Overall knowledge of DM was poor; only 16.3%, 17.8%, and 13.4% of those with UDM, IFG, and normal FG knew that diabetes causes eye disease, compared with 55.6% of those with known DM (Ptrend  < 0.001).

CONCLUSIONS

In this rural Bangladeshi community, UDM was high. Lower socioeconomic status was associated with a higher risk of UDM. Overall knowledge of DM was poor. Public health programmes should target those of low socioeconomic status and aim to increase knowledge of DM in rural Bangladesh.