Lao Tropical and Public Health Institution, Vientiane, Lao PDR.
Faculty of Postgraduate Studies, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR.
Trop Med Int Health. 2019 Jan;24(1):65-72. doi: 10.1111/tmi.13164. Epub 2018 Oct 23.
Diabetes is a major and fast-growing public health problem in Southeast Asia. We determined the prevalence of pre-diabetes and diabetes and assessed the levels of awareness, treatment and control in Lao People's Democratic Republic (PDR).
A national cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The sample comprised 2492 individuals aged 18-64 years (59.3% females; mean age 38.7 years, SD = 12.8) from Lao PDR. We followed the WHO STEPS method: step 1, questionnaire interview; step 2, anthropometric and Blood Pressure (BP) measurements; and step 3, biochemistry tests. Multinominal logistic regression was used to investigate the determinants of pre-diabetes and diabetes (fasting plasma glucose levels ≥ 7.0 mmol/L; or using insulin or oral hypoglycaemic drugs; or having a history of diagnosis of diabetes).
5.7% of the population had diabetes, 4.7% of men and 6.4% of women, and 2.3% had pre-diabetes, 1.8% of men and 2.6% of women. Only 14.1% of the population sample indicated that they had ever their blood glucose measured by a health-care worker. This was higher in urban (20.9%) than rural (10.9%) dwellers (P < 0.001), and among female (16.6%) than male (10.5%) participants (P < 0.001). Among those with diabetes, 58.1% were aware of their diabetes status, 40.3% were taking treatment and 10.9% had controlled diabetes. The factor independently associated with impaired fasting glycaemia (IFG) or pre-diabetes was central obesity (Adjusted Relative Risk Ratio-ARRR: 3.92, Confidence Interval-CI: 1.89, 8.14) but none of the other health (general body weight, fruit and vegetable consumption, physical activity, substance use, hypertension and cholesterol) and sociodemographic (age, sex, education, employment status, marital status, ethno-linguistic group and residence status) variables. Factors independently associated with diabetes were older age (ARRR: 5.12, CI: 1.55, 10.20), central obesity (ARRR: 2.15, CI: 1.16, 4.00), low or moderate physical activity (ARRR: 0.75, CI: 0.60, 0.93), having hypertension (ARRR: 1.68, CI: 1.01, 2.83), and dyslipidaemia (ARRR: 1.75, CI: 1.08, 2.81).
A public health response is needed in the form of integrated and comprehensive action targeting major non-communicable diseases in the country.
糖尿病是东南亚地区一个主要且快速增长的公共卫生问题。我们旨在确定老挝人民民主共和国（老挝）的糖尿病前期和糖尿病的患病率，并评估其认知率、治疗率和控制率。
2013 年，我们开展了一项基于分层整群随机抽样的全国性横断面研究。该样本包括 2492 名年龄在 18-64 岁之间的个体（59.3%为女性；平均年龄 38.7 岁，标准差 12.8 岁）。我们遵循世界卫生组织 STEPS 方法：第 1 步，问卷调查；第 2 步，人体测量和血压（BP）测量；第 3 步，生物化学检测。采用多分类逻辑回归分析来探讨糖尿病前期和糖尿病（空腹血糖水平≥7.0mmol/L；或使用胰岛素或口服降糖药物；或有糖尿病诊断史）的决定因素。
该人群中糖尿病的患病率为 5.7%，男性为 4.7%，女性为 6.4%，糖尿病前期的患病率为 2.3%，男性为 1.8%，女性为 2.6%。仅有 14.1%的样本人群表示曾由医护人员测量过血糖。城镇居民（20.9%）高于农村居民（10.9%）（P<0.001），女性（16.6%）高于男性（10.5%）（P<0.001）。在糖尿病患者中，58.1%的人知晓其糖尿病状况，40.3%的人接受治疗，10.9%的人血糖得到控制。与空腹血糖受损（IFG）或糖尿病前期相关的独立因素是中心性肥胖（调整后的相对风险比-ARR：3.92，置信区间-CI：1.89，8.14），而其他健康（总体体重、水果和蔬菜摄入量、身体活动、物质使用、高血压和胆固醇）和社会人口学（年龄、性别、教育、就业状况、婚姻状况、民族语言群体和居住状况）变量则无显著关联。与糖尿病相关的独立因素是年龄较大（ARR：5.12，CI：1.55，10.20）、中心性肥胖（ARR：2.15，CI：1.16，4.00）、低或中度体力活动（ARR：0.75，CI：0.60，0.93）、患有高血压（ARR：1.68，CI：1.01，2.83）和血脂异常（ARR：1.75，CI：1.08，2.81）。
该国需要采取综合和全面的行动来应对主要的非传染性疾病，这是一种公共卫生应对措施。
