Diabetes and Pre-Diabetes among Persons Aged 35 to 60 Years in Eastern Uganda: Prevalence and Associated Factors
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
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® Plus (Acon) rapid glucose meters,
following overnight fasting. AGR was defined as FPG ≥6.1mmol 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.
Description
Keywords
Diabetes, Pre-Diabetes, Years, Eastern Uganda, Prevalence
Citation
: Mayega RW, Guwatudde D, Makumbi F, Nakwagala FN, Peterson S, et al. (2013) Diabetes and Pre-Diabetes among Persons Aged 35 to 60 Years in Eastern Uganda: Prevalence and Associated Factors. PLoS ONE 8(8): e72554. doi:10.1371/journal.pone.0072554