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Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors.

ABSTRACT: BACKGROUND: Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and pre-diabetes) 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 ?6.1 mmol L?¹ (World Health Organization (WHO) criteria or ?5.6 mmol L?¹ (American Diabetes Association (ADA) criteria. Diabetes was defined as FPG >6.9 mmol 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.

SUBMITTER: Mayega RW

PROVIDER: S-EPMC3743823 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors.

Mayega Roy William RW Guwatudde David D Makumbi Fredrick F Nakwagala Frederick Nelson FN Peterson Stefan S Tomson Goran G Ostenson Claes-Goran CG

PloS one 20130814 8

<h4>Background</h4>Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and pre-diabetes) and its associated factors among people aged 35-60 years so as to clarify the relevance of targeted screening in rural Africa.<h4>Methods</h4>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, follow ...[more]

PMID: 23967317

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Project description:Obesity increases the risk of heart failure and atrial fibrillation. Left atrial (LA) dysfunction is increasingly recognized as a mediator of cardiovascular disease. Early effects of obesity on LA function have not been examined in large population samples. We quantified LA strain and strain rate (SR) through speckle tracking echocardiography in 1,531 middle-aged community-based participants enrolled in the Asklepios study. We compared LA function between individuals with body mass index (BMI) < 25 kg/m2 (n?=?779), 25 to 29.9 kg/m2 (n?=?618) and ? 30 kg/m2 (n?=?134). Significant differences in reservoir longitudinal LA strain (BMI < 25 kg/m2?=?35.3%, BMI 25-29.9 kg/m2?=?33.1%, and BMI ? 30 kg/m2?=?30.9%; p < 0.00001) strain rate ([SR] BMI < 25 kg/m2?=?151; BMI 25 to 29.9 kg/m2?=?141; and BMI ? 30 kg/m2?=?135 %/s; p <0.00001) and expansion index (BMI < 25 kg/m2?=?1.6, BMI 25 to 29.9 kg/m2?=?1.4, and BMI ? 30 kg/m2?=?1.4; p <0.00001) were seen, indicating reduced reservoir function with increasing BMI. Obesity was also associated with impaired LA conduit function, including conduit longitudinal LA strain (BMI < 25 kg/m2?=?21.6%, BMI 25 to 29.9 kg/m2?=?18.9%, and BMI ? 30 kg/m2?=?16.7%; p <0.00001), SR (BMI < 25 kg/m2?=?-189, BMI 25 to 29.9 kg/m2?=?166, and BMI ? 30 kg/m2?=?150 %/s; p <0.0001) and passive LA emptying fraction (BMI < 25 kg/m2?=?40.5, BMI 25 to 29.9 kg/m2?=?36.5, and BMI ? 30 kg/m2?=?36%, p <0.00001). These differences persisted after adjustment for age, gender and other potential confounders. In contrast to reservoir and conduit function, obesity was associated with increased booster pump function (active LA emptying fraction: BMI < 25 kg/m2?=?19.4%, BMI 25 to 29.9 kg/m2?=?20.5%, and BMI ? 30 kg/m2?=?21.5%; p <0.00001). In middle-aged adults, obesity is associated with impaired reservoir and conduit LA function and higher booster function, which may be compensatory. Loss of booster LA function, either because of more advanced LA dysfunction or atrial fibrillation, may play an important role in precipitating heart failure in obese individuals.

Dataset Information

Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors.

Publications

Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors.

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