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Prevalence and social and health determinants of pre‐diabetes and diabetes among adults in Laos: a cross‐sectional national population‐based survey, 2013
Author(s) -
Vonglokham Manithong,
Kounnavong Sengchanh,
Sychareun Vanphanom,
Pengpid Supa,
Peltzer Karl
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13164
Subject(s) - diabetes mellitus , medicine , population , anthropometry , cross sectional study , obesity , impaired fasting glucose , logistic regression , demography , type 2 diabetes , gerontology , endocrinology , environmental health , impaired glucose tolerance , pathology , sociology
Summary Objective 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). Methods 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). Results 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). Conclusion A public health response is needed in the form of integrated and comprehensive action targeting major non‐communicable diseases in the country.