English abstract
Diabetes mellitus (DM) is a growing worldwide health problem. It is recognized as a group of heterogeneous disorders with the common elements of hyperglycaemia and glucose intolerance. Prevention of diabetes is based on a better understanding of pathophysiology of the disease and early identification of the associated risk factors in apparently healthy individuals. The present study aimed to investigate the prevalence of prediabetes in a selected population of wilayatt Bidbid and to examine association of lifestyle factors such as sociodemographic, diet, obesity, and physical activity with the risk of prediabetes. Community based cross-sectional study was conducted to identify individuals with prediabetes as per WHO 1999 diagnostic criteria. Anthropometric measurements, biochemical data including plasma lipid profile, fasting and oral glucose tolerance tests were performed. A validated comprehensive questionnaire on sociodemograhic status, dietary intake, and physical activity assessment was conducted as well. Descriptive analysis was used to determine prediabetes prevalence, Logistic regression was applied to predict risk factors of prediabetes by obtaining odds ratio (OR) and their 95% confidence interval (CI). Out of 1219 participants, 19.5% were found to be prediabetics and 6.2% were newly diagnosed diabetics. 10.7% of prediabetic subjects were diagnosed as impaired glucose tolerant (IGT), 5.7% as impaired fasting glucose (IFG), and 3.2% were with both IFG and IGT. Sociodemographic determinants such as age (OR= 6.8, 95% CI = 3.1-15.0) and educational status were significantly associated with elevated risk of prediabetes. Individuals of 60 years old or more were 6.8 times at higher risk of developing prediabetes than those of 18 to 19 years (OR= 6.8, 95% CI = 3.1-15.0). The risk of being prediabetic was 3.4 times higher among illiterates compared to university graduates (OR = 3.4, 95% CI = 1.5 -7.6). Age and gender adjusted logistic regression revealed that obesity (BMI > 30 kg/m) was associated with increased risk of prediabetes (OR=2.6, 95% CI = 1.8-3.8). The risk of being prediabetic elevated among subjects with large waist circumference (WC) by 2.3 times than those with normal WC (OR = 2.3, 95% CI = 1.6-3.3). Subjects who were with high waist to hip ratio (WHR) increased their risk of prediabetes by 2.1 times compared to those with normal WHR (OR = 2.1, 95% CI= 1.5-2.9). However, no statistically significant association was obtained between dietary intake of various food groups and risk of prediabetes. Total leisure time exercise metabolic equivalence task per week (MET/week) contributed to the lower risk of prediabetes only among the individuals in the highest quartile group (OR = 0.5, 95% CI = 0.3 0.9), whereas walking pace and Total MET/week spent on walking were insignificantly associated with the risk. Individuals of 40 years old or more, lower educational status, overweight or obese especially of large waist circumference and waist hip ratio, and characterized with abnormal lipid profile, irrespective of their dietary intake, were at higher risk of developing prediabetes. In conclusion, illiteracy, obesity, abdominal obesity, sedentary lifestyle appears to be markedly associated with the risk of prediabetes. Thus, a community-based multiple strategies are required to combat the increasing rate of prediabetes and its subsequent end stage of DM.
