Dagenais, G R and Gerstein, H C and Zhang, X and McQueen, M and Lear, S and Lopez-Jaramillo, P and Mohan, V and Mony, Prem and Gupta, R and Kutty, V Raman and Kumar, R and Rahman, Omar and Yusoff, Khalid and Zatonska, Katarzyna and Oguz, Aytekin and Rosengren, Annika and Kelishadi, Roya and Yusufali, Afzalhussein and Diaz, Rafael and Avezum, Alvaro and Lanas, Fernando and Kruger, Annamarie and Peer, Nasheeta and Chifamba, Jephat and Iqbal, Romaina and Ismail, Noorhassim and Xiulin, Bai and Jiankang, Liu and Wenqing, Deng and Gejie, Yue and Rangarajan, Sumathy and Teo, Koon and Yusuf, Salim (2016) Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results From the Prospective Urban and Rural Epidemiological Study. Diabetes Care, 39 (5). p. 780. ISSN 0149-5992
OBJECTIVE The goal of this study was to assess whether diabetes prevalence varies by countries at different economic levels and whether this can be explained by known risk factors. RESEARCH DESIGN AND METHODS The prevalence of diabetes, defined as self-reported or fasting glycemia ‡7 mmol/L,was documented in 119,666 adults from three high-income (HIC), seven uppermiddle-income (UMIC), four lower-middle-income (LMIC), and four low-income (LIC)countries. Relationships between diabetes and its risk factors within these country groupings were assessed using multivariable analyses. RESULTS Age- and sex-adjusted diabetes prevalences were highest in the poorer countries and lowest in the wealthiest countries (LIC 12.3%, UMIC 11.1%, LMIC 8.7%, and HIC 6.6%; P < 0.0001). In the overall population, diabetes risk was higher with a 5-year increase in age (odds ratio 1.29 [95% CI 1.28–1.31]), male sex (1.19 [1.13–1.25]), urban residency (1.24 [1.11–1.38]), low versus high education level (1.10 [1.02– 1.19]), low versus high physical activity (1.28 [1.20–1.38]), family history of diabetes (3.15 [3.00–3.31]), higher waist-to-hip ratio (highest vs. lowest quartile; 3.63 [3.33–3.96]), and BMI (‡35 vs. <25 kg/m2 ; 2.76 [2.52–3.03]). The relationship between diabetes prevalence and both BMI and family history of diabetes differed in higher- versus lower-income country groups (P for interaction < 0.0001). After adjustment for all risk factors and ethnicity, diabetes prevalences continued to show a gradient (LIC 14.0%, LMIC 10.1%, UMIC 10.9%, and HIC 5.6%). CONCLUSIONS Conventional risk factors do not fully account for the higher prevalence of diabetes in LIC countries. These findings suggest that other factors are responsible for the higher prevalence of diabetes in LIC countries.
|Uncontrolled Keywords:||Epidemiology; Diabetes|
|Divisions:||Department of Diabetology|
|Deposited By:||surendar radha|
|Deposited On:||27 May 2016 15:52|
|Last Modified:||27 May 2016 15:52|
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