Baseline prevalence of hyperglycemia and its predictors among community clinic users of a selected rural area of Bangladesh: A cross-sectional study using the WHO PEN Protocol 1

J Diabetes Investig. 2023 Dec;14(12):1368-1377. doi: 10.1111/jdi.14074. Epub 2023 Aug 23.

Abstract

Aims/introduction: Our objective was to estimate the prevalence of hyperglycemia at baseline, and identify its predictors among community clinic (CC) users from a selected rural area of Bangladesh.

Materials and methods: This cross-sectional study partly used the baseline data of implementation research in which a total of 11,244 adults visited the CC, and their blood glucose, blood pressure and anthropometry were evaluated according to 'Action 2' of the World Health Organization (WHO) Package of Essential Noncommunicable Disease Interventions (PEN) protocol 1. Of these, 11,144 had complete information on demography, chronic diseases and their risk factors, which were collected during the implementation of 'Action 1' of WHO PEN protocol 1 at the household level. Hyperglycemia, prediabetes (PreD) and type 2 diabetes were diagnosed using the WHO criteria.

Results: Using WHO PEN protocol 1, the estimated baseline prevalence was 12.5% for hyperglycemia, 3.4% for PreD and 9.2% for type 2 diabetes, and was more prevalent among men compared with women. PreD and type 2 diabetes had significantly higher odds ratio (OR >1) of having common risk factors as follows: age ≥40 years (PreD, P < 0.001; type 2 diabetes, P < 0.001), generalized obesity (PreD, P < 0.001; type 2 diabetes, P = 0.005) and hypertension (PreD, P < 0.000; type 2 diabetes, P < 0.001). Furthermore, participants with a family history of diabetes appeared to be a significant predictor of type 2 diabetes (P < 0.001), but not for PreD (P = 0.303).

Conclusions: Hyperglycemia, preD and type 2 diabetes showed a comparatively high prevalence among the CC users of the selected rural area. Obesity and hypertension are the key modifiable risk factors that should be reduced using a CC-centered risk reduction strategy.

Keywords: Bangladesh; WHO PEN; hyperglycemia.

MeSH terms

  • Adult
  • Bangladesh / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Humans
  • Hyperglycemia* / epidemiology
  • Hypertension* / epidemiology
  • Male
  • Obesity / complications
  • Obesity / epidemiology
  • Prediabetic State* / epidemiology
  • Prevalence
  • Risk Factors
  • Rural Population

Supplementary concepts

  • PEN protocol