Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic class, and higher WHR were proven to be independent risk factors for glucose intolerance in either area.

OBJECTIVE -To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a rural population of Bangladesh.RESEARCH DESIGN AND METHODS -A cluster sampling of 4,923 subjects Ն20 years old in a rural community were investigated. Fasting plasma glucose, blood pressure, height, weight, and girth of waist and hip were measured. BMI and waist-to-hip ratio (WHR) were calculated. Total cholesterol, triglycerides, and HDL cholesterol were also estimated. We used the 1997 American Diabetes Association diagnostic criteria.RESULTS -The crude prevalence of type 2 diabetes was 4.3% and IFG was 12.4%. The age-standardized prevalence of type 2 diabetes (95% CI) was 3.8% (3.12-4.49) and IFG was 13.0% (11.76 -14.16). The subjects with higher family income had significantly higher prevalence of type 2 diabetes (5.9 vs. 3.5%, P Ͻ 0.001) and IFG (15.6 vs. 10.8%, P Ͻ 0.001) than those with lower income. Employing logistic regression in different models, we found that wealthy class, family history of diabetes, reduced physical exercise, and increased age, BMI, and WHR were the important predictors of diabetes. Total cholesterol, triglycerides, and HDL cholesterol showed no association with diabetes and IFG.CONCLUSIONS -The prevalence of diabetes and IFG in the rural population was found to be on the increase compared with the previous reports of Bangladesh and other Asian studies. Older age, higher obesity, higher income, family history of diabetes, and reduced physical activity were proved significant risk factors for diabetes and IFG, whereas plasma lipids showed no association with diabetes and IFG. Further study may address whether diabetes is causally associated with insulin deficiency or insulin resistance.

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The prevalence of non-communicable diseases (NCD) like diabetes, hypertension, dyslipidemia and atherosclerotic cardiovascular diseases (CVD) are on the increase globally and predominantly in the South East Asian Region (SEAR). The increasing NCD and its complications burdened the health cost of Bangladesh. The available literatures suggest that edible mushrooms are effective in controlling metabolic risks like hyperglycemia and hypercholesterolemia.The study addressed the metabolic effects of edible oyster mushroom (Pleurotus ostreatus) in diabetic individuals and to assess the undesirable effects of mushroom.A total of 5000 newly registered diabetic women were screened for eligible participants (urban housewives, age 30 – 50y, BMI 22 – 27, FBG 8 – 12 mmol/l; free from complications or systemic illnesses and agreed to adhere to the study for 360 days). The investigations included weight and height for BMI, waist- and hip-girth for WHR, BP, FBG, 2ABF, T-chol, TG, HDL, LDL, ALT and Creatinine starting from the day 0 (baseline) and each subsequent follow-up days: 60, 120, 180, 240, 300 and 360 for comparison between placebo and mushroom groups and also within group (baseline vs. follow up days), individually for placebo and mushroom. The daily intake of mushroom was 200g for the mushroom group and an equivalent calorie of vegetables for the placebo group.Overall, 73 diabetic housewives (mushroom / placebo = 43 /30) volunteered. The mean (with SEM) values of BMI, WHR, BP, FBG, 2ABF, T-chol, TG, HDL, LDL, ALT and Creatinine of the placebo group were compared with the mushroom group. Compared with the placebo, the mushroom group showed significant reductions of FBG (p<0.001), 2ABF (p<0.001), T-chol (p<0.001), TG (p=0.03) and LDL (p<0.001); whereas, no difference was observed for BMI, SBP, DBP, HDL, Hb, creatinine and ALT. The comparison within groups (baseline vs. follow-up) there were significant reduction of these variables in mushroom but not in the placebo group.Mushroom was found to have significant effect in reducing blood glucose, T-chol, TG and LDL. No impaired function was observed for liver, kidney and hemopoeitic tissue in taking mushroom for 360 days of the study period.Ibrahim Med. Coll. J. 2014; 8(1): 6-11

The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. Increased morbidity and mortality among mothers and newborns in Bangladesh may, in part, be because of increased prevalence of GDM.

OBJECTIVE -To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a tribal population of Bangladesh. RESEARCH DESIGN AND METHODS-A cluster sampling of 1,287 tribal subjects of age Ն20 years was investigated. They live in a hilly area of Khagrachari in the far northeast of Bangladesh. Fasting plasma glucose, blood pressure, height, weight, waist girth, and hip girth were measured. Lipid fractions were also estimated. We used the 1997 American Diabetes Association diagnostic criteria.RESULTS -The crude prevalence of type 2 diabetes was 6.6% and IFG was 8.5%. The age-standardized (20 -70 years) prevalence of type 2 diabetes (95% CI) was 6.4% (4.96 -7.87) and of IFG was 8.4% (6.48 -10.37). Both tribesmen and women had equal risk for diabetes and IFG. Compared with the lower-income group, the participants with higher income had a significantly higher prevalence of type 2 diabetes (18.8 vs. 3.1%, P Ͻ 0.001) and IFG (17.2 vs. 4.3%, P Ͻ 0.001). Using logistic regression, we found that increased age, high-income group, and increased central obesity were the important risk factors of diabetes.CONCLUSIONS -The prevalence of diabetes in the tribal population was higher than that of the nontribal population of Bangladesh. Older age, higher central obesity, and higher income were proven significant risk factors of diabetes. High prevalence of diabetes among these tribes indicates that the prevalence of diabetes and its complications will continue to increase. Evidently, health professionals and planners should initiate diabetes care in these tribal communities.

Coronary heart disease (CHD) is a major global health problem with the majority of burden observed increasingly in the developing countries. There has been no estimate of CHD in Bangladesh. This study addresses the prevalence of CHD in a Bangladeshi rural population which also aimed to determine the risk factors related to CHD. Ten villages of Nandail sub-district under Mymensingh were selected purposively. All subjects of age ≥20y were considered eligible and were interviewed about family income, family history of T2DM, CHD and HTN. The investigations included height, weight, waist-girth, hip-girth, systolic and diastolic blood pressure (SBP & DBP), fasting blood glucose (FBG), triglycerides (TG), cholesterol (Chol) and high density lipoprotein (HDL). Hemoglobin A1c (HbA1c) and albumin-creatinine ratio (ACR) were also estimated. Finally, electrocardiography (ECG) was undertaken in all participants who had family history of diabetes or hypertension or CHD. Diagnosis of CHD was based on history of angina or changes in ECG or diagnosed by a cardiologist. A total of 6235 subjects were enlisted as eligible (age ≥20y) participants. Of them, 4141 (m / f: 1749 / 2392) subjects volunteered for the study. The age-adjusted (20-69y) prevalence of CHD was 1.85 with 95% CI, 1.42 -2.28. There was no significant difference between men and women. The mean (SD) values of age (p<0.001), SBP (p<0.01), DBP (p<0.05), HbA1c (p<0.05) and ACR (p<0.01) were significantly higher among subjects with CHD than those without; whereas, there were no significant differences in BMI and WHR, TG, Chol and HDL. Logistic regression analysis showed that adjusted for age, sex, social class and obesity, the subjects with higher age (≥45y), higher 2hBG (≥7.0mmol/l), higher ACR (≥17.2) and family history of CHD had significant risk for CHD. The prevalence of CHD is comparable with other Asian population. Family history of CHD and age over 45 years, and who had hyperglycemia and higher ACR were proved to be the independent predictors of CHD. CHD was found to affect participants irrespective of sex, social class, obesity and lipid status. Though the IFG and diabetes groups appeared to have similar biophysical characteristics, only the diabetes group had significant risk for CHD. Further study in a larger sample may be undertaken to confirm the study findings and to explore some unidentified risk factors of CHD.Ibrahim Med. Coll.

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