Awareness, treatment, and control of diabetes in Bangladesh: evidence from the Bangladesh Demographic and Health Survey 2017/18

Abstract

Background The prevalence of diabetes is increasing in Bangladesh; however, the management of diabetes assessed by diabetes awareness, treatment, and control, remains poor. We aimed to estimate the age-standardised prevalence of awareness, treatment, and control of diabetes and its associated factors. Methods In this cross-sectional study, data from 1,174 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017-18 were analysed. Awareness, treatment, and control of diabetes were our outcomes of interest. Crude and age-stadarised prevalence of awareness, treatment, and control were estimated using the survey weight and direct standardisation, respectively. Multilevel mixed-effects Poisson regression models were used to identify factors associated with awareness, treatment, and control of diabetes. Results Among those with diabetes (n=1,174), only 41.6% (95% CI, 38.3-45.0) were aware that they had the condition, and 39.3% (95% CI, 35.9-42.6) were taking treatment. Among those treated for diabetes, only 33.3% (95% CI, 28.9-37.6) had controlled diabetes. Factors positively associated with awareness and treatment were increasing age and hypertension while factors negatively associated with awareness and treatment were being men and having lower education. Factors associated with poor control were secondary education and residing in Rajshahi and Rangpur divisions. Conclusion This study provides evidence of poor management of diabetes in Bangladesh, especially in men. Less than half of the people with diabetes were aware of their condition, and only one-third had controlled diabetes. Interventions targeting younger people, in particular men and those with lower education, are urgently needed. The government needs to strengthen diabetes management programs within primary health care and address structural factors including the costs of diabetes care to improve awareness, treatment, and control of diabetes in Bangladesh.