Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017

Abstract

Background Type 2 diabetes in the Gulf Cooperation Council countries, including Oman, is currently the fastest growing health crisis and is a significant cause of premature mortality and disability. There is currently insufficient up-to-date information available on prevalence of type 2 diabetes. This study aimed to assess the latest prevalence of type 2 diabetes mellitus and its associated demographic, behavioural, and clinical risk factors. Methods Using the WHO STEPwise approach to chronic disease surveillance, a nationally representative population-based survey was conducted from January to April 2017 of adults aged 18 years and above. A multi-stage, stratified, geographically clustered random sampling surveyed 9053 households including Omani nationals and non-Omani residents. Univariate and multiple logistic regression analysis was performed to determine the predictors of diabetes. Results Overall prevalence of diabetes among the population was 15.7% (95% CI: 14.0–17.5%) whereas prevalence of prediabetes was 11.8% (95% CI: 11.4–12.2%). Age, educational level, raised blood pressure, family history of diabetes, abnormal waist-to-hip ratio, and hypertriglyceridemia were found to be significantly associated with diabetes mellitus. Of the cases of diabetes mellitus, 17% were newly diagnosed and 13.2% were on medication and had an uncontrolled glucose level while 55.5% were not taking medication (although diagnosed) and had an uncontrolled blood glucose level. Conclusions The present study provides reliable information regarding the high prevalence of diabetes mellitus among the adult population in Oman with urgent attention needed to address this significant burden on the health system. The high proportion of uncontrolled cases warrants further research, awareness programmes, and community interventions.

Higher fasting triglyceride predicts higher risks of diabetes mortality in US adults

“…Epidemiological [ 2 , 3 ] and longitudinal cohort studies [ 4 – 6 , 30 , 31 ] showed that higher triglyceride may be a cause of new-onset of diabetes. However, this is not without controversy, as genetic studies provided mixed results.…”

“…Although it has been widely reported that higher triglyceride is associated with diabetes prevalence and incidence [ 2 – 6 , 30 , 31 ], one important piece of information is missing from the literature, i.e., whether higher triglyceride is associated with higher diabetes mortality. The current study filled this knowledge gap.…”

“…Confounding covariates included age (continuous) [ 2 ], sex (male or female) [ 10 ], ethnicity (non-Hispanic white, non-Hispanic black, Mexican-American, or other) [ 11 ], obesity (underweight, normal, overweight, obese, or unknown) [ 3 , 12 ], education (< high school, high school, or > high school) [ 2 ], poverty-income ratio (< 130, 130–349%, ≥ 350%, or unknown) [ 10 , 13 ], and survey periods (1988–1991, 1991–1994, 1999–2000, 2001–2002, 2003–2004, 2005–2006, 2007–2008, 2009–2010, 2011–2012, or 2013–2014). NHANES III was conducted in two stages, i.e., from 1988 to 1991 and then from 1991 to 1994, and the subsequent cycles of NHANES were conducted once every 2 years.…”

“…In brief, the inactive group was defined as those with no reported moderate-to-vigorous leisure-time physical activity; the active group was defined as those who had ≥3 times per week of vigorous leisure-time physical activities, or a combination of 2 vigorous and 2 moderate leisure-time physical activities per week, or ≥ 5 times per week of any type of leisure-time physical activities (moderate or vigorous or a combination); and insufficiently active group was defined as those who were not inactive and did not meet the criteria for the active group [ 15 ]. Clinical confounders included hypercholesterolemia (yes or no) [ 19 ], diabetes (yes or no), hypertension (yes, no, or unknown) [ 2 ], and family history of diabetes (yes, no, or unknown) [ 2 ]. Hypercholesterolemia was defined as total cholesterol ≥240 mg/dL or self-reported diagnosis of hypercholesterolemia [ 20 ].…”

“…Epidemiological studies frequently show that circulating triglyceride is higher in people with diabetes than that in those without diabetes [ 2 , 3 ]. Higher baseline triglyceride was reported to be associated with new-onset of diabetes in various populations such as Chinese [ 4 ], Japanese [ 5 ], and Americans [ 6 ].…”