Risk factors for self-reported diabetes among Bhutanese adults: A nationally representative survey data analysis

Abstract

BackgroundBhutan, a small land-locked country in the eastern Himalayas has been undergoing an epidemiological and nutritional transition in the last two decades. The objective of this paper was to determine the prevalence and explore the risk factors of self-reported diabetes among Bhutanese adults.MethodsWe conducted a secondary data analysis among adults 18 years and older Bhutanese using the data from the National Health Survey 2012 (NHS, 2012) of Bhutan. The self-reported information on risk factors was obtained using standard protocols of the WHO STEPwise approach to Surveillance. The outcome of interest was self-reported diabetes on medication. Adjusted and unadjusted logistic regression analyses were performed to identify the risk factor of diabetes.ResultsA total of 31,066 participants aged 18 years and older were included for the analysis. The prevalence of self-reported hypertension was 1.8% (491). Risk factors for diabetes were: age groups: 35–44 years adjusted odds ratio (AOR) = 2.82 (95% CI, 1.07, 7.41), 45–54 years AOR = 6.02 (95% CI, 2.29, 15.83), 55–64 year AOR = 15.7 (95% CI 5.93, 41.55) and >65 years AOR = 19.60 (95% CI, 6.93, 55.71); high school and diploma/certificate education AOR = 2.57, (95% CI 1.62, 4.07) and AOR = 3.92 (95% CI 1.70, 9.07); and urban dwellers AOR = 2.37, (95% 1.58, 3.57); hypertension AOR = 3.3, (95% CI 2.47, 4.41); and fruit servings of 1–3 per week AOR = 1.63 (95% CI 1.15, 2.31).ConclusionThe number of Bhutanese adults with diabetes and co-morbidities associated with it is likely to increase with the ageing of the population, nutrition transition, and high rural-urban migration in the near future. This calls for an urgent need to implement strategies to prevent diabetes in the Bhutanese population targeting risk factors including healthy lifestyle with increased physical activities and reduced smoking. At the same time treating other chronic morbidities including hypertension.

Prevalence and predisposing factors for self-reported hypertension in Bhutanese adults

“…This is due to the shared risk factors such as sedentary lifestyle and obesity [35], smoking and alcohol use, and share a common metabolic pathway [36]. Diabetes in general Bhutanese population was around 1.8% [17,37]. Therefore, national preventive strategies should take a holistic approach incorporating both hypertension and diabetes.…”

Diabetes Case Burden at Central Regional Referral Hospital, Gelephu, Bhutan; A Retrospective Study

“…Population ageing has set in Bhutan. 18 The current study found that 59.51% of new cases of diabetes were ≥50 years. Ageing society also plays a critical role in moderation of lifestyle related diseases.…”

Comparison of Laboratory and Non-Laboratory-Based 2019 World Health Organization Cardiovascular Risk Charts in the Bhutanese Population

“…Noncommunicable diseases including CVD are becoming an important public health problem in Bhutan because of epidemiological and nutritional transition in the last two decades. [12][13][14][15][16] This was driven by rising disposable income levels and a shift to diets lower in carbohydrates and higher in saturated fat, sugar and salt from traditional high-carbohydrate and low-fat diets. As a result, a significant increase in chronic diseases including CVD, diabetes, hypertension, and smoking has been reported.…”

“…As a result, a significant increase in chronic diseases including CVD, diabetes, hypertension, and smoking has been reported. In 2012, the prevalence of diabetes was 1.8%, 12 hypertension 17.4%, 16 alcohol use 30.9%, 14 betel quid use 45.0%, 15 and smoking 4%. 17 In 2019, the national prevalence of CVD was 37.9%.…”