title: Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors.
abstract: BACKGROUND
  Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and pre-diabetes) and its associated factors among people aged 35-60 years so as to clarify the relevance of targeted screening in rural Africa.
  
  
  METHODS
  A population-based survey of 1,497 people (786 women and 711 men) aged 35-60 years was conducted in a predominantly rural Demographic Surveillance Site in eastern Uganda. Participants responded to a lifestyle questionnaire, following which their Body Mass Index (BMI) and Blood Pressure (BP) were measured. Fasting plasma glucose (FPG) was measured from capillary blood using On-Call® Plus (Acon) rapid glucose meters, following overnight fasting. AGR was defined as FPG ≥6.1 mmol L⁻¹ (World Health Organization (WHO) criteria or ≥5.6 mmol L⁻¹ (American Diabetes Association (ADA) criteria. Diabetes was defined as FPG >6.9 mmol L⁻¹, or being on diabetes treatment.
  
  
  RESULTS
  The mean age of participants was 45 years for men and 44 for women. Prevalence of diabetes was 7.4% (95%CI 6.1-8.8), while prevalence of pre-diabetes was 8.6% (95%CI 7.3-10.2) using WHO criteria and 20.2% (95%CI 17.5-22.9) with ADA criteria. Using WHO cut-offs, the prevalence of AGR was 2 times higher among obese persons compared with normal BMI persons (Adjusted Prevalence Rate Ratio (APRR) 1.9, 95%CI 1.3-2.8). Occupation as a mechanic, achieving the WHO recommended physical activity threshold, and higher dietary diversity were associated with lower likelihood of AGR (APRR 0.6, 95%CI 0.4-0.9; APRR 0.6, 95%CI 0.4-0.8; APRR 0.5, 95%CI 0.3-0.9 respectively). The direct medical cost of detecting one person with AGR was two US dollars with ADA and three point seven dollars with WHO cut-offs.
  
  
  CONCLUSIONS
  There is a high prevalence of AGR among people aged 35-60 years in this setting. Screening for high risk persons and targeted health education to address obesity, insufficient physical activity and non-diverse diets are necessary.
authors: Division of Global Health-IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. wromay2000@yahoo.co.uk
authors: Roy William
authors: RW
authors: Mayega
authors: David
authors: D
authors: Guwatudde
authors: Fredrick
authors: F
authors: Makumbi
authors: Frederick Nelson
authors: FN
authors: Nakwagala
authors: Stefan
authors: S
authors: Peterson
authors: Goran
authors: G
authors: Tomson
authors: Claes-Goran
authors: CG
authors: Ostenson
mesh_terms: D000328:Adult; D001519:Behavior; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk; D012424:Rural Population / Q000706:statistics & numerical data; D014454:Uganda / Q000453:epidemiology
chemical_list: D001786:Blood Glucose
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