title: Prevalence and predictors of prediabetes and diabetes among adults in Palau: population-based national STEPS survey.
abstract: We aimed to investigate the prevalence and predictors of diabetes and prediabetes among adults in Palau. We used data of 1915 adults, aged 25 to 64 years, who participated in the World Health Organization's (WHO) STEPwise Approach to Risk Factor Surveillance (STEPS) study in Palau. Information on behavioral risk factors of NCDs and physical and biochemical measurements were obtained using standard methods of the WHO. The diagnosis of diabetes and prediabetes was based on the recent American Diabetes Association criteria. Predictors of the prevalence of diabetes and prediabetes were identified using multinomial logistic regression analysis. The overall age-standardized prevalence of prediabetes and diabetes were 40.4% (43.6% for men, 37.4% for women) and 17.7% (18.6% for men, 17% for women), respectively. Old age, overall obesity (high BMI), central obesity (large waist circumference or waist-hip ratio), hypertension and hypertriglyceridemia were significant predictors of prediabetes and/or diabetes. Diabetes occurred at a younger age in "obese" individuals than that of their "non-obese" counterparts. We confirmed that prediabetes and diabetes are highly prevalent in Palau affecting 40% and 18% adults, respectively. Introducing public health interventions to reduce and prevent obesity as early as possible could prove useful to curb the problem.
authors.affiliation: Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Esayas Haregot
authors.initials: EH
authors.lastname: Hilawe
authors.affiliation: Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Chifa
authors.initials: C
authors.lastname: Chiang
authors.affiliation: Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuya
authors.affiliation: Department of Public Health, Aichi Medical University, Nagakute, Japan.
authors.forename: Chaochen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Ministry of Health, Republic of Palau, Koror, Palau.
authors.forename: Edolem
authors.initials: E
authors.lastname: Ikerdeu
authors.affiliation: Public Health, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Honjo
authors.affiliation: Institute for Academic Initiatives, Osaka University, Suita, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mita
authors.affiliation: Public Health, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Renzhe
authors.initials: R
authors.lastname: Cui
authors.affiliation: Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hirakawa
authors.affiliation: Ministry of Health, Republic of Palau, Koror, Palau.
authors.forename: Sherilynn
authors.initials: S
authors.lastname: Madraisau
authors.affiliation: Ministry of Health, Republic of Palau, Koror, Palau.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Ngirmang
authors.affiliation: Public Health, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.affiliation: Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Aoyama
keywords: Palau; diabetes; prediabetes; predictors; prevalence