Key result
Older age (>65 years) was strongly associated with self-reported diabetes (AOR 19.60; 95% CI 6.93-55.71), along with higher education, urban dwelling, and hypertension.
Why the study?
Bhutan has undergone an epidemiological and nutritional transition, motivating an assessment of the prevalence and risk factors of self-reported diabetes among Bhutanese adults.
Cross-Sectional (n=31,066)
Yes
Odds Ratio: 19.6 (95% CI 6.93–55.71)
Older age, urban dwelling, higher education, and hypertension are significant risk factors for self-reported diabetes among Bhutanese adults.
May warrant prioritized diabetes screening in older adults; leaves open causal mechanisms and generalizability.
BACKGROUND: Bhutan, 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. METHODS: We 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. RESULTS: A 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). CONCLUSION: The 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.
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Wangdi et al. (2018) conducted a cross-sectional in self-reported diabetes (n=31,066). Risk factors (including older age, higher education, urban dwelling, and hypertension) vs. Reference groups was evaluated on self-reported diabetes on medication (AOR 19.60, 95% CI 6.93-55.71). Older age (>65 years) was strongly associated with self-reported diabetes (AOR 19.60; 95% CI 6.93-55.71), along with higher education, urban dwelling, and hypertension.
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