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

• Published in: PloS one Vol. 13; no. 11; p. e0206034
• Main Authors: Wangdi, Kinley, Jamtsho, Tshering
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15.11.2018; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Age Factors; Aged; Aging; Aging - pathology; Alcohol Drinking - epidemiology; Alcohol use; Bhutan - epidemiology; Biology and Life Sciences; Cardiovascular disease; Data analysis; Data processing; Demographics; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - pathology; Disease prevention; Education; Epidemiology; Exercise; Female; Fruits; Health risk assessment; Health risks; Heart; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - pathology; Lifestyles; Logistic Models; Male; Medicine; Medicine and Health Sciences; Metabolic syndrome; Middle Aged; Migration; Mortality; Nutrition; Obesity - complications; Obesity - diagnosis; Obesity - epidemiology; Obesity - pathology; People and Places; Physical fitness; Population; Public health; Regression analysis; Research and Analysis Methods; Risk analysis; Risk Factors; Rural areas; Rural urban migration; Self Report; Sex Factors; Smoking; Smoking - epidemiology; Smoking - pathology; Social Sciences; Sports medicine; Studies; Bhutan; Australia; Canberra Australian Capital Territory Australia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0206034

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. 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. 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). 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.