Prevalence and Associated Factors of Prediabetes and Diabetes in Rural and Peri-Urban Bangladesh: A Community-Based Cross-Sectional Study

Abstract

Background and objectives The global burden of prediabetes and diabetes is rising rapidly, particularly in low- and middle-income countries like Bangladesh, where lifestyle and nutritional transitions are accelerating. Economically disadvantaged rural populations often lack awareness and access to care, making them highly vulnerable. Measuring the prevalence and identifying associated factors is essential for guiding public health strategies and resource allocation. This study aimed to assess the prevalence and associated factors of prediabetes and diabetes in a rural and peri-urban Bangladeshi community to inform targeted prevention and control strategies. Methodology We recruited 891 adults for this cross-sectional study in January-June 2020 through random sampling from the Mirzapur Demographic Surveillance System in Bangladesh, ensuring at least five years of residency. Trained Community Health Workers collected sociodemographic data using a semi-structured questionnaire and performed physical examination and anthropometric measurements. We used fasting blood sugar to screen patients for prediabetes and diabetes, and measured serum creatinine and urine albumin to creatinine ratio to diagnose chronic kidney disease (CKD). We also collected blood samples to measure serum albumin, hemoglobin, total cholesterol, and triglycerides. Blood and urine samples were tested in an accredited laboratory. Results Prevalence of prediabetes was 38% (n=343), and diabetes was 17% (n=151). Age-specific prevalences of prediabetes were 5%, 12% and 22%, and of diabetes were 1%, 3% and 13%, for the age groups of 18-30, 31-45, and ≥46 years, respectively. Sex-specific prevalences of prediabetes were 22% and 17%, and diabetes were 9% and 8%, for female and male participants, respectively. In multiple multinomial logistic regression, for prediabetes, significant risk factor was age ≥31 years (adjusted odds ratio (aOR) 2.84, 95%CI 1.64-4.92), and protective factors were smokeless tobacco use (aOR 0.58, 95%CI 0.36-0.94) and hypoalbuminemia (aOR 0.48, 95%CI 0.24-0.99), and for diabetes, significant risk factors were age ≥31 years (aOR 4.04, 95%CI 1.37-11.95), abdominal obesity (aOR 2.80, 95%CI 1.49-5.30), CKD (aOR 2.80, 95% CI 1.70-4.62), hypercholesterolemia (aOR 1.97, 95%CI 1.17-3.30) and hypertriglyceridemia (aOR 2.33, 95%CI 1.44-3.79), and protective factors were being female (aOR 0.21, 95%CI 0.066-0.68), and smokeless tobacco user (aOR 0.32, 95%CI 0.17-0.63). Conclusion This study reveals a high burden of prediabetes and diabetes in a rural and peri-urban Bangladeshi population. The findings underscore the urgent need to strengthen community-based screening and targeted prevention strategies to address the growing diabetes burden in underserved areas.