Type 2 diabetes and impaired fasting blood glucose in rural Bangladesh: a population-based study.

BACKGROUND: Diabetes is a fast expanding global health problem but more so in the developing countries. Therefore, it is of particular interest to study the epidemiological transition of the state and to identify the risk factors in order to recognize the extent of the problem. METHODS: A random sample of 5000 rural individuals (age >/=20 years) were included in a cross-sectional study. Fasting capillary blood glucose levels were measured from 4757 individuals. Height, weight, waist, hips including blood pressure and demographic information was collected. RESULTS: The study population was lean [mean body mass index (BMI) 19.4] with a low prevalence of type 2 diabetes but relatively high impaired fasting glucose. No relationship between type 2 diabetes and BMI in men, but an overall relationship was observed for women (P = 0.04) (data not shown). Age, sex, and waist/hip ratio appeared to be important risk factors for the occurrence of type 2 diabetes in this population. CONCLUSIONS: Low prevalence of type 2 diabetes and relative high impaired fasting blood glucose was observed. The factors associated with the occurrence of diabetes in this population appeared to differ than its known relations with BMI. This may indicate that the risk factors for type 2 diabetes are likely to differ in different population. Our results are likely to be in line with the Indian data suggesting that a revised guideline for anthropometric measures in the South Asian population is called for, in order to classify people at risk.

Nutritional status and birth outcomes of the diabetic and non-diabetic pregnant women.

This cross sectional study compares the nutritional status and birth outcomes of 357 diabetic and non-diabetic pregnant women (203 DM and 154 NDM as control). Uncomplicated diabetic and non-diabetic pregnant women of singleton pregnancies with age range of 19-35 years were enrolled at term in BIRDEM hospital. Maternal anthropometry and neonatal anthropometric measurements were taken following standard techniques. Educational level was significantly different between the groups. The diabetic mothers were found significantly less educated (p<0.0001) compared to non-diabetic mothers. Highly significant differences were observed between the groups on mean maternal age, weight at term, height, body mass index (BMI), mid arm circumference (MAC), and hemoglobin concentration (p values for all: <0.001) with higher values for the DM group. Most of the DM pregnant mothers were either overweight (BMI: 26.0-29.0) or obese (BMI: >29.0), on the other hand most of the NDM pregnant mothers were within normal range (BMI: 19.8-26.0). DM pregnant mothers were found more anemic (45.8% vs. 23.4%; p<0.001). Mean birth weight of the infants of DM & NDM groups were 3100g +/- .500g and 2850g +/- 360g respectively. The mean chest circumference of the infants of DM mothers was found significantly higher for diabetic group (p<0.01). DM mothers delivered most of the preterm babies (16.3% vs. 5.8%; p<0.002) and macrosomy babies were found only in this group (5.9%). Significant correlation was observed between birth weight and maternal MAC (p<0.001) in both the groups. Head circumference was found significantly correlated with maternal MAC and age in the DM group only. Diabetic pregnant women were significantly different compared to the non-diabetic group by nutritional status. The DM group experienced more anemia and preterm deliveries and macrosomic babies were born only in them.