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Diabetes and cardiometabolic risk factors in Cambodia: Results from two screening studies.
Journal of Diabetes 2018 Februrary
BACKGROUND: Despite growing attention to diabetes throughout Asia, data from Southeast Asia are limited. This article reports rates of diabetes, hypertension, and obesity in Cambodia.
METHODS: Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863). Blood pressure and anthropometrics were also measured.
RESULTS: In the screening study, rates of diabetes were significantly higher in urban than rural sites, with intermediate rates in semi-urban areas. There was a significant dose-response effect for urbanicity on overweight, obesity, and waist:hip ratio, with higher rates for urban versus semi-urban and for semi-urban versus rural locales. Rural sites had the lowest rates of hypertension, followed by urban and semi-urban sites. Among people who screened positive for diabetes, there was a dose-response effect for urbanicity on undiagnosed diabetes; rates of previously undiagnosed diabetes were lowest in urban (51%), followed by semi-urban (55%) and rural (67%) locales. Rural participants reported the highest rates of smoking and alcohol use. In the urban epidemiological study, prevalence rates of diabetes and impaired glucose tolerance were approximately 10%, indicating a prevalence of total glucose intolerance of approximately 20%.
CONCLUSIONS: In Cambodia, diabetes rates are high among urban residents and undiagnosed diabetes is highest among rural residents. A country-wide public health response is urgently needed; as development continues, rates of diabetes are expected to rise.
METHODS: Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863). Blood pressure and anthropometrics were also measured.
RESULTS: In the screening study, rates of diabetes were significantly higher in urban than rural sites, with intermediate rates in semi-urban areas. There was a significant dose-response effect for urbanicity on overweight, obesity, and waist:hip ratio, with higher rates for urban versus semi-urban and for semi-urban versus rural locales. Rural sites had the lowest rates of hypertension, followed by urban and semi-urban sites. Among people who screened positive for diabetes, there was a dose-response effect for urbanicity on undiagnosed diabetes; rates of previously undiagnosed diabetes were lowest in urban (51%), followed by semi-urban (55%) and rural (67%) locales. Rural participants reported the highest rates of smoking and alcohol use. In the urban epidemiological study, prevalence rates of diabetes and impaired glucose tolerance were approximately 10%, indicating a prevalence of total glucose intolerance of approximately 20%.
CONCLUSIONS: In Cambodia, diabetes rates are high among urban residents and undiagnosed diabetes is highest among rural residents. A country-wide public health response is urgently needed; as development continues, rates of diabetes are expected to rise.
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