Diabetes and Impaired Fasting Glycemia in the Tribes of Khagrachari Hill Tracts of Bangladesh

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Abstract
OBJECTIVE—To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a tribal population of Bangladesh. RESEARCH DESIGN AND METHODS—A cluster sampling of 1,287 tribal subjects of age ≥20 years was investigated. They live in a hilly area of Khagrachari in the far northeast of Bangladesh. Fasting plasma glucose, blood pressure, height, weight, waist girth, and hip girth were measured. Lipid fractions were also estimated. We used the 1997 American Diabetes Association diagnostic criteria. RESULTS—The crude prevalence of type 2 diabetes was 6.6% and IFG was 8.5%. The age-standardized (20–70 years) prevalence of type 2 diabetes (95% CI) was 6.4% (4.96–7.87) and of IFG was 8.4% (6.48–10.37). Both tribesmen and women had equal risk for diabetes and IFG. Compared with the lower-income group, the participants with higher income had a significantly higher prevalence of type 2 diabetes (18.8 vs. 3.1%, P < 0.001) and IFG (17.2 vs. 4.3%, P < 0.001). Using logistic regression, we found that increased age, high-income group, and increased central obesity were the important risk factors of diabetes. CONCLUSIONS—The prevalence of diabetes in the tribal population was higher than that of the nontribal population of Bangladesh. Older age, higher central obesity, and higher income were proven significant risk factors of diabetes. High prevalence of diabetes among these tribes indicates that the prevalence of diabetes and its complications will continue to increase. Evidently, health professionals and planners should initiate diabetes care in these tribal communities.