Childhood diabetes in a Bangladeshi population

Backgrounds and Aims: Several epidemiological investigations revealed that the prevalence of Type 2 Diabetes Mellitus (T2DM) has been increasing in the adult population of Bangladesh. But the prevalence of diabetes among the children and adolescents in Bangladesh has not been reported. This study addressed the prevalence of diabetes among the younger people in Bangladesh. Subjects and Methods: We investigated school children of age group 10 - 18 years in rural, suburban and urban communities. Investigations included socio-demographic information, height, weight, mid-upper-arm circumference (MUAC), blood pressure (SBP, DBP) and fasting plasma glucose (FPG). We used WHO criteria (1999) for impaired fasting glucose (IFG) and diabetes mellitus (T2DM). Results: A total of 2152 students (boys/girls: 1064/1088) volunteered the study. Their mean (SD) age was 13.3 (2.0) y, BMI was 18.5 (3.1) and MUAC was 21.2 (3.4) cm. The mean (SD) of FPG was 4.6 (0.87) mmol/l. The prevalence of IFG (95% CI) was 3.4% (2.63 - 4.17) and T2DM was 1.8% (1.23 - 2.37). BMI showed no association with FPG in either sex. In assessing risk for hyperglycemia (FPG > = 5.6mmol/l), logistic regression showed [odds ratio (OR) with 95% CI] that compared with lower age (<12 vs="">16 y) higher age had excess risk (OR 5.2, 2.92 - 9.23). Compared with the rural the urban children had higher risk (OR 14.7, 6.41 - 33.78). Higher family income was also found to have higher risk (BDT <5000 vs="">8000: OR 2.03, 1.30 - 3.18); whereas, higher BMI and MUAC were proved to be not significant. Conclusions: The prevalence of IFG and T2DM in Bangladeshi children and adolescents appears to be high. The urban children from the higher family income are the most vulnerable for developing diabetes, obesity and hypertension. A prospective cohort including other variables like physical activities, waist-girth, insulin or macro-/micronutrients may explain which risk factors are significant for developing diabetes among children and adolescents in Bangladesh.