Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011
Diabetes mellitus is rising disproportionately but is not frequently diagnosed until complications appear, which results in adverse health consequences. We estimated the prevalence of undiagnosed diabetes among adult diabetic patients and associated socioeconomic inequalities in Bangladesh. We used...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2019-01-01
|
Series: | International Journal of Environmental Research and Public Health |
Subjects: | |
Online Access: | http://www.mdpi.com/1660-4601/16/1/115 |
id |
doaj-50abe22c88344ce5a5561ce3ea61adb1 |
---|---|
record_format |
Article |
spelling |
doaj-50abe22c88344ce5a5561ce3ea61adb12020-11-24T20:42:55ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012019-01-0116111510.3390/ijerph16010115ijerph16010115Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011Md. Mehedi Hasan0Fariha Tasnim1Md. Tariqujjaman2Sayem Ahmed3Institute for Social Science Research, The University of Queensland, Indooroopilly 4068, Queensland, AustraliaMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 1212 Dhaka, BangladeshNutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 1212 Dhaka, BangladeshHealth Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 1212 Dhaka, BangladeshDiabetes mellitus is rising disproportionately but is not frequently diagnosed until complications appear, which results in adverse health consequences. We estimated the prevalence of undiagnosed diabetes among adult diabetic patients and associated socioeconomic inequalities in Bangladesh. We used nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2011 data. Among patients with diabetes, we identified undiagnosed cases as having fasting plasma glucose ≥ 7.0 mmol/L, never having taken prescribed medicine and being told by health professionals. Among 938 patients with diabetes, 53.4% remained undiagnosed. The poorest (75.9%) and rural (59.0%) patients had significantly higher undiagnosed cases than the richest (36.0%) and urban (42.5%), respectively. Multiple logistic regression analysis revealed that the likelihood of being undiagnosed was lower among patients with age ≥ 70 years vs. 35–39 years (adjusted odds ratio (AOR) = 0.35; 95% confidence interval (CI) 0.19, 0.64) and patients with higher education vs. no education (AOR = 0.36; 95% CI 0.21, 0.62). Conversely, a high level of physical activity and being in a poor socioeconomic quintile were associated with a higher risk of remaining undiagnosed for diabetes. The Concentration Index (C) also showed that undiagnosed diabetes was largely distributed among the socioeconomically worse-off group in Bangladesh (C = −0.35). Nationwide diabetes screening programs may reduce this problem in Bangladesh and other similar low-income settings.http://www.mdpi.com/1660-4601/16/1/115undiagnosed diabetessocioeconomic conditioninequalityodds ratioconcentration indexBangladesh |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Md. Mehedi Hasan Fariha Tasnim Md. Tariqujjaman Sayem Ahmed |
spellingShingle |
Md. Mehedi Hasan Fariha Tasnim Md. Tariqujjaman Sayem Ahmed Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 International Journal of Environmental Research and Public Health undiagnosed diabetes socioeconomic condition inequality odds ratio concentration index Bangladesh |
author_facet |
Md. Mehedi Hasan Fariha Tasnim Md. Tariqujjaman Sayem Ahmed |
author_sort |
Md. Mehedi Hasan |
title |
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 |
title_short |
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 |
title_full |
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 |
title_fullStr |
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 |
title_full_unstemmed |
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011 |
title_sort |
socioeconomic inequalities of undiagnosed diabetes in a resource-poor setting: insights from the cross-sectional bangladesh demographic and health survey 2011 |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2019-01-01 |
description |
Diabetes mellitus is rising disproportionately but is not frequently diagnosed until complications appear, which results in adverse health consequences. We estimated the prevalence of undiagnosed diabetes among adult diabetic patients and associated socioeconomic inequalities in Bangladesh. We used nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2011 data. Among patients with diabetes, we identified undiagnosed cases as having fasting plasma glucose ≥ 7.0 mmol/L, never having taken prescribed medicine and being told by health professionals. Among 938 patients with diabetes, 53.4% remained undiagnosed. The poorest (75.9%) and rural (59.0%) patients had significantly higher undiagnosed cases than the richest (36.0%) and urban (42.5%), respectively. Multiple logistic regression analysis revealed that the likelihood of being undiagnosed was lower among patients with age ≥ 70 years vs. 35–39 years (adjusted odds ratio (AOR) = 0.35; 95% confidence interval (CI) 0.19, 0.64) and patients with higher education vs. no education (AOR = 0.36; 95% CI 0.21, 0.62). Conversely, a high level of physical activity and being in a poor socioeconomic quintile were associated with a higher risk of remaining undiagnosed for diabetes. The Concentration Index (C) also showed that undiagnosed diabetes was largely distributed among the socioeconomically worse-off group in Bangladesh (C = −0.35). Nationwide diabetes screening programs may reduce this problem in Bangladesh and other similar low-income settings. |
topic |
undiagnosed diabetes socioeconomic condition inequality odds ratio concentration index Bangladesh |
url |
http://www.mdpi.com/1660-4601/16/1/115 |
work_keys_str_mv |
AT mdmehedihasan socioeconomicinequalitiesofundiagnoseddiabetesinaresourcepoorsettinginsightsfromthecrosssectionalbangladeshdemographicandhealthsurvey2011 AT farihatasnim socioeconomicinequalitiesofundiagnoseddiabetesinaresourcepoorsettinginsightsfromthecrosssectionalbangladeshdemographicandhealthsurvey2011 AT mdtariqujjaman socioeconomicinequalitiesofundiagnoseddiabetesinaresourcepoorsettinginsightsfromthecrosssectionalbangladeshdemographicandhealthsurvey2011 AT sayemahmed socioeconomicinequalitiesofundiagnoseddiabetesinaresourcepoorsettinginsightsfromthecrosssectionalbangladeshdemographicandhealthsurvey2011 |
_version_ |
1716821236358578176 |