EFFECT OF SOCIOECONOMIC RISK-FACTORS ON THE DIFFERENCE IN PREVALENCE OF DIABETES BETWEEN RURAL AND URBAN POPULATIONS IN BANGLADESH

OBJECTIVE - To compare the prevalence of diabetes between the poor and rich of rural and urban populations in Bangladesh. RESEARCH DESIGN AN D METHODS - A total of 1,052 subjects from urban and 1,319 from rural communities (age greater than or equal to 20 years) of different socio economic classes were investigated. Capillary blood glucose levels, fa sting and 2 h after a 75-g glucose drink (2-h blood glucose [BG]), wer e measured. Height, weight, waist, hips, and blood pressure were also measured. RESULTS - Age-adjusted (30-64 years) prevalence of NIDDM was higher in urban (7.97% with 95% CI 6.17-9.77) than in rural subjects (3.84%, CI 2.61-5.07), whereas impaired glucose tolerance (IGT) preval ence was higher in rural subjects. In either urban or rural areas, the highest prevalence of NIDDM was observed among the rich, and the lowe st prevalence was observed among the poor socioeconomic classes. The r ural rich had much higher prevalence of IGT than their urban counterpa rt (16.5 vs. 4.4%, CI 6.8-17.4). Increased age was an important risk f actor for IGT and NIDDM in both rural and urban subjects, whereas the risk related to higher BMI and waist-to-hip ratio (WHR) was less signi ficant in rural than urban subjects. Using logistic regression and adj usting for age, sex, and social class, the urban subjects had no exces s risk for NIDDM. In contrast, an excess risk for glucose intolerance (2-h BG greater than or equal to 7.8 mmol/1) was observed in the rural subjects. CONCLUSIONS - Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic c lass, and higher WHR were proven to be independent risk factors for gl ucose intolerance in either area.