Diabetes in the Caribbean: results of a population survey from Spanish Town, Jamaica

Aims To characterize the prevalence of diabetes and associated risk attribu tes in the Jamaican population. Methods A random population sample was recruited by door-to-door canvassing (n = 1303). A final participation of 60% was achieved. Oral glucose tolera nce testing was conducted after an overnight fast and standard anthropometr ic and demographic data were collected. Results The prevalence of Type 2 diabetes mellitus was 9.8% (95% confidence interval (CI) 7.2-12.4) among men and 15.7% (95% CI 13.1-18.3) among women with. an overall prevalence of 13.4% (95% CI 11.5-15.2). Impaired glucose tolerance was found among 12.3% of men and 14.7% of women. The sex patterns were consistent with a fourfold excess of obesity in women compared to men . The odds ratios for diabetes, fourth vs. first quartiles were 5.42 (95% C I 2.02-16.88) in men and 3.32 (95% CI 1.73-6.63) in women for body mass ind ex (BMI) and 17.39 (95% CI 3.86-78.27) in men and 5.48 (95% CI 2.84-11.00) in women for WHR in a logistic model controlling for age. The population at tributes risk percentage, for diabetes, of being overweight and having wais t-to-hip ratio (WHR) greater than the median (0.80) were 66% and 80%, respe ctively. The contribution of central obesity, as characterized by WHR, was also significant in sex-specific multivariate models that included age and BMI. Prevalent hypertension and family history of diabetes were likewise as sociated with increased odds of having the disease. Conclusions The prevalence of diabetes in Jamaica now exceeds that observed among European-origin populations and reflects the emerging epidemic of ob esity. The excess risk for this population could not be attributed entirely to relative weight. The pronounced sexual dimorphism in diabetes prevalenc e most likely reflects the substantial excess of obesity among women compar ed to men. Like many other island nations, Caribbean societies now appear t o be at substantial risk of diabetes.