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Open Access Research article

Prevalence and risk factors of diabetes and impaired fasting glucose in Nauru

Amina Khambalia1, Philayrath Phongsavan2*, Ben J Smith3, Kieren Keke4, Li Dan5, Andrew Fitzhardinge6 and Adrian E Bauman2

Author Affiliations

1 Clinical and Population Perinatal Research, Kolling Institute of Medical Research, University of Sydney, Uni Dept O&G, Building 52, Royal North Hospital, St Leonards NSW 2065, Australia

2 Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

3 School of Public Health and Preventive Medicine, Monash University, PO Box 197, Caulfield East, Victoria 3145, Australia

4 Government of Nauru, Republic of Nauru

5 World Health Organization Office for the South Pacific/Division of Pacific Technical Support, Suva, Fiji

6 Biochemistry Dept-GDU, Concord Repatriation General Hospital, Concord, NSW 2137, Australia

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BMC Public Health 2011, 11:719  doi:10.1186/1471-2458-11-719

Published: 23 September 2011

Abstract

Background

No comprehensive assessment of diabetes prevalence in Nauru has been conducted since an extreme prevalence was documented more than two decades ago. This study aims to determine the prevalence and risk factors of diabetes and impaired fasting glucose.

Methods

A nationwide survey in 2004 of people aged 15- 64 years (n = 1592). Fasting plasma glucose levels were used to defined diabetes (≥7.0 mmol/l or 126 mg/dl) and prediabetes (6.1-6.9 mmol/l or 110-125 mg/dl).

Results

The sex-standardized prevalence of diabetes was 13.0% (95% CI: 10.6, 15.4) in men, 14.4% (11.9, 16.9) in women, and 13.7% (12.0, 15.4) combined. The sex-standardized prevalence of prediabetes was 6.4% (4.6, 8.2) for men, 5.5% (3.9, 7.2) for women, and 6.0% (4.8, 7.3) combined. The prevalence of diabetes for individuals 15-24, 25-34, 35-44, 45-54 and 55-64 years was 4.5%, 7.6%, 24.1%, 32.9%, and 42.7%, respectively. The prevalence of prediabetes for the same age categories was 4.2%, 8.8%, 5.9%, 6.6%, 7.1%, respectively. Multivariable, multinomial logit modeling found risk factors for prediabetes were high cholesterol levels (OR: 2.02, 95% CI: 1.66, 2.47) and elevated waist circumference (OR: 1.04, 95% CI: 1.00, 1.08), and for diabetes were age in years (OR: 1.06; 95% CI: 1.04, 1.07), cholesterol levels (OR: 1.84, 95% CI: 1.58, 2.14) and waist circumference (OR: 1.04, 95% CI: 1.02, 1.07).

Conclusions

Diabetes remains a major public health problem in Nauru, affecting one out of every ten people. While the prevalence of diabetes has declined, its burden has persisted among the old but also extended towards the younger age groups.

Keywords:
risk factors; epidemiology; adult diabetes; population studies