Socioeconomic inequalities of undiagnosed diabetes in a resource-poor setting: insights from the cross-sectional Bangladesh Demographic and Health Survey 2011

Hasan, M. M., Tasnim, F., Tariqujjaman, M. and Ahmed, S. (2019) 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, 16(1), 115. (doi: 10.3390/ijerph16010115) (PMID:30609855) (PMCID:PMC6338882)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ahmed, Dr Sayem
• Authors: Hasan, M. M., Tasnim, F., Tariqujjaman, M., and Ahmed, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: International Journal of Environmental Research and Public Health
• Publisher: MDPI
• ISSN: 1661-7827
• ISSN (Online): 1660-4601
• Published Online: 03 January 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in International Journal of Environmental Research and Public Health 16(1): 115
• Publisher Policy: Reproduced under a Creative Commons License