Assessment of the Magnitude of Contextual and Individual Demographic Effects on Diabetes Mellitus and Glucose Intolerance in Rural Southwest China: A Multilevel Analysis

OBJECTIVE: This study aimed to determine the contribution of individual and contextual socioeconomic status (SES) to the prevalence of diabetes mellitus and glucose intolerance in the adult population in rural southwest China. METHODS: A population-based cross-sectional study of diabetes was performed in 4801(2152 men) Chinese adults (≥25 years old). Multilevel logistic regression model was used to examine the association between individuals’ and townships’ variables and the prevalence of diabetes mellitus and glucose intolerance. RESULTS: The age-and gender-standardized prevalence of diabetes mellitus and glucose intolerance were 7.1% (3.6% for undiagnosed) and 8.8% in adults aged ≥25 years, respectively, and increasing with age. Females were more likely to develop diabetes than males. The probability of developing diabetes increased with BMI. Both contextual and individual educational level and yearly household income were found to be negatively associated with the prevalence of diabetes. Residence in communities with a higher percentage of ethnic minorities was associated with higher prevalence of diabetes. Smoking had a protective effect for diabetes, drinking had a positive association with diabetes mellitus and glucose intolerance. CONCLUSIONS: Diabetes mellitus and glucose intolerance are common in rural adults of southwest China by international standards. These results indicate that diabetes mellitus has become a major public health problem in rural areas in southwest China, and strategies aimed at the prevention and treatment of diabetes mellitus and glucose intolerance are needed.