Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China

BACKGROUND: The Three Gorges Dam in China is the world’s largest hydro-electric scheme in the contemporary world. After the construction of the Dam, great changes took place on the residents’ lifestyles characterized by reduced physical activity due to the loss of arable land and a series of psychological problems caused by resettlement, which might be regarded as contributing factors to the development of diabetes in Three Gorges Reservoir Region (TGRR). However, there is no study that has been conducted targeting large population samples with the aim of determining the prevalence of diabetes in TGRR. This study purposed to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in the adult population ≥18 years in TGRR and to evaluate the associated risk factors. METHODS: A total of 3721 randomly selected adults, aged ≥18 years and having lived in TGRR for at least one year, participated in questionnaire-based interview from April to May 2013 and had their physical examinations and standard glucose taken. 75 g oral glucose tolerance test (OGTT) was conducted on the subjects with fasting glucose levels being ≥ 5.6 mmol/L. Diabetes and IFG were defined according to WHO 1999 criteria. RESULTS: The age-standardized prevalence of diabetes and IFG were 7.6% (7.9% among men and 7.4% among women) and 9.0% (9.1% among men and 8.9% among women), respectively. Among the identified cases of diabetes in this study, 54.46% (171/314) were newly diagnosed. The prevalence of diabetes cases rose with age (4.0%, 4.5%, 8.1%, 11.2%, 12.4% and 12.9% among persons who were 18 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69 and ≥ 70 years of age, respectively). The results of multivariate logistic-regression analyses showed that the diabetes was significantly linked to age, family history of diabetes, central obesity, educational level and hypertension for both men and women. In addition, smoking was significantly associated with diabetes in men. CONCLUSIONS: Diabetes has become a major public health problem in the TGRR with a large number of the cases undiagnosed. These results suggest that regular population-based diabetes screening should be conducted to identify early-stage diabetes and integrated strategies aimed at the prevention and treatment of diabetes initiated.