Public health burden of pre-diabetes and diabetes in Luxembourg: finding from the 2013–2015 European Health Examination Survey

OBJECTIVE: The aim of this study was to determine the burden and risk factors of prediabetes and diabetes in the general adult population of Luxembourg. DESIGN: Cross-sectional survey between 2013 and 2015. SETTING: Data were collected as part of the European Health Examination Survey in Luxembourg (EHES-LUX). PARTICIPANTS: 1451 individuals were recruited in a random sample of the 25–64-year-old population of Luxembourg. OUTCOMES: Diabetes was defined by a glycaemic biomarker (fasting plasma glucose (FPG) ≥7.0 mmol/L), self-reported medication and medical diagnosis; prediabetes by a glycaemic biomarker (FPG 5.6–6.9 mmol/L), no self-reported medication and no medical diagnosis. Undiagnosed diabetes was defined only from the glycaemic biomarker; the difference between total and undiagnosed diabetes was defined as diagnosed diabetes. Odds of diabetes and prediabetes as well as associated risk factors were estimated. RESULTS: The weighted prevalence of prediabetes and diabetes was 25.6% and 6.5%, respectively. Nearly 4.8% (men: 5.8%; women: 3.8%) were diagnosed diabetes and 1.7% (men: 2.6%; women: 0.7%) were undiagnosed diabetes. The multivariable-adjusted OR (MVOR) for diabetes risk were: age 1.05 (95% CI 1.01 to 1.09), family history of diabetes 3.24 (1.95–5.38), abdominal obesity 2.63 (1.53–4.52), hypertension 3.18 (1.76–5.72), one-unit increase of triglycerides 1.16 (1.10–1.22) and total cholesterol 0.74 (0.64–0.86). The MVOR for prediabetes risk were: age 1.04 (95% CI 1.02 to 1.06), male sex 1.84 (1.30–2.60), moderate alcohol consumption 1.38 (1.01–1.89), family history of diabetes 1.52 (1.13–2.05), abdominal obesity 1.44 (1.06–1.97), second-generation immigrants 0.61 (0.39–0.95) and a one-unit increase of serum high-density lipoprotein cholesterol 0.70 (0.54–0.90). CONCLUSIONS: In Luxembourg, an unexpectedly high number of adults may be affected by prediabetes and diabetes. Therefore, these conditions should be addressed as a public health priority for the country, requiring measures for enhanced detection and surveillance, which are currently lacking, especially in primary care settings.