In a recent article entitled “Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China,” published in the journal BMC Public Health, a team of researchers from China sought to estimate the prevalence of diabetes and impaired fasting glucose in The Three Gorges Dam (TGRR). The findings add to increasing evidence that environment and psychological issues may relate to the development of the disease as much as diet, genetics, and other factors.
TGRR is the world’s largest hydroelectric installation and has created a reservoir with a total water surface area of 1,080 km2. In order to examine the health profile of residents in TGRR surrounding areas, Li Qin and colleagues conducted a large population cross-sectional study in a sample adults aged >18 years, to understand the prevalence and risk factors related to diabetes.
Evidence shows that most people with diabetes live in low and middle income countries such as China, and that psychological problems, parasitic diseases, and environmental factors are implicated in the development of the disease.
The clinical assumptions behind the study relate to the fact that residents in TGRR present a lifestyle 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.
The sample of this study included 3,721 randomly selected adults, aged ≥18 years with an inclusion criterion of residency TGRR for at least one year. Participants had physical examinations and standard glucose readings were 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 indicate significant differences in marital status, education level, occupational level, and family income between men and women. The percentage of central obesity and the mean of BMI for women were significantly higher than that of men, while the percentage of smoking, drinking and sedentary life for more than six hours per day of men was significantly greater than that of women. In this study, the majority of diabetes cases were undiagnosed (54.46%).
Results revealed that the crude prevalence of diabetes and IFG was 8.4% and 9.8%, respectively. After age-standardization, and based on China’s 2010 census data, the prevalence was 7.6% for diabetes and 9.0% for IFG. The age-standardized prevalence estimates of diabetes and IFG were similar for men and women, and the prevalence of diabetes and IFG significantly increased with age,
Multivariate analysis with logistic-regression indicated that diabetes was significantly linked to age, family history of diabetes, central obesity, educational level, and hypertension in both genders. Moreover, smoking was significantly associated with diabetes in men.
Results from this study indicate that diabetes is a major public health problem in the TGRR region, with the finding that majority of cases of diabetes are undiagnosed — an issue that needs to be addressed by public health officials. Furthermore, central obesity and hypertension were highly prevalent and are strongly linked to diabetes.
Researchers concluded that regular population-based diabetes screenings are needed to identify early-stage diabetes, and that an integrated health-education program should encouraged to boost public awareness of diabetes, risk factors, and complications in TGRR — all recommendations that are germane to at-rick populations throughout the world.