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Urban-rural differences in the prevalence of diabetes mellitus among 25-74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies.

Urban-rural differences in the prevalence of diabetes mellitus among 25-74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies.
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Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR,


Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR, (click to view)

Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR,

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BMJ open 2018 03 308(3) e020406 doi 10.1136/bmjopen-2017-020406
Abstract
OBJECTIVES
To investigate the association between urban-rural location and the occurrence of diabetes mellitus (DM) in the Yangon Region, and to estimate the proportion of urban and rural participants already diagnosed with DM, and of those, the proportion under treatment and under control.

DESIGN
Two cross-sectional studies, using the WHO STEPs methodology.

SETTING
The Yangon Region of Myanmar, urban and rural areas.

PARTICIPANTS
Men and women, aged 25-74 years, included during the study period from September-November 2013 (urban) and 2014 (rural areas) (n=1372). Institutionalised people, physically and mentally ill person, monks and nuns were excluded.

RESULTS
The age-standardised prevalence of DM was 12.1% in urban and 7.1% in rural areas (p=0.039). In urban areas, the prevalence of DM was lowest in the highest educational groups (p<0.001). There were no differences in DM prevalence between gender or income levels. In rural areas, those who were physically inactive had a low intake of fruit and vegetable and were overweight/obese had a higher DM prevalence than others. In a logistic regression, the OR for DM in rural compared with urban areas was 0.38 (0.22, 0.65), adjusted for sociodemographic variables and behavioural risk factors. In urban areas, 43.1% of participants had the experience of receiving blood glucose measurements by a doctor or health worker, and 61.5% of all cases of DM were already diagnosed, 78.7% were under treatment and 45.8% were under control. The corresponding proportions in rural areas were 26.4%, 52.4%, 78.1% and 32.0%, respectively. CONCLUSION
The prevalence of DM in the Yangon Region was high, and significantly higher in urban than in rural areas. More health services are needed to serve this population with a large proportion of undiagnosed diabetes. Preventive measures to halt and reduce the prevalence of DM are urgently needed.

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