Aims: Concerns have been raised about the increasing trend in diabetes among lean populations including Southeast Asians. However, this issue is less studied in Vietnam. We determined the prevalence of diabetes and prediabetes, and quantitatively evaluated associated risk factors among Vietnamese adults.
Methods: Subjects were 5,602 men and 10,680 women aged 30-69 years who participated in community diabetes screening programs during 2011-2013 in northeastern Vietnam. Diabetes was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L or 2-h postload PG ≥11.1 mmol/L. Prediabetes was defined as FPG ≥6.1 mmol/L and <7.0 mmol/L or FPG <7.0 mmol/l and 2-h postload PG ≥7.8 mmol/L and <11.1 mmol/L. Putative risk factors were elicited through an interview-administered questionnaire. The authors calculated standardized prevalence rates of prediabetes and diabetes in 2011-2013 and demographic projections for 2030, and used multiple logistic regression analysis to estimate odds ratios and 95% confidence intervals for the association of multiple risk factors with diabetes and prediabetes.
Results: The overall age- and sex-standardized prevalence of diabetes was 6.0% and of prediabetes was 13.5%. Among urban residents, age- and sex-adjusted prevalence of diabetes was 6.7%, compared with 5.2% among rural/mountainous inhabitants. The age- and residence-adjusted prevalence of diabetes was 8.0% in men and 5.4% in women. Population aging is projected to raise the total prevalence of diabetes to 7.0% and of prediabetes to 15.3% by 2030. Advancing age, obesity, large waist-to-hip ratio and hypertension were each associated with higher prevalence of diabetes, whereas the opposite direction of association was observed for underweight and ethnic minority peoples in both genders. In addition, diabetes was positively associated with family history of diabetes in women, and inversely related to physically heavy work in men.
Conclusions: The present study found that in 2011-2013, around one in 17 adults had diabetes and one in 7 adults had prediabetes in northeastern Vietnam . Urbanization, population aging, elevated adiposity, uncontrolled hypertension and sedentary work may be important contributors to the increased prevalence of diabetes in this country.
Dr. Ngoc Minh Pham, the 2014-15 Stanford-APO Developing Asia Health Policy fellow with the Stanford Asia Health Policy Program, is a health professional with teaching and research experiences in epidemiology and public health in Vietnam and Japan. He obtained his MD degree from Thai Nguyen University of Medicine and Pharmacy - Vietnam in 1997, MPH from The University of Melbourne - Australia in 2004, and PhD from Kyushu University - Japan in 2011. His main interests are public health, disease prevention and the rural-urban divide in developing countries, including the epidemiology of lifestyle-related diseases including diabetes, metabolic syndrome, cancer, insulin resistance and mental illness. At Stanford, Pham is studying the epidemiology of diabetes and developing a conceptual framework for diabetes prevention and management in Vietnam, particularly in mountainous areas of that country.