BMJ Open
Volume 9, Issue 1, 2019

Public health burden of pre-diabetes and diabetes in Luxembourg: Finding from the 2013-2015 European Health Examination Survey (Article) (Open Access)

Bocquet V.* , Ruiz-Castell M. , De Beaufort C. , Barré J. , De Rekeneire N. , Michel G. , Donahue R.P. , Kuemmerle A. , Stranges S.
  • a Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
  • b Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
  • c DCCP-Clinique Pédiatrique de Luxembourg, Luxembourg, Luxembourg, Department of Pediatric Endocrinology, UZBrussels, Bruxelles, Belgium
  • d Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
  • e Epidemiology Unit at the Directorate of Health, Ministry of Health, Luxembourg, Luxembourg
  • f Société Luxembourgeoise de Diabétologie, Luxembourg, Luxembourg
  • g Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States
  • h Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
  • i Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg, Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

Abstract

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. © Author(s) (or their employer(s)) 2019.

Author Keywords

general diabetes Public health Epidemiology Prevalence european health examination survey

Index Keywords

alcohol consumption cholesterol blood level medical examination human abdominal obesity middle aged diabetes mellitus controlled study hypertension sensitivity analysis Luxembourg cross-sectional study glycosylated hemoglobin male female risk factor prevalence cholesterol Article glucose blood level major clinical study adult high density lipoprotein cholesterol triacylglycerol blood level triacylglycerol high density lipoprotein cholesterol level glucose family history disease burden body mass public health impaired glucose tolerance
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060391657&doi=10.1136%2fbmjopen-2018-022206&partnerID=40&md5=fe827b0b0c1402664f2f02d714fa334b
DOI: 10.1136/bmjopen-2018-022206
ISSN: 20446055
Original Language: English