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Rising diabetes in Bangladesh: changing socioeconomic and geographic gradients and the contribution of unhealthy weight

Sarah Wetzel, Heidelberg University
Nikkil Sudharsanan, Heidelberg University
Pascal Geldsetzer, Stanford University
Malabika Sarker, BRAC James P Grant School of Public Health, BRAC University
Mehedi Hasan, BRAC James P Grant School of Public Health, BRAC University
Animesh Talukder, BRAC James P Grant School of Public Health, BRAC University

Asian countries have the largest number of individuals with diabetes worldwide and have become the epicenter of the global diabetes epidemic. While awareness of diabetes is rising in South Asia, there is a weak understanding of how diabetes prevalence has changed over time and whether specific population groups were disproportionately affected. Since repeated cross-sectional and nationally representative data with glucose measurements have not been available so far, existing evidence on trends is based on small non-representative samples, indirect estimates, or projections. Based on the 2011 and the recently released 2017/2018 Bangladesh Demographic and Health Surveys we provide the first direct evidence on recent changes in the prevalence of diabetes, both overall and across population groups. We then assess the contribution of body mass index to diabetes trends and changing socioeconomic gradients. Our results indicate that diabetes prevalence increased by nearly 3 percentage points on the national level. It grew disproportionately fast among the wealthiest 60% of the population, among the more educated, and in three national regions (Dhaka, Chittagong, and Khulna). Overweight/obesity also increased at an alarming rate (12 percentage points) and was the main factor underlying both the national trend in diabetes prevalence and the changing socioeconomic gradients.

Keywords: Health and morbidity, Decomposition analysis/methods, Sustainable Development Goals (SDGs), Inequality

See paper.

Presented in Session 181. Trajectories in Multimorbidity