ASSESSMENT OF PREDIABETES PREVALENCE AMONG RURAL AND URBAN POPULATIONS OF ANDIJAN

Abstract

Relevance. The global prevalence of diabetes mellitus (DM) and prediabetes is steadily increasing, taking on the characteristics of a pandemic. About 90% of all diabetes cases are type 2 diabetes (T2DM), the rise of which is attributed to demographic and behavioral factors such as urbanization, population aging, reduced physical activity, and increasing prevalence of overweight. Consequently, the proportion of individuals with prediabetes is also growing. Prediabetes is increasingly recognized as a serious metabolic disorder and a predictor of diabetes development—annually, 5–10% of prediabetes cases progress to overt diabetes without intervention. Complications can already arise at the prediabetes stage, with evidence linking it to cardiovascular disease, retinopathy, neuropathy, and increased overall mortality. Therefore, early detection of carbohydrate metabolism disorders before the onset of diabetes is critically important to prevent serious health consequences.

Aim of the Study. To assess the prevalence of prediabetes and type 2 diabetes among residents of Andijan city and the Markhamat district, with analysis of the influence of age, gender, and geographic location.

Materials and Methods. To achieve the aim and objectives of this dissertation research, we conducted a cross-sectional epidemiological study involving men and women aged 35 to 75 years, residing in both rural and urban areas. The survey included 1,800 individuals over the age of 40 in the Markhamat district of Andijan region, and 1,600 individuals over the age of 40 in the city of Andijan. The study was      conducted   in      three stages. The stepwise approach involved: (1) collecting data on major risk factors via a structured questionnaire; (2) conducting basic physical examinations; and (3) performing blood sampling for biochemical tests. The diagnosis of prediabetes was made according to the criteria proposed by the World Health Organization (WHO) and the recommendations developed by experts from the Russian Association of Endocrinologists (2017), the European Association for the Study of Diabetes (EASD), and the American Diabetes Association (ADA) (2015, 2018). Prediabetes was defined as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Hyperglycemia included diagnoses of both diabetes and prediabetes. Carbohydrate metabolism parameters were assessed using capillary blood glucose levels measured with glucometers. The HbA1c level was determined using a reagent kit from HUMAN, which included automatic hemoglobin measurement and calculation of the percentage of HbA1c in total hemoglobin.

Results. In the Markhamat district, prediabetes was diagnosed in 53 individuals: 20 with IFG, 30 with IGT, and 50 with type 2 diabetes. In addition, 30 individuals showed no disturbances in carbohydrate metabolism. In the city of Andijan, the prevalence of prediabetes and type 2 diabetes was similar: 19 cases of IFG, 30 cases of IGT, and 52 cases of type 2 diabetes, while 30 individuals had no metabolic disorders. In both regions, the highest percentage of individuals with carbohydrate metabolism disorders was observed in the 45–59 age group, where the risk of developing T2DM was significantly higher among middle-aged individuals. Statistical analysis revealed that women were more frequently affected by carbohydrate metabolism disorders, with urban areas showing 2–2.5 times higher rates among women compared to men.

Conclusion. The findings underscore the need for enhanced prevention and early detection of carbohydrate metabolism disorders, particularly among women over the age of 40. The results of this study may serve as a basis for developing effective regional programs for the prevention and diagnosis of diabetes.