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Prevalence of Diabetes, Prediabetes, and Associated Risk Factors Among Agricultural Village Residents in the Dominican Republic

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  • 1 Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida;
  • 2 Emerging Pathogens Institute, University of Florida, Gainesville, Florida;
  • 3 Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands;
  • 4 The Carter Center, Atlanta, Georgia;
  • 5 Memorial Healthcare System, Office of Human Research, Hollywood, Florida;
  • 6 Centro Nacional para el Control de Enfermedades Tropicales (CENCET), Santo Domingo, Dominican Republic;
  • 7 Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida

Abstract.

This study examined the prevalence and risk factors of prediabetes and type 2 diabetes among residents of agricultural settlement villages (bateyes) in the Dominican Republic. From March to April 2016, a cross-sectional, multi-stage cluster survey was conducted across the country’s three agricultural regions (southwest, east, and north). At selected households, an adult completed a questionnaire to assess demographics, diabetes knowledge, and care, and two household residents of any age provided finger-prick blood samples that were analyzed for hemoglobin A1c (HbA1c). HbA1c was categorized as normal (< 5.7%), prediabetic (5.7–6.4%), or diabetic (≥ 6.5%). The prevalence rates of diabetes and prediabetes were 8.6% (95% confidence interval [CI], 6.2–11.8%) and 20.4% (95% CI, 17.9–23.2%), respectively, among all participants (N = 1293; median age, 35 years; range, 2–96 years), and 10.0% (95% CI, 7.2–13.8%) and 20.0% (95% CI, 17.4–23.0%), respectively, among adults 18 years or older (N = 730). The average age of participants with diabetes was 47.2 years. The average age of participants with prediabetes was 40.7 years. Among adult questionnaire respondents, 64.8% of all participants and 39.4% of patients with diabetes had not been tested for diabetes previously. Among patients with diabetes, 28.4% were previously diagnosed; 1.2% of prediabetes patients were previously diagnosed. Half (50.7%) of the respondents had heard of diabetes. The majority (94.1%) of patients previously diagnosed with diabetes reported using diabetes medication. Among both undiagnosed and previously diagnosed patients with diabetes, diabetes knowledge, previous diabetes testing, and diabetes care-seeking were lowest among Haitian-born participants. A high burden of undiagnosed diabetes and deficiencies in diabetes knowledge, access to care, and diagnosis exist among all batey inhabitants, but most acutely among Haitians. Improvements will require a multi-sectoral approach.

Author Notes

Address correspondence to Valery E. Madsen Beau De Rochars, Emerging Pathogens Institute and Department of Health Services Research, Management and Policy, University of Florida, Health Sciences Center, PO Box 100195, Gainesville, FL 32610. E-mail: madsenbeau@phhp.ufl.edu

Financial support: Portions of this work were supported by startup funds from the College of Public Health and Health Professions of University of Florida to VMBDR, a Research Talent Award funded by the Netherlands Organization for Scientific Research (to HK), and a PAHO/TDR Small Grant Programme grant (number SCON2016-02343 to GSN). The funders had no role in the design, analysis, or interpretation of the study or its results.

Authors’ addresses: Valery E. Madsen Beau De Rochars, Ara Jo, and Arch G. Mainous III, Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, FL, E-mails: madsenbeau@phhp.ufl.edu, ara13j@phhp.ufl.edu, and arch.mainous@phhp.ufl.edu. Hunter Keys, Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands, E-mail: hunter.keys@cartercenter.org. Shenae K. Samuels, Memorial Healthcare System, Office of Human Research, Hollywood, FL, E-mail: shsamuels@mhs.net. Gregory S. Noland and Stephen Blount, The Carter Center, Atlanta, GA, E-mails: gregory.noland@cartercenter.org and stephen.blount@cartercenter.org. Manuel Gonzales, Centro Nacional para el Control de Enfermedades Tropicales (CENCET), Santo Domingo, Dominican Republic, E-mail: manuelgonpe@gmail.com.

These authors contributed equally to this work.

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