Burden of diabetes and prediabetes among teaching and non-teaching staff in educational institutions of Bahawalpur, Pakistan: a cross-sectional study (BDEB study).

Abstract

To assess the burden of diabetes and prediabetes in the educational sector in Bahawalpur City, Pakistan. Cross-sectional study. Teaching institutes of Bahawalpur, Pakistan, during January 2024 to December 2024. A total of 955 participants from 15 universities, colleges and schools were included. Eligible participants were aged 18-75 years and employed as teachers or academic staff and enrolled using a non-probability consecutive sampling technique. Primary anthropometric measurements, blood pressure, smoking status and HbA1c levels were recorded. Prediabetes was defined as HbA1c 5.7-6.4% and type 2 diabetes mellitus (T2DM) as HbA1c ≥6.5%. Among 955 participants, 622 (65.1%) were male and 713 (74.7%) were teaching staff. The median age was 42 years, and median BMI was 27.3 kg/m². The prevalence of prediabetes and T2DM was 31.7% and 15.4%, respectively, with 8.5% newly diagnosed cases of T2DM. Multivariate binary logistic regression analysis found that age (p=0.006), BMI (p=0.008) and family history of diabetes (p<0.001) were independent predictors of prediabetes/T2DM. Males had a higher median HbA1c (5.60%, IQR: 5.20-6.30) than females (5.40%, IQR: 5.20-5.80). HbA1c levels rose with age: 6.10% (IQR: 5.75-8.95) in ages 61-75, 5.80% (IQR: 5.40-6.80) in 46-60 and 5.35% (IQR: 5.00-5.70) in 18-45. Higher education was associated with lower HbA1c (above master's: 5.40%, IQR: 5.10-5.80). No significant HbA1c differences were found by occupation (p=0.711) or income (p=0.655). Hypertensive individuals had a higher HbA1c (5.90%, IQR: 5.40-6.85) versus non-hypertensives (5.50%, IQR: 5.10-5.90), and those with a family history also had elevated HbA1c (5.70%, IQR: 5.30-6.50) versus those without (5.40%, IQR: 5.10-5.90). HbA1c correlated moderately with age (r=0.388) and weakly with BMI (r=0.228) and waist circumference (r=0.254) (all p<0.001). This study highlights a significant prevalence of T2DM and prediabetes in the educational sector of Bahawalpur, Pakistan. Increasing age, BMI and positive family history of diabetes were independent predictors of prediabetes/T2DM.