Diabetic Prevalence, Awareness And Control In Rural Areas Of Jiangsu Province

ObjectiveThis study aims to describe the prevalence, awareness, treatment and glycemic control of diabetes mellitus (DM) in a population of Jiangsu rural areas, and analyze their influencing factors. We also tried to probe the disease burden, health demand, as well as health utilization on elder DM patients with related complication of diabetic foot ulcer (DFU).MethodsWe used a mixed quantitative and qualitative study design. First, a cross-sectional survey was conducted in two rural counties of China. Residents aged over 18 years were sampled from 8 towns in Jintan (JT) and 6 towns in Yangzhong (YZ) by a multi-stage stratified cluster sampling method. The prevalence, awareness, treatment and control of DM among adults as well as the related factors were analyzed. Then, we performed an individual in-depth interview in one Diabetic Foot Center of Nanjing, in order to explore the disease burden on the elderly DFU patients and current self-management and social support situation.ResultsA total number of 15404 people were entered into the analysis. The DM prevalence, awareness, treatment and control rates were 7.31%,58.35%,51.87% and 14.12%, respectively. Multivariable logistic regression analysis showed that being female was positively related to prevalence (OR=1.21,95% CI:1.07-1.37), awareness (OR=1.52,95% CI:1.19-1.93), treatment (OR=1.48,95% CI: 1.17-1.88) and control (OR=1.87,95% CI:1.30-2.67) of DM. Having a family history of diabetes was significantly correlated with DM risk (OR=1.86,95% CI: 1.37-2.54) and increased awareness (OR=3.12,95% CI:2.19-4.47), treatment (OR=3.47,95% CI:2.45-4.90) and control (OR=1.81,95% CI:1.22-2.68) of DM. Former smoking status (OR=1.82,95% CI:1.23-2.71), overweight (OR=2.11,95% CI:1.72-2.60) and obesity (OR=3.46,95% CI:2.67-4.50) were related to the risk of DM. Additionally, we found current drinking status to be positively correlated with DM risk (OR=1.30,95% CI:1.01-1.66) and negatively correlated with DM awareness (OR=0.41,95% CI:0.29-0.59) and treatment (OR=0.41,95% CI: 0.29-0.59). In the qualitative interview, we observed that part of the elderly DFU patients could monitor the blood glucose by themselves, but lack the abilities of diet control, foot health care and exercise intervention, etc. Their demands for health care in the community as well as the medical insurance reimbursement were not satisfied.ConclusionOur study highlights the high prevalence and inadequate awareness, treatment and control of DM in the rural areas. Management and prevention of DM-related complications should be considered an essential strategy by governments and society. This study assessed the reasons why DM has been increasing and established the first step in determining where to start regarding preventative methods. We should also pay attention to the DM complications like Diabetic foot ulcers. Measures regarding relieving the burden and increasing the life quality for the patients should be implemented.