Rising Trends in Diabetes and Fasting Plasma Glucose among Bangladeshi Adults: Insights from National Surveys, 2011-2022

BackgroundBangladesh faces a rapidly increasing diabetes burden; however, current evidence is lacking. This study examines recent trends and identifies risk factors associated with changes in the prevalence of diabetes and fasting plasma glucose (FPG) among adults in Bangladesh between 2011 and 2022. MethodsData from three cycles of the Bangladesh Demographic and Health Surveys from 2011 to 2022 were analysed, involving individuals aged 35 years and older. Diabetes was defined according to the WHO criteria as a FPG level of 7.0 mmol/L or higher, and/or self-reported use of glucose-lowering medication. Age-standardised diabetes prevalence was calculated using the direct method, and trends were examined using a generalised estimating equation and generalized additive models. ResultsThe overall age-standardised prevalence of diabetes in 2022 was 20.4% (95%CI: 19.2-21.7), significantly rising from 10.7% (95%CI: 9.8-11.6) in 2011 and 12.8% (95%CI: 11.7-14.0) in 2017-18. After adjusting for potential covariates, prevalence ratios (PRs) increased by 37% (PR: 1.37; 95%CI: 1.31-1.43) per BDHS cycle, with women showing the largest increase (PR: 1.43; 95%CI: 1.34-1.52). Likewise, FPG levels increased by 0.32 mmol/L overall (95%CI: 0.29-0.35), with a larger increase observed in women (0.36 mmol/L; 95%CI: 0.31-0.41) compared to men (0.27 mmol/L; 95%CI: 0.23-0.32). Body mass index and socio-economic status were the key risk factors for changes in diabetes and elevated FPG. InterpretationThe prevalence of diabetes and FPG levels have significantly increased among adults in Bangladesh from 2011 to 2022, especially among women. Population-level interventions are urgently needed to control this increasing burden of diabetes in Bangladesh. FundingNone. Research in ContextO_ST_ABSEvidence before this studyC_ST_ABSDiabetes prevalence is escalating globally, with the largest increases projected for low- and middle-income countries (LMICs) like Bangladesh. However, recent data on diabetes trends and risk factors in Bangladesh remain sparse, particularly across nationally representative samples. Prior studies have shown an increase in diabetes but have not captured recent trends or provided a comprehensive analysis of risk factors across a decade. Added value of this studyThis study offers the most up-to-date examination of diabetes prevalence and fasting plasma glucose (FPG) levels among adults in Bangladesh from 2011 to 2022, based on three nationally representative survey cycles. It reveals significant increases in diabetes prevalence and FPG, with notable gender disparities and a sharp rise in recent years, particularly among women. By identifying body mass index and socio-economic status as key risk factors, this study highlights areas for targeted interventions. Implications of all the available evidenceOur findings indicate an urgent need for population-level interventions to address the diabetes epidemic in Bangladesh, particularly as diabetes rates are projected to continue rising. This evidence can guide policymakers to prioritize resources toward diabetes prevention and control efforts, especially among women, who are experiencing a disproportionate increase in diabetes risk.