Assessment of sex disparities in prevalence of diagnosed and undiagnosed diabetes mellitus: results from the Bangladesh demographic and health survey data

The global health concern regarding the low prevalence of diagnosed diabetes mellitus (DDM) is evident, but the prevalence of DDM is increasing. This is attributed to the frequent underestimation of undiagnosed diabetes mellitus (UDM). Given the limited research on this matter in Bangladesh, there is a need to investigate sex differences in both the prevalence and risk factors of DDM among Bangladeshi adults. This study utilizes the latest data from the Bangladesh Demographic and Health Survey (BDHS) conducted between 2017 and 2018, involving 11,911 adult participants. The research focuses on exploring sex-specific differences in the prevalence of diagnosed diabetes mellitus (DDM) and undiagnosed diabetes mellitus (UDM). Multinomial logistic regression models are applied to examine the sex effect after adjusting socio-demographic, household, and community-related factors associated with these conditions. In the group of 5127 (43%) males, the prevalence of diagnosed diabetes mellitus (DDM) and undiagnosed diabetes mellitus (UDM) stood at 344 (7%) and 94 (2%), respectively. Among 6784 (57%) females, these figures were slightly lower at 424(6%) for DDM and 138 (2%) for UDM. In males aged 30-39, UDM exhibited significantly (RRR: 6.83, 95% CI: 2.01-23.18), associations, in contrast to the nonsignificant association observed for DDM. Unemployed female had a high risk of diagnosed (RRR: 1.28, 95% CI: 1.02-1.6) and undiagnosed (RRR: 1.52, 95% CI: 1.01-2.31) diabetes. Age, hypertension, wealth, overweight status, and residing in Dhaka had significant relationship with DDM and UDM for both males and females. This study reveals that diabetes prevalence in Bangladesh is influenced by various risk factors, with distinct impacts on men and women. Women living in Dhaka who are unemployed are at a significantly higher risk of both diagnosed and undiagnosed diabetes compared to men. To effectively combat the rising diabetes rate, we must implement targeted interventions that address these sex-specific disparities. These interventions should focus on age, wealth, regional variations, and especially on unemployed women in Dhaka, considering their heightened risk.