The prevalence of diabetes among adults aged 40 years and over in Fiji

Aim To estimate the prevalence of diabetes among adults aged ≥40 years in Fiji, and determine the demographic characteristics associated with this diagnosis. Method During a population-based survey, participant glycosylated haemoglobin (HbA1c) was determined and physician diagnosis of diabetes self-reported. HbA1c ≥6.5% or claimed previous diagnosis, independent of HbA1c, defined presence of diabetes. Results were extrapolated to the whole population. Predictors of risk for diabetes were investigated using logistic regression models. Results Of those enumerated, 1381 participated (73.0%). For 1353 with either a history of diabetes or valid HbA1c, prevalence of diabetes was 44.8% (95%CI 42.2– 47.5). Adjusting for age and domicile, Indians had significantly higher risk of diabetes than Melanesians among males (OR 2.02, 95%CI 1.37–2.97, p<0.001) and females (OR 1.99, 95%CI 1.44–2.73, p<0.001). Females were at greater risk than males among Melanesians (OR 1.75, 95%CI 1.30–2.36, p<0.001) and Indians (OR 1.94, 95%CI 1.33–2.84, p<0.001). Risk increased with age for both genders and ethnicities, adjusting for ethnicity and domicile, then gender and domicile. The ethnicity-gender-age- domicile adjusted prevalence of diabetes among adults aged ≥40 years in Fiji was 41.0% (95%CI 38.4–43.6): 99,000 people. Conclusion As identified in 1970, diabetes continues to be a substantial population health problem in Fiji.