Risk factors, incidence, and prevalence of diabetes among rural farm and non-farm residents of Saskatchewan, Canada; a p
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RESEARCH ARTICLE
Risk factors, incidence, and prevalence of diabetes among rural farm and non-farm residents of Saskatchewan, Canada; a population-based longitudinal cohort study Md Saiful Alam 1 & Roland Dyck 2 & Bonnie Janzen 1 & Chandima Karunanayake 3 & James Dosman 3 & Punam Pahwa 1,3 Received: 31 August 2020 / Accepted: 12 November 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Saskatchewan has a high prevalence of diabetes. It is the largest, rurally populated, predominantly agricultural province in Canada. This research aims to determine the risk factors associated with the incidence and longitudinal changes in the prevalence of diabetes among Saskatchewan’s adult rural farm and non-farm residents. Methods The Saskatchewan Rural Health Study (SRHS) is a prospective cohort study conducted in two phases: a baseline survey (2010, 8261 participants) and a follow-up survey (2014, 4867 participants). Generalized estimation equations and survival analysis techniques were used to determine diabetes prevalence and incidence risk factors, respectively. Results Incidence of diabetes among rural residents was 2.75%. Positive family history, high BMI, sleep apnea and an abnormal Epworth Sleepiness Score (ESS) were significant predictors for diabetes incidence. A substantial increase (1.98%) of diabetes prevalence was observed after four years of follow-up. Risk factors of diabetes prevalence were increasing age, male, low income, positive family history, high BMI, hypertension and heart attack. Conclusion A mix of individual and contextual factors interacting in complex pathways were responsible for the high incidence and prevalence of diabetes among rural residents. The most original finding of that study was a positive association of sleep apnea, and ESS with incident diabetes warrants further research to identify a causal linkage. Increased diabetes risk among rural male insecticide users indicates an adverse consequence of unprotected chemical exposures in the agricultural field. Urgent population-based preventive measures should initiate to slow the increasing trend of diabetes prevalence among rural residents. Keywords Diabetes . Rural . Predictors . Agriculture . Incidence . Prevalence
Introduction Diabetes is a global epidemic and imposes an enormous threat to human health and the economy of a country [1, 2], Canada is a prime example [3], with one out of three Canadians suffering from either diabetes or prediabetes [4]. The cost of managing
diabetes in Canada heightens every year with the increasing prevalence of diabetes [5]. Diabetes adversely impacts not only the health of an individual but also causes work limitations, economic instability, diminished quality of life and life expectancy. Canadian adults who have diabetes are three times more likely to be admitted to the hospital due to cardiovascular
* Punam Pahwa [email protected]
James Dosman [email protected]
Md Saiful Alam [email protected]
1
Department of Community Health and Epidemiology, University of Saskatchewan, 104
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