Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Mar 25, 2025)
Date Submitted: Oct 4, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Metabolic Syndrome Surrogates and Glycaemic Control among People With and Without Diabetes: A Five-Year, Population, Follow-Up Study
ABSTRACT
Background:
The most recent Malaysian National Health and Morbidity Survey reported an overwhelming increase in Metabolic Syndrome surrogates among the adult population. The rising trends in diabetes and surrogates of Metabolic Syndrome are concerning because they can lead to poor health and an increased burden of disease. In an earlier, cross-sectional study in 2013, our group reported that a significant number of people with diabetes had poor glycaemic control, and this was associated with age and ethnicity.
Objective:
This paper aims to assess the metabolic control among people with diabetes and those without diabetes in a rural population in the district of Segamat, Johor, Malaysia.
Methods:
The study assesses five-year changes in blood glucose, blood pressure, body mass index, and waist circumference among diabetes and non-diabetes participants in a Health and Demographic Surveillance Site (HDSS). Factors associated with undiagnosed diabetes at baseline and factors associated with uncontrolled diabetes at exit are also determined. Participants were from health round surveys 2013 and 2018 in South-East Asia Community Observatory HDSS in Malaysia. Among 13,769 participants in 2013, 6,988 individuals were followed up in 2018.
Results:
Among diabetes participants, random blood glucose (12.8 to 11.8 mmol/L), diastolic blood pressure (79.6 to 75.7 mmHg), body mass index (29.0 to 28.4 kg/m2), and waist circumference (93.6 to 94.3 cm) changed significantly. For non-diabetes participants, random blood glucose (6.9 to 7.5 mmol/L), systolic blood pressure (131.7 to 133.9 mmHg), diastolic blood pressure (78.8 to 77.5 mmHg), body mass index (26.9 to 27.3 kg/m2), and waist circumference (86.9 to 89.1 cm) changed significantly.
Conclusions:
Indian ethnicity, older age groups, uncontrolled blood pressure, obesity, and abdominal obesity were associated with undiagnosed diabetes. Indian ethnicity and younger age groups were positively associated with uncontrolled diabetes. The metabolic risk factors remained suboptimal. Public health and clinical interventions need to be targeted at high-risk populations to improve metabolic surrogates.
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