Prevalence and risk factors of non-insulin-dependent diabetes mellitus in the rural and urban population of Tunisia

Background: Prevalence of non-insulin-dependent diabetes mellitus was analyzed from a baseline survey of risk factors for cardiovascular disease in a random sample of the 35-50-year old population of the Gouvernorat of Nabeul, Tunisia. Methods: Diabetes was assessed on the basis of an interview and fasting blood glucose level among a sample of 692 men and women (35% aged 35-40 years, 30% aged 40-45 years, 35% aged 4550 years). Results: Forty-six percent of the sample were men. The prevalence of diabetes was 7.2%; two-thirds of the identified cases of diabetes were known. The prevalence of diabetes was much higher in the urban area (9.3% in men and 10.4% in women) compared with the rural area (2.0% in men and 4.5% in women). Mean body mass index was significantly different (p<0.01) between normal and diabetic subjects. Hypertension was three times higher in diabetic subjects (33%) than in normal subjects (9%). Triglycerides level was higher in diabetic subjects (1.92 +/- 1.72 mmol/l) compared with non-diabetic subjects (1.29 +/- 1.02 mmol/l). There was a positive relation between blood glucose level and triglycerides level, independently of obesity in women, but dependently in men. Conclusion: In the Tunisian population, known to have a low level of cardiovascular risk factors, the relationships between diabetes, obesity, hypertension, and lipid abnormalities are similar to those observed in Western populations.