Prevalence of Type 2 Diabetes in Mongolia: Results from Population-Based Survey Compared with 1999 Study

Figures & data

Table 1 Sociodemographic Characteristics of Study Participants

	Male	Female	Total
	n (%)	n (%)	n (%)
Age
29 or under	5 (0.4)	12 (0.6)	17 (0.5)
30–39	157 (12.2)	248 (12.5)	405 (12.4)
40–49	355 (27.6)	573 (28.9)	928 (28.4)
50–59	408 (31.7)	673 (33.9)	1081 (33)
60 and above	363 (28.2)	478 (24.1)	841 (25.7)
Geographical location
Urban	392 (30.4)	852 (42.9)	1244 (38)
Rural	896 (69.6)	1132 (57.1)	2028 (62)
Study site
Bayanzurkh district	196 (15.2)	418 (21.1)	614 (18.8)
Songinokhairkhan district	196 (15.2)	434 (21.9)	630 (19.3)
Khovd province	168 (13)	358 (18)	526 (16.1)
Umnugovi province	266 (20.7)	259 (13.1)	525 (16)
Dornod province	244 (18.9)	270 (13.6)	514 (15.7)
Arkhangai province	218 (16.9)	245 (12.3)	463 (14.2)
Ethnicity
Khalkh	1048 (81.4)	1591 (80.2)	2639 (80.7)
Buryat	41 (3.2)	47 (2.4)	88 (2.7)
Kazakh	19 (1.5)	38 (1.9)	57 (1.7)
Others	180 (14)	308 (15.5)	488 (14.9)
Educational attainment level
None	47 (3.6)	52 (2.6)	99 (3)
High school	708 (55)	1013 (51.1)	1721 (52.6)
Vocational training	119 (9.2)	252 (12.7)	371 (11.3)
Higher education	376 (29.2)	635 (32)	1011 (30.9)
Others	38 (3)	32 (1.6)	70 (2.1)
Employment status
Government or public sector	267 (20.7)	409 (20.6)	676 (20.7)
Non-governmental sector	123 (9.5)	189 (9.5)	312 (9.5)
Self-employed, small business	365 (28.3)	422 (21.3)	787 (24.1)
Unemployed	190 (14.8)	356 (17.9)	546 (16.7)
Others	343 (26.6)	608 (30.6)	951 (29.1)
Marital status
Never married	54 (4.2)	93 (4.7)	147 (4.5)
Married	1184 (91.9)	1608 (81)	2792 (85.3)
Divorced or separated	17 (1.3)	30 (1.5)	47 (1.4)
Widower	33 (2.6)	253 (12.8)	286 (8.7)
Total	1288 (39.4)	1984 (60.6)	3272 (100)

Table 2 Diabetes Prevalence Across Age Groups and Age-Standardized Rate in Mongolia, 2019

	Prevalence of Prediabetes		Prevalence of Diabetes		Newly Diagnosed Cases
	n (%)	95% CI	n (%)	95% CI	n (%)	95% CI
Male
Under 29	0 (0)		0 (0)		0 (0)
30–39	10 (6.4)	3.3–11	7 (4.5)	2–8.6	1 (0.6)	0.1–2.9
40–49	22 (6.2)	4–9.1	38 (10.7)	7.8–14.2	8 (2.3)	1.1–4.2
50–59	41 (10)	7.4–13.2	44 (10.8)	8.1–14.1	7 (1.7)	0.8–3.3
Above 60	44 (12.1)	9.1–15.8	59 (16.3)	12.7–20.3	10 (2.8)	1.4–4.8
Total	117 (9.1)	7.6–10.7	148 (11.5)	9.8–13.3	26 (2)	1.4–2.9
Age-standardized rate^†	8.2% (6.2–10.3)		10.2% (8.1–12.3)
Female
Under 29	2 (16.7)	3.6–43.6	1 (8.3)	0.9–32.8	0 (0)
30–39	17 (6.9)	4.2–10.5	11 (4.4)	2.4–7.5	2 (0.8)	0.2–2.6
40–49	56 (9.8)	7.5–12.4	39 (6.8)	5–9.1	5 (0.9)	0.3–1.9
50–59	85 (12.6)	10.3–15.3	83 (12.3)	10–15	11 (1.6)	0.9–2.8
Above 60	76 (15.9)	12.8–19.4	84 (17.6)	14.4–21.2	17 (3.6)	2.2–5.5
Total	236 (11.9)	10.5–13.4	218 (11)	9.7–12.4	35 (1.8)	1.3–2.4
Age-standardized rate^†	10.8% (9.2–12.5)		9.9% (8.3–11.6)
Total
Under 29	2 (11.8)	2.5–32.7	1 (5.9)	0.6–24.4	0 (0)
30–39	27 (6.7)	4.5–9.4	18 (4.4)	2.8–6.8	3 (0.7)	0.2–2
40–49	78 (8.4)	6.7–10.3	77 (8.3)	6.7–10.2	13 (1.4)	0.8–2.3
50–59	126 (11.7)	9.8–13.7	127 (11.7)	9.9–13.8	18 (1.7)	1–2.6
Above 60	120 (14.3)	12–16.8	143 (17)	14.6–19.7	27 (3.2)	2.2–4.6
Total	353 (10.8)	9.8–11.9	366 (11.2)	10.1–12.3	61 (1.9)	1.4–2.4
Age-standardized rate^†	9.8% (8.5–11.1)		10.0% (8.7–11.3)

Note: ^†Age standardized rates for diabetes prevalence weighted for standard world population.

Figure 1 Geographical variation of prediabetes and diabetes prevalence in Mongolia, 2019; (a) the study clusters and regions of Mongolia. (b) Prediabetes prevalence. (c) Diabetes prevalence.

Figure 2 Prediabetes and diabetes prevalence across age groups in Mongolia; (A) males, (B) females.

Table 3 Anthropometric Profile and Some Body Composition Features Among Normoglycemic, Prediabetic and Diabetic Mongolian Adults

	Normal	Prediabetes	Diabetes	P value^†	P value^‡
	Mean ± SD	Mean ± SD	Mean ± SD
Male
Body mass index (kg/m^2)	27.3 ± 4.8	29.1 ± 5.4	30 ± 4.8	0.0001	0.0001
Waist circumference (cm)	95.4 ± 12.8	100.7 ± 13.7	103.4 ± 11.5	0.0001	0.0001
Hip circumference (cm)	99.5 ± 8.1	101.7 ± 9.3	102.8 ± 7.7	0.0001	0.0001
Waist–hip ratio	0.91 ± 0.08	0.94 ± 0.08	0.96 ± 0.07	0.0001	0.0001
Body fat (%)	26.9 ± 6.2	29.4 ± 6	30 ± 5.5	0.0001	0.0001
Visceral fat mass (kg)	14.4 ± 4	16.3 ± 4.1	16.9 ± 3.8	0.0001	0.0001
Visceral fat mass (%)	18.4 ± 3.6	19.9 ± 3.3	19.7 ± 3.4	0.0001	0.0001
Total muscle mass (kg)	52.9 ± 7.3	53.7 ± 8.2	55.9 ± 6.7	0.0001	0.0001
Total muscle mass (%)	69.8 ± 19.6	66.8 ± 5.8	66.3 ± 5.2	0.028	0.026
Total body water (%)	53.5 ± 4.5	51.7 ± 4.4	51 ± 4.5	0.0001	0.0001
Bone mass (kg)	2.9 ± 0.4	2.9 ± 0.4	3.1 ± 0.4	0.0001	0.0001
Mean systole (mmHg)	128.6 ± 18.1	132.7 ± 18.6	137.9 ± 21.7	0.0001	0.0001
Mean diastole (mmHg)	84.8 ± 11.3	87.4 ± 10.9	90 ± 12.3	0.0001	0.0001
Female
Body mass index (kg/m^2)	28 ± 4.8	29.8 ± 5.7	30.4 ± 5.3	0.0001	0.0001
Waist circumference (cm)	93.5 ± 11.6	96.9 ± 11.7	99.7 ± 12.2	0.0001	0.0001
Hip circumference (cm)	100.8 ± 8.9	103 ± 9.6	103.3 ± 9.1	0.0001	0.0001
Waist–hip ratio	0.88 ± 0.07	0.89 ± 0.07	0.92 ± 0.07	0.0001	0.0001
Body fat (%)	39.5 ± 6.3	41.9 ± 6.8	42.5 ± 6.4	0.0001	0.0001
Visceral fat mass (kg)	8.8 ± 2.8	9.8 ± 3	10.4 ± 2.8	0.018	0.005
Visceral fat mass (%)	12.5 ± 2.5	13.4 ± 2.4	13.8 ± 2.3	0.0001	0.0001
Total muscle mass (kg)	38.6 ± 4.4	38.6 ± 4.4	39.5 ± 4.3	0.0001	0.0001
Total muscle mass (%)	56.9 ± 6.1	54.7 ± 6.5	53.9 ± 6.2	0.0001	0.0001
Total body water (%)	44.4 ± 4.5	42.6 ± 5	42.2 ± 4.8	0.0001	0.0001
Bone mass (kg)	2.4 ± 0.4	2.4 ± 0.4	2.5 ± 0.4	0.023	0.006
Mean systole (mmHg)	120.3 ± 17.2	126.4 ± 20.5	129 ± 20.5	0.0001	0.0001
Mean diastole (mmHg)	80.9 ± 10.6	83.3 ± 11.7	84.7 ± 11.4	0.0001	0.0001

Notes: ^†One-way ANOVA test, ^‡T-test for linear contrasts in One-Way ANOVA test.

Table 4 Factors Associated with Prediabetes and Diabetes in Mongolia, 2019

Variables	Total	Prediabetes					Diabetes
	n	n (%)	cOR [95% CI]	p value	aOR [95% CI]^†	p value	n (%)	cOR [95% CI]	p value	aOR [95% CI]^†	p value
Geographical location
Rural	2028	208 (10.3)	0.836 [0.666–1.049]	0.122	0.92 [0.73–1.16]	0.48	207 (10.2)	0.759 [0.608–0.947]	0.015	0.806 [0.642–1.012]	0.063
Urban	1244	145 (11.7)	1		1		159 (12.8)	1		1
Ethnicity
Khalkh	2639	295 (11.2)	2.657 [0.964–7.321]	0.059	2.572 [0.931–7.108]	0.068	290 (11)	1.045 [0.534–2.045]	0.898	1.024 [0.52–2.019]	0.944
Kazakh	57	9 (15.8)	3.872 [1.125–13.331]	0.032	3.849 [1.11–13.343]	0.034	5 (8.8)	0.86 [0.276–2.683]	0.796	0.869 [0.275–2.742]	0.81
Others	488	45 (9.2)	2.179 [0.761–6.243]	0.147	2.066 [0.719–5.939]	0.178	61 (12.5)	1.182 [0.579–2.412]	0.647	1.147 [0.558–2.359]	0.709
Buryat	88	4 (4.5)	1		1		10 (11.4)	1		1
Educational attainment
None	99	18 (18.2)	1.76 [1.012–3.061]	0.045	1.517 [0.861–2.673]	0.149	8 (8.1)	0.688 [0.323–1.462]	0.33	0.526 [0.244–1.138]	0.103
High school	1721	177 (10.3)	0.927 [0.719–1.195]	0.559	0.867 [0.67–1.121]	0.277	181 (10.5)	0.833 [0.652–1.064]	0.144	0.759 [0.592–0.974]	0.03
Vocational training	371	41 (11.1)	1.038 [0.707–1.524]	0.85	0.848 [0.573–1.254]	0.408	48 (12.9)	1.068 [0.745–1.531]	0.72	0.844 [0.584–1.219]	0.367
Other	70	8 (11.4)	1.002 [0.465–2.156]	0.996	0.987 [0.456–2.14]	0.974	5 (7.1)	0.55 [0.216–1.4]	0.21	0.509 [0.198–1.308]	0.161
Higher education	1011	109 (10.8)	1		1		124 (12.3)	1		1
Employment status
Unemployed, social care, pension	1497	191 (12.8)	1.547 [1.238–1.935]	0.0001	1.091 [0.835–1.425]	0.524	202 (13.5)	1.617 [1.297–2.015]	0.0001	0.997 [0.764–1.3]	0.98
Employed	1775	162 (9.1)	1		1		164 (9.2)	1		1
Marital status
Never married	147	12 (8.2)	0.698 [0.381–1.278]	0.244	0.769 [0.418–1.416]	0.399	9 (6.1)	0.489 [0.246–0.971]	0.041	0.579 [0.29–1.159]	0.123
Divorced or separated	47	7 (14.9)	1.425 [0.629–3.232]	0.396	1.385 [0.608–3.158]	0.438	4 (8.5)	0.761 [0.269–2.151]	0.606	0.753 [0.264–2.148]	0.596
Widower	286	37 (12.9)	1.267 [0.876–1.834]	0.209	0.812 [0.547–1.206]	0.302	35 (12.2)	1.12 [0.769–1.631]	0.556	0.712 [0.477–1.062]	0.096
Married	2792	297 (10.6)	1		1		318 (11.4)	1		1
Body weight status
Underweight	37	4 (10.8)	1.594 [0.544–4.672]	0.396	1.504 [0.508–4.452]	0.461	4 (10.8)	3.047 [1.014–9.157]	0.047	2.985 [0.975–9.138]	0.055
Overweight	1302	131 (10.1)	1.478 [1.082–2.019]	0.014	1.47 [1.074–2.013]	0.016	147 (11.3)	3.171 [2.158–4.658]	0.0001	3.28 [2.224–4.838]	0.0001
Obese	1083	153 (14.1)	2.36 [1.736–3.209]	0.0001	2.337 [1.713–3.187]	0.0001	181 (16.7)	5.338 [3.65–7.806]	0.0001	5.591 [3.805–8.215]	0.0001
Normal	850	65 (7.6)	1		1		34 (4)	1		1
Central obesity
Yes	2338	286 (12.2)	2.016 [1.526–2.664]	0.0001	1.886 [1.413–2.517]	0.0001	318 (13.6)	3.129 [2.284–4.286]	0.0001	3.292 [2.379–4.558]	0.0001
No	934	67 (7.2)	1		1		48 (5.1)	1		1
Arterial hypertension status
Hypertensive	1130	133 (11.8)	1.565 [1.178–2.078]	0.002	1.478 [1.108–1.972]	0.008	124 (11)	1.754 [1.296–2.374]	0.0001	1.576 [1.16–2.141]	0.004
Elevated blood pressure	1065	131 (12.3)	1.756 [1.32–2.337]	0.0001	1.627 [1.206–2.195]	0.001	168 (15.8)	2.709 [2.027–3.62]	0.0001	2.228 [1.646–3.017]	0.0001
Normotensive	1077	89 (8.3)	1		1		74 (6.9)	1		1
Fat consumption
Yes	2993	320 (10.7)	0.874 [0.594–1.284]	0.492	0.911 [0.617–1.344]	0.639	331 (11.1)	0.852 [0.585–1.241]	0.404	0.935 [0.638–1.368]	0.728
No	279	33 (11.8)	1		1		35 (12.5)	1		1
Additional salt
Yes	491	48 (9.8)	0.884 [0.64–1.22]	0.452	0.951 [0.686–1.319]	0.763	57 (11.6)	1.036 [0.765–1.402]	0.821	1.058 [0.777–1.44]	0.719
No	2781	305 (11)	1		1		309 (11.1)	1		1
Salty meals in diet
Yes	1029	113 (11)	1.024 [0.807–1.3]	0.844	1.105 [0.868–1.408]	0.417	112 (10.9)	0.959 [0.756–1.216]	0.731	1.026 [0.805–1.307]	0.836
No	2243	240 (10.7)	1		1		254 (11.3)	1		1
Salted foods consumption
Yes	1350	147 (10.9)	1.012 [0.807–1.268]	0.92	1.156 [0.917–1.457]	0.219	147 (10.9)	0.952 [0.761–1.19]	0.663	1.113 [0.885–1.4]	0.361
No	1922	206 (10.7)	1		1		219 (11.4)	1		1
Tobacco smoking
Yes	774	62 (8)	0.673 [0.503–0.9]	0.008	0.806 [0.574–1.132]	0.213	93 (12)	1.095 [0.849–1.414]	0.484	1.254 [0.924–1.702]	0.146
Used to	182	23 (12.6)	1.162 [0.733–1.842]	0.523	1.278 [0.777–2.102]	0.334	26 (14.3)	1.425 [0.917–2.215]	0.115	1.469 [0.912–2.364]	0.114
No	2316	268 (11.6)	1		1		247 (10.7)	1		1
Alcohol consumption
Yes	2735	284 (10.4)	0.765 [0.576–1.016]	0.064	0.875 [0.654–1.171]	0.37	298 (10.9)	0.814 [0.613–1.082]	0.156	0.908 [0.677–1.218]	0.52
No	537	69 (12.8)	1		1		68 (12.7)	1		1
Alcohol drinking in 12 months
Yes	2157	212 (9.8)	0.731 [0.582–0.918]	0.007	0.841 [0.665–1.064]	0.149	227 (10.5)	0.794 [0.633–0.996]	0.046	0.918 [0.725–1.162]	0.476
No	1115	141 (12.6)	1		1		139 (12.5)	1		1
Occupational characteristics
Sedentary mostly	1874	219 (11.7)	1.327 [1.056–1.668]	0.015	1.233 [0.978–1.554]	0.076	246 (13.1)	1.664 [1.32–2.099]	0.0001	1.533 [1.212–1.94]	0.0001
Physically demanding	1398	134 (9.6)	1		1		120 (8.6)	1		1
Seats 6 hours per day
Yes	1333	152 (11.4)	1.137 [0.907–1.423]	0.265	1.196 [0.952–1.501]	0.124	161 (12.1)	1.18 [0.946–1.472]	0.142	1.268 [1.013–1.588]	0.038
No	1939	201 (10.4)	1		1		205 (10.6)	1		1
Physical exertions
No	2336	250 (10.7)	0.981 [0.768–1.254]	0.88	1.067 [0.832–1.368]	0.608	268 (11.5)	1.106 [0.864–1.415]	0.425	1.249 [0.971–1.606]	0.084
Yes	936	103 (11)	1		1		98 (10.5)	1		1
Diabetic inheritance
Yes	382	46 (12)	1.339 [0.956–1.877]	0.09	1.432 [1.017–2.015]	0.04	80 (20.9)	2.515 [1.898–3.334]	0.0001	2.863 [2.141–3.827]	0.0001
Unknown	226	23 (10.2)	0.952 [0.607–1.496]	0.833	0.93 [0.588–1.471]	0.757	23 (10.2)	1.029 [0.654–1.617]	0.903	0.9 [0.565–1.434]	0.659
No	2664	284 (10.7)	1		1		263 (9.9)	1		1
Total	3272	353 (10.8)					366 (11.2)

Note: ^†Multinomial logistic regression analysis adjusted for sex and age group.