Epidemiological Analyses of Type 2 Diabetes Associated Risk Factors in Bangladeshi Adults: The Assessment of National Health Survey Database

Background: Type 2 diabetes mellitus (T2DM) is a growing public health challenge in Bangladesh. Using a nationally representative health survey database, we assessed the prevalence of T2DM and quantified associations between T2DM and sociodemographic, behavioural, and clinical risk factors. Methods: We performed a cross-sectional analysis of the National Health Survey Database from 2023 to 2024 including adults aged ≥18 years. T2DM was defined by fasting plasma glucose ≥7.0 mmol/L (126 mg/dL), self-reported clinician diagnosis, or use of antidiabetic medication. Exposures included age, sex, urban/rural residence, education, household wealth index, BMI categories, waist circumference, hypertension, smoking status, physical activity, and dietary indicators. Descriptive statistics, age-standardised prevalence estimates, and multivariable logistic regression were used to quantify associations. Missing data were handled by multiple imputation where appropriate. Sensitivity analyses included alternative T2DM definitions and stratified models by sex and urban/rural status. Results: The overall weighted prevalence of T2DM was 9.8% (95% CI 9.1–10.6), rising from 2.3% in adults aged 18–34 years to 21.7% in those aged ≥60 years. Urban residents exhibited a higher prevalence (12.6%) than rural residents (8.1%). In fully adjusted models, older age (per 10-year increase: aOR 1.82, 95% CI 1.70–1.95), BMI ≥30 kg/m² (aOR 2.36, 95% CI 1.95–2.86), central obesity (aOR 1.98, 95% CI 1.71–2.30), hypertension (aOR 1.54, 95% CI 1.36–1.74), and highest household wealth quintile (aOR 1.47, 95% CI 1.23–1.76) were independently associated with T2DM. Sex and smoking status were not significantly associated after adjustment. Low physical activity showed a modest association (aOR 1.19, 95% CI 1.02–1.39). Conclusion: Approximately 1 in 10 Bangladeshi adults has T2DM, with strong links to age, obesity, central adiposity, hypertension, and higher socioeconomic status. These findings underscore the need for national prevention strategies focused on obesity control, integrated cardiometabolic risk screening, and urban-targeted interventions.