Factors Associated with the 4-Year Estimated Incidence of Type 2 Diabetes Mellitus by Sex in Korean Adults: Secondary Data Analysis

Abstract

It is important to prevent the increase in the prevalence of diabetes mellitus (DM) worldwide by efficiently managing its controllable risk factors. This study aimed to identify factors associated with the 4-year estimated incidence of type 2 DM (T2DM) by sex and provide basic data for a sex-specific strategic approach to lifestyle modification. We performed a secondary data analysis using raw data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES, 2016–2018). The KNHANES is a descriptive correlational survey designed to examine sex differences in the factors associated with the 4-year estimated incidence of T2DM. This study included 9,614 Korean adults (4,134 men and 5,480 women) aged 40–69 years without a diagnosis of T2DM. For the statistical analysis, a complex sample analysis was performed for sex comparison using the χ2-test or one-way analysis of variance; a multiple regression analysis was performed to analyze the sex-specific influencing variables of 4-year estimated T2DM incidence. The waist-to-height ratio, an indicator of central obesity in adults, showed the strongest association with the 4-year estimated incidence of T2DM in both groups (male: β = 0.33, p≤0.001; female: β = 0.38, p≤0.001). The influencing variables were the monthly drinking rate (β = 0.07, p≤0.001) and sleep time (β = −0.03, p<0.05) in men and the sedentary time in women (β = 0.03, p<0.05). The overall explanatory power of these variables was 11.3% for men and 14.3% for women. Thus, significant sex differences were found in the 4-year estimated incidence of T2DM. Therefore, intervention programs need to be sex-specific to enhance the efficacy of the interventions in reducing the incidence of T2DM, and such intervention programs should be administered with a strategic approach differentiated by sex.