Author: Abdullah Hasan
Hasan, Abdullah, 2023 Studies to explore the association between health-related behaviours and HbA1c among Kuwaiti young people at risk of T2DM, Flinders University, College of Nursing and Health Sciences
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Introduction: Non-communicable diseases in children and adolescents are a global issue, with no country successfully addressing this issue to date. Over the last 20 years, the incidence of such diseases in adolescents and young people has increased. This growing burden presents an even greater risk of younger generations in Kuwait developing type 2 diabetes mellitus. Assessing the health-related behaviours that are associated with the development of type 2 diabetes mellitus in young people would provide a clearer picture of the non-communicable diseases that affect this cohort and present possible solutions that could assist in overcoming cultural barriers and the inability to adopt a healthier lifestyle among this population.
Aim: This study investigated the current situation regarding prediabetes and type 2 diabetes mellitus among the at-risk population in Kuwait. This study hypothesised that young adults aged 10‒24 years at risk of type 2 diabetes mellitus: (1) will have an elevated level of glycated haemoglobin A1c, and (2) there is a significant relationship between health-related behaviours and glycated haemoglobin A1c.
Methods: This study followed a positivist approach to quantitative research and a repeated cross-sectional observational design. A convenience sampling strategy was used to recruit participants. Data collection was conducted over two phases. The baseline was in September 2021, and the follow up at 6-months started on March 2022. Stata® software version 17 was used to analyse the data.
Results: One hundred and forty-six young people aged between 10 and 24 years completed the baseline assessment. Of them, 60 participants (41.10 %) were in the prediabetes stage, and three participants (2.05 %) were newly diagnosed with type 2 diabetes mellitus by abiding with the American Diabetes Association’s criteria for diagnosing prediabetes and type 2 diabetes mellitus. A total of 123 participants responded to the health-related behaviours questionnaire and completed the baseline and follow-up assessments. Almost all participants had a family history of diabetes, and were obese or overweight. Young Kuwaitis have a high prevalence of prediabetes and type 2 diabetes mellitus compared to regional and international countries. Body mass index and daily screen time both significantly influenced the mean glycated haemoglobin A1c levels among the participants of this study. Furthermore, higher sleep disturbance predicted higher glycated haemoglobin A1c, whereas higher physical activity and healthier eating predicted lower glycated haemoglobin A1c.
Conclusion: This repeated cross-sectional study design lays the foundation for the association between health-related behaviours and glycated haemoglobin A1c among young people at risk of type 2 diabetes mellitus in Kuwait. Young people’s behaviours are likely to be encouraged by their environment. Thus, the Kuwaiti Government has a responsibility to promote healthy environments to adopt healthy lifestyles. School nurses can play an important role in implementing intervention strategies to prevent type 2 diabetes mellitus and promote health-related behaviours. It is important that stakeholders ensure that school clinics are equipped with medical devices and materials. These materials help school nurses to early detect prediabetes and type 2 diabetes mellitus in school clinics. As a matter of priority, the type 2 diabetes mellitus prevention program should start early, as young people’s behaviours could be shaped at a very early age, and it is possible for unhealthy behaviours to continue into adulthood.
Keywords: ‘young people’, ‘diabetes mellitus’, ‘T2DM’, ‘NIDDM’, ‘T2D’, ‘prediabetes’, ‘prediabetic state’, ‘early stage diabetes’, ‘health-related behaviours’, ‘health behaviours’,' adolescent’, ‘child’
Subject: Public Health thesis
Thesis type: Doctor of Philosophy
Completed: 2023
School: College of Nursing and Health Sciences
Supervisor: Prof Yvonne Barry