Risk factors for Diabetes Mellitus among caregivers of dialysis-dependent patients: results from a case-control study in Pakistan

Abstract

OBJECTIVE: To analyze the effect of the caregiver role on the diet intake, physical activity and future risk of developing chronic diseases like Diabetes Mellitus (DM) in adult female cases of patients with long-term illness in Pakistan.

METHODS: This hospital-based Case control study was conducted between October 2017 and March 2018 at three dialysis centers located in Rawalpindi, Pakistan. The cases included female caregivers who had been looking after patients with long-term Chronic Kidney Disease for at least 6 months. The comparison group consisted of female caregivers accompanying patients with short-term conditions lasting one month or less. Data on socio-demographic factors, anthropometry, diet, and physical activity were collected. Random measurements of blood glucose, triglycerides, and cholesterol levels were taken. Additionally, the Women's Diet Diversity Score (WDDS) and Finnish Diabetes Risk Score (FDRS) were calculated.

RESULTS: Cases (n=124) compared to controls (n=128) showed higher Diabetes risk score (2.51±0.90 vs. 2.22±1.01, p=0.048) and similar WDDS. Both groups exhibited a high prevalence of overweight (BMI >29 kg/m²) and limited fruit intake. Despite similar diet diversity, caregivers reported increased physical activity and altered household responsibilities. More than half of all participants were overweight (BMI >29kg/m2). The mean WDDS of cases and controls were 4.77±1.51 and 4.90±1.62, respectively.

CONCLUSION: Our study shows that overweight and poor diet diversity was prevalent in both groups. The overall risk of chronic disease was low in both groups, however caregivers of patients with long-term illness had higher risk scores for DM than controls.