Early-Onset Type 2 Diabetes in Bangladesh: National Estimates and Risk Correlates

Objective Early-onset type 2 diabetes (T2D) is an emerging public health concern. Despite its rising burden, national data on the prevalence and risk factors in Bangladesh remain scarce. This study aimed to estimate the prevalence of early-onset T2D and identify risk factors among young people in Bangladesh. Methods This nationwide, population-based survey encompassed 2,300 young people—adolescents (10-18 years) and young adults (19-34 years)—from rural and urban sites across 8 divisions of Bangladesh using multistage random sampling in 2024. Glycemic status (by oral glucose tolerance test except in pre-existing diabetes mellitus), fasting lipid profile, sociodemographics, lifestyle, anthropometry, and blood pressure were assessed. Glucose was measured by the glucose-oxidase method, and lipids by the enzymatic method. Results Prevalence of early-onset T2D and prediabetes was 4.5% (104/2,300) and 18.4% (423/2,300), respectively. Among those with diabetes, 66.3% (69/104) were newly diagnosed. Diabetes prevalence was higher in young adults (89/1,182; 7.5%) than in adolescents (15/1,118; 1.3%), and in urban residents (65/1,079; 6.0%) than in rural residents (39/1,221; 3.2%) ( P < .05 for both). Higher odds for diabetes were linked with suboptimal physical activity (odds ratio [OR] 2.0, 95% CI: 1.1-4.0), smokeless tobacco use (OR 2.6, 95% CI: 1.4-4.9), central obesity (OR 2.0, 95% CI: 1.3-3.3), hypertension (OR 3.3, 95% CI: 1.6-6.7), and hypertriglyceridemia (OR 2.9, 95% CI: 1.8-4.5). Conclusion Early-onset T2D affects 4.5% of young people in Bangladesh, whereas 18.4% have prediabetes. Prevalence is higher in young adults and urban residents. Suboptimal physical activity, smokeless tobacco use, central obesity, hypertension, and hypertriglyceridemia are key risk factors.