Prevalence and Determinants of Diabetes Mellitus Among the Adult Population of District Swat and Peshawar, Khyber Pakhtunkhwa, Pakistan

Authors

  • Naeemullah Saidu Medical College, Swat, Pakistan
  • Mohammad Khalid Khan Gajju Khan Medical College, Swabi, Pakistan
  • Mohammad Munib Swat Medical College, Swat, Pakistan
  • Muhammad Jibran Khan Khyber Medical University – Institute of Medical Sciences, Kohat, Pakistan
  • Muhammad Nadeem Saidu Medical College, Swat, Pakistan
  • Syed Jawad Hussain Khyber Medical University – Institute of Medical Sciences, Kohat, Pakistan
  • Muhammad Ishtiaq Khyber Medical University – Institute of Medical Sciences, Kohat, Pakistan
  • Jaweria Ahmad Khattak Khyber Medical University – Institute of Medical Sciences, Kohat, Pakistan

DOI:

https://doi.org/10.52206/jsmc.2026.16.1.1376

Abstract

Background: Diabetes mellitus is a rapidly growing global public health challenge affecting both developed and developing countries. Its prevalence is strongly influenced by demographic, epidemiological, nutritional, and environmental determinants. South Asian countries, including Pakistan, are experiencing a disproportionate rise in diabetes burden due to urbanization, sedentary lifestyles, and dietary transitions.

Objective: To estimate the prevalence of diabetes mellitus and examine its association with selected modifiable and non-modifiable determinants among the adult population of District Swat and District Peshawar.

Methodology: After obtaining ethical approval, a descriptive cross-sectional study was conducted from February to June 2024 among adults aged 18 years and above residing in Swat and Peshawar districts. A sample size of 309 participants was calculated using standard prevalence-based assumptions. Data were collected using a structured and pre-tested proforma covering sociodemographic characteristics, lifestyle behaviors, dietary patterns, and clinical history. Diabetes mellitus was defined based on prior diagnosis, use of anti-diabetic medication, and/or HbA1c level >6.6.

Results: Out of 309 participants, 19.74% were found to have diabetes mellitus. Among diabetic individuals, 44.26% were aged above 60 years, 60.66% were males, and 68.85% belonged to urban or semi-urban areas. Overweight or obesity was present in 39.34%, while 40.98% were unemployed. Significant associations were observed between diabetes mellitus and tobacco smoking (57.38%, p<0.001), positive family history (31.15%, p=0.0248), sedentary lifestyle (67.21%, p=0.0003), lack of physical exercise (80.33%, p=0.011), and meat consumption (p<0.001). Advanced age, marital status, low income, and overweight/obesity also showed significant associations.

Conclusion: The prevalence of diabetes mellitus in the study population was lower than national estimates but showed strong associations with both modifiable and non-modifiable determinants.

Keywords: Diabetes Mellitus, Lifestyle, Prevalence, Physical Activity, Risk Factors, Tobacco Smoking.

References

Sakir NAI, Hwang S Bin, Park HJ, Lee BH. Associations between food consumption/dietary habits and the risks of obesity, type 2 diabetes, and hypertension: a cross-sectional study in Jakarta, Indonesia. Nutr Res Pract. 2024;18(1):132–48. https://doi.org/10.4162/nrp.2024.18.1.132

Pires C. Superfoods for Type 2 Diabetes: A Narrative Review and Proposal for New International Recommendations. Med. 2023;59(7). https://doi.org/10.3390/medicina59071184

Zegeye MY, Yosef T, Asres A. Prevalence of Diabetes and Associated Factors Among Government Employees of Mizan-Aman Town and Zonal Sector Office, Bench Sheko Zone, Southwest Ethiopia Region, 2022. Diabetes, Metab Syndr Obes. 2024;17(January):725–38. https://doi.org/10.2147/DMSO.S444487

Ewunie TM, Sisay D, Kabthymer, Hussen R. Diabetes mellitus and its association with central obesity, and overweight/ obesity among adults in Ethiopia. A systematic review and meta-analysis. PLoS One [Internet]. 2022;17(6 June):1–12. http://dx.doi.org/10.1371/journal.pone.0269877

Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health. 2022;22(1):1-6. https://doi.org/10.1186/s12889-022-13759-9

Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A, Dehghani Tafti AA. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: Results from Yazd health study. BMC Public Health. 2020;20(1):1–9. https://doi.org/10.1186/s12889-020-8267-y

Lambrinou E, Hansen TB, Beulens JW. Lifestyle factors, self-management and patient empowerment in diabetes care. Eur J Prev Cardiol. 2019;26(2 (suppl)):55–63. https://doi.org/10.1177/2047487319885455

Ansari P, Samia JF, Khan JT, Rafi MR, Rahman MS, Rahman AB, et al. Protective Effects of Medicinal Plant-Based Foods against Diabetes: A Review on Pharmacology, Phytochemistry, and Molecular Mechanisms. Nutrients. 2023;15:1–25. https://doi.org/10.3390/nu15143266

De Silva AP, De Silva SHP, Haniffa R, Liyanage IK, Jayasinghe S, Katulanda P, et al. Inequalities in the prevalence of diabetes mellitus and its risk factors in Sri Lanka: A lower middle income country. Int J Equity Health. 2018;17(1):1–10. https://doi.org/10.1186/s12939-018-0759-3

Carvalho F, Lahlou RA, Pires P, Salgado M, Silva LR. Natural Functional Beverages as an Approach to Manage Diabetes. Int J Mol Sci. 2023;24(23):1–22. https://doi.org/10.3390/ijms242316977

Zainuddin, Abdullah AZ, Jafar N, Suriah, Nursalam, Darmawansyah, et al. Health Literacy Brisk Walking Exercise on Clinical Outcomes of Blood Sugar in Patients with Type 2 Diabetes Mellitus in Indonesia. Pharmacogn J. 2023;15(2):433–8. https://doi.org/10.5530/pj.2023.15.68

Tirfessa D, Abebe M, Darega J, Aboma M. Dietary practice and associated factors among type 2 diabetic patients attending chronic follow-up in public hospitals, central Ethiopia, 2022. BMC Health Serv Res. 2023;23(1):1–13. https://doi.org/10.1186/s12913-023-10293-1

Almousa AY, Hakami OA, Qutob RA, Alghamdi AH, Alaryni AA, Alammari YM, et al. Knowledge, Attitude, and Practice Toward Diabetes Mellitus and Their Association With Socioeconomic Status Among Patients With Type 2 Diabetes Mellitus in Saudi Arabia. Cureus. 2023;15(5). https://doi.org/10.7759/cureus.39641

Mengome MFA, Kono HN, Bivigou EA, M’bondoukwe NP, Ngomo JMN, Ditombi BM, et al. Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa. PLoS One. 2024;19(4 April):1–19. https://doi.org/10.1371/journal.pone.0285907

Issaka A, Stevenson C, Paradies Y, Houehanou YCN, Bosu WK, Kiwallo JB. Association between urban-rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: A cross-sectional population-based epidemiological study. BMJ Open. 2023;13(9):1–11. https://doi.org/10.1136/bmjopen-2022-063318

Urrutia I, Martín-Nieto A, Martínez R, Casanovas-Marsal JO, Aguayo A, del Olmo J, et al. Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain. Sci Rep. 2021;11(1):1–8. https://doi.org/10.1038/s41598-021-82548-y

Barouti AA, Tynelius P, Lager A, Björklund A. Fruit and vegetable intake and risk of prediabetes and type 2 diabetes: results from a 20-year long prospective cohort study in Swedish men and women. Eur J Nutr. 2022;61(6):3175–87. https://doi.org/10.1007/s00394-022-02871-6

Alhusseini N, Ramadan M, Aljarayhi S, Arnous W, Abdelaal M, Dababo H, et al. Added sugar intake among the saudi population. PLoS One. 2023;18(9 September):1–13. https://doi.org/10.1371/journal.pone.0291136

Rondanelli M, Barrile GC, Cavioni A, Donati P, Genovese E, Mansueto F, et al. A Narrative Review on Strategies for the Reversion of Prediabetes to Normoglycemia: Food Pyramid, Physical Activity, and Self-Monitoring Innovative Glucose Devices. Nutrients. 2023;15(23):1–121. https://doi.org/10.3390/nu15234943

Mortensen SR, Skou ST, Brønd JC, Ried-Larsen M, Petersen TL, Jørgensen LB, et al. Detailed descriptions of physical activity patterns among individuals with diabetes and prediabetes: The Lolland-Falster Health Study. BMJ Open Diabetes Res Care. 2023;11(5). https://doi.org/10.1136/bmjdrc-2023-003493

Talukder A, Sara SS, Hossain MT, Nath CD, Rahman R, Hussain S, et al. Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh. PLoS One. 2024;19(4 April):1–15. https://doi.org/10.1371/journal.pone.0298071

Meisters R, Albers J, Sezer B, de Galan BE, Eussen SJPM, Stehouwer CDA, et al. Socioeconomic inequalities in health- related functioning among people with type 2 Diabetes: longitudinal analyses in the Maastricht Study. BMC Public Health. 2024;24(1):1–10.

https://doi.org/10.1186/s12889-023-17553-z

Yen FS, Wei JCC, Liu JS, Hwu CM, Hsu CC. Parental Income Level and Risk of Developing Type 2 Diabetes in Youth. JAMA Netw Open. 2023;6(11):E2345812. https://doi.org/10.1001/jamanetworkopen.2023.45812

Agbana RD, Adegbilero-Iwari OE, Amu EO, Ijabadeniyi OA. Awareness and risk burden of diabetes mellitus in a rural community of Ekiti State, South-Western Nigeria. J Prev Med Hyg. 2021;61(4):E593–600.

Rashid T, Afnan BH, Baloch AA, Mughal S, Hasan M, Khan MU. Dietary Patterns and Physical Activity Levels Among People With Type 2 Diabetes. Nutr Metab Insights. 2023;16. https://doi.org/10.1177/11786388231189591

Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: A silent killer. Ann Med Surg. 2022;79 (June):103901. https://doi.org/10.1016/j.amsu.2022.103901

Naveed MA, Ali A, Neppala S, Ahmed F, Patel P, Azeem B, et al. Trends in coronary artery disease mortality among adults with diabetes: Insights from CDC WONDER (1999–2020). Cardiovasc Revascularization Med. 2024; https://doi.org/10.1016/j.carrev.2024.11.002

Silva A, Silva L, Lopes I, Francisco A, Neto A, Monteiro M, et al. Association of Dietary Pattern and Physical Inactivity with Hypertension, Obesity, Diabetes and Metabolic Syndrome. In: Metabolic Syndrome-Lifestyle and Biological Risk Factors. IntechOpen; 2024. https://doi.org/10.5772/intechopen.115218

Lindstro?m J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, et al. The Finnish Diabetes Prevention Study (DPS) Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26(12):3230–6. https://doi.org/10.2337/diacare.26.12.3230

Additional Files

Published

04-02-2026

How to Cite

1.
Naeemullah, Khan MK, Munib M, Khan MJ, Nadeem M, Hussain SJ, Ishtiaq M, Khattak JA. Prevalence and Determinants of Diabetes Mellitus Among the Adult Population of District Swat and Peshawar, Khyber Pakhtunkhwa, Pakistan. J Saidu Med Coll [Internet]. 2026 Feb. 4 [cited 2026 Nov. 10];16(1):148-55. Available from: http://jsmc.pk/index.php/jsmc/article/view/1376