• Abdul Wahed Wasiq Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
  • Najibullah Fazli Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
  • Abdul Nasir Ahadi Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
  • Mohammad Zakariya Amirzada Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
  • Mohammad Sami Hayat
  • Niamatullah Ishaq Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
  • Mohammad Sediq Sahrai Department of Internal Medicine, Faculty of Medicine, Kandahar University, 03801 Kandahar, Afghanistan
Keywords: Afghanistan, Kandahar, Prevalence, Socio-economic status, Type 2 diabetes mellitus


Diabetes mellitus is a chronic disease with a life long duration and generally of gradual progression. Beside the upward trend in the prevalence rate, diabetes and its complications also have a significant economic impact on countries and their health systems. This study was aimed to assess the prevalence of type 2 diabetes mellitus (T2DM) and its association with socioeconomic status (SES) in the urban population of Kandahar city. A population-based cross-sectional study was conducted from January 2019 to May 2019 in the urban area of Kandahar province. A total of 1308 subjects, 837 (64%) women and 471 (36%) men, were included in the study. Data on sociodemographic characteristics, medical history, dietary intake and physical activity were collected in a standardized questionnaire. Diagnosis of diabetes was established according to the WHO criteria. Mean age (SD) was significantly higher in men than in women (50.3 (14.4) vs. 44.9 (11.4) years). The difference in BMI was not significant between men and women (28.1 vs. 28.7 kg/m2). Majority of the study population was aged 40-54 years (46.3%), married (86.7%), illiterate (87.4%), and obese (39%). 6.6% were tobacco smokers, higher in men (13.6%) than in women (2.6%). The prevalence of diabetes mellitus, hypertension, obesity and central obesity was 15.2%, 25.5%, 39%, and 67.1%, respectively. In this study population, it could be suggested that socioeconomic factors are associated with T2DM and socioeconomic status is worth further investigation nationwide to properly understand the role of SES.


1. International Diabetes Federation. International Diabetes Federation Diabetes Atlas 9th Edition. 9th ed. Brussels, Belgium: IDF Diabetes Atlas; 2019. 176 p.
2. World Health Organization. Global status report on noncommunicable diseases 2014. World Health Organization; 2014. 302 p.
3. International Diabetes Federation. IDF Diabetes Atlas : sixth edition [Internet]. 6th ed. Basel, Switzerland: International Diabetes Federation; 2013. 155 p. Available from:
4. Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5(8):585–96.
5. Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44(9):1094–101.
6. Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RDA, Wijeratne S, et al. Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med. 2008;25(9):1062–9.
7. Sayeed MA, Mahtab H, Khanam PA, Latif ZA, Ali SK, Banu A, et al. Diabetes and impaired fasting glycemia in a rural population of Bangladesh. Diabetes Care. 2003;26(4):1034–9.
8. Bommer C, Heesemann E, Sagalova V, Manne-Goehler J, Atun R, Bärnighausen T, et al. The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study. Lancet Diabetes Endocrinol. 2017 Jun;5(6):423–30.
9. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4–14.
10. World Health Organization. Diabetes [Internet]. 2016 [cited 2020 May 18]. Available from:
11. World Health Organization. WHO EMRO | Diabetes affects the health and well-being of millions of Afghans – a growing epidemic [Internet]. 2020. Available from:
12. Ministry of Public Health (Afghanistan). Afghanistan National Health Accounts 2017. 2019 p. 60.
13. Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol. 2011 Jun 1;40(3):804–18.
14. NSIA. Afghanistan Statistical Yearbook 2018-19. Kabul, Afghanistan: National Statistics and Information Authority; 2019. 274 p.
15. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. 2011;
16. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–104.
17. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.
18. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43(Supplement 1):S14–31.
19. Omer W, Al Hadithi T. Developing a socioeconomic index for health research in Iraq. East Mediterr Health J. 2017 Oct 1;23(10):670–7.
20. Saeed KMI, Asghar RJ, Sahak MN, Ansari J. Prevalence and risk factors associated with diabetes mellitus among Kabul citizens—Afghanistan, 2012. Int J Diabetes Dev Ctries. 2015;35(3):297–303.
21. Saeed KM, Rasooly MH, Alkozai A. Prevalence of risk factors for noncommunicable diseases in Jalalabad city, Afghanistan, evaluated using the WHO STEPwise approach. East Mediterr Health J. 2016;21(11):783–90.
22. Saeed KMI, Rasooly M. Prevalence of Risk Factors for Non-Communicable Diseases (NCD) Using WHO STEP-Wise Approach in Herat City Afghanistan. IOSR J Pharm. 2016;6(10):34–40.
23. Saeed KMI, Mohammad Hafez Rasooly. Prevalence of Risk Factors for Non-Communicable Diseases in Mazar-e-Sharif city using WHO STEP-Wise Approach. IOSR J Pharm IOSRPHR. 2017 Jun;07(01):51–8.
24. Saeed KMI. Prevalence of Diabetes and its Risk Factors in Urban Setting of Kandahar City, Afghanistan-2015. IOSR J Pharm. 2016;6(11):53–60.
25. Zafar J, Bhatti F, Akhtar N, Rasheed U, Bashir R, Humayun S, et al. Prevalence and risk factors for diabetes mellitus in a selected urban population of a city in Punjab. JPMA-J Pak Med Assoc. 2011;61(1):40.
26. Li R, Lu W, Jiang QW, Li YY, Zhao GM, Shi L, et al. Increasing prevalence of type 2 diabetes in Chinese adults in Shanghai. Diabetes Care. 2012;35(5):1028–30.
27. Valliyot B, Sreedharan J, Muttappallymyalil J, Valliyot SB. Risk factors of type 2 diabetes mellitus in the rural population of North Kerala, India: a case control study. Diabetol Croat. 2013;42(1).
28. Al Khalaf MM, Eid MM, Najjar HA, Alhajry KM, Thalib L. Screening for diabetes in Kuwait and evaluation of risk scores. EMHJ-East Mediterr Health J 16 7 725-731 2010. 2010;
29. Khlid Al A AAM, Nisha S. Risk Factors Associated with Diabetes Mellitus in a Saudi Community: A Cross-Sectional Study. Prim Health Care. 2017;7(270):2167–1079.
30. Rimm EB, Chan J, Stampfer MJ, Colditz GA, Willett WC. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. Bmj. 1995;310(6979):555–9.
31. Mohammad FH, Nanji K. Risk of Type 2 Diabetes among the Pakistani population: Results of a cross-sectional survey. Cureus. 2018;10(8).
32. Houston TK, Person SD, Pletcher MJ, Liu K, Iribarren C, Kiefe CI. Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study. Bmj. 2006;332(7549):1064–9.
33. Spijkerman AM, Nilsson PM, Ardanaz E, Gavrila D, Agudo A, Arriola L, et al. Smoking and long-term risk of type 2 diabetes: the EPIC-InterAct study in European populations. Diabetes Care. 2014;37(12):3164–71.
34. Corsi DJ, Subramanian SV. Association between socioeconomic status and self-reported diabetes in India: a cross-sectional multilevel analysis. BMJ Open. 2012;2(4):e000895.
35. Brown AF. Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature. Epidemiol Rev. 2004 Jul 1;26(1):63–77.
36. Ministry of Public Health (Afghanistan), KIT Royal Tropical Institute, NSIA. Afghanistan Health Survey 2018. 2019 p. 138.
37. Seuring T, Archangelidi O, Suhrcke M. The Economic Costs of Type 2 Diabetes: A Global Systematic Review. PharmacoEconomics. 2015 Aug;33(8):811–31.
How to Cite
Wasiq, A. W., Fazli, N., Ahadi, A. N., Amirzada, M. Z., Hayat, M. S., Ishaq, N., & Sahrai, M. S. (2021). PREVALENCE OF TYPE 2 DIABETES MELLITUS AND ITS ASSOCIATION WITH SOCIOECONOMIC STATUS IN KANDAHAR CITY: A CROSS-SECTIONAL STUDY. Malaysian Journal of Public Health Medicine, 21(3), 26-35.