Title of Thesis

Incidence of Diabetes and Estimating The Effects of Different Risk Factors on Diabetes in Pakistan

Author(s)

Zahid Ahmed

Abstract
The effect of different risk factors on development of diabetes in Pakistan was estimated in a cross-sectional hospital based study both with descriptive and analytic components. Sample of 1000 persons (490 males, 510 females), 200 from each hospital of Sir Ganga Ram Hospital, Lahore, Federal Government Services Hospital, Islamabad, Jinnah Postgraduate Medical Center, Karachi, Hayatabad Medical Complex Hospital, Peshawar and Bolan Medical Complex Hospital, Quetta; aged 20 years and above entering the diabetic center as outdoor patient was taken. Urine and blood glucose test were performed and the diagnosis of diabetes was
made according to W.H.O criteria. Heights, weights, BMI and blood pressure of the study population were recorded. Eight risk factors were included in the study. The chi-square test was used to measure the association among the different variables. Logistic regression and discriminant analysis techniques were applied to check the main significant risk factors and for the prediction of model. Questionnaire method was used for collecting the data. In the epidemiological study it was observed that risk of diabetes increases with advancing age and education is a tool for awareness about diabetes. In overall sample analysis; Obesity and Family
History of diabetes were positively associated with D.M while Exercise was negatively associated with D.M. In the city wise study; Obesity was significant risk factor for data of SGRH, Lahore (O.R=2.627, P=0.003); FGSH, Islamabad (O.R=2.295, P=0.012); JPMC, Karachi (O.R=6.436, P=0.000) and BMCH, Quetta (O.R=5.906, P=0.000). It has a positive association with DM and is statistically significant. The risk factor F.H was positively associated with DM and significant for data of SGRH, Lahore; FGSH, Islamabad, HMCH, Peshawar and BMCH, Quetta; but it was dangerous variable for Lahore (O.R=4.222, P=0.000) and Quetta (O.R= 6.310, P=0.000).Hypertension was significant only for the study of SGRH, Lahore. (O.R = 1.952, P=0.033). Exercise was significant variable for SGRH, Lahore; JPMC, Karachi; HMCH, Peshawar and BMCH, Quetta. The present work concluded that no specific factor can be declared as the cause of DM, even yet family history and obesity may be considered as accelerating agent of this
diseases and exercise is an important precautionary measure. It is further suggested that change associated with psychological and behavioral problem in Pakistan along with genetic components individually and collectively must be studied thoroughly.

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1.1 Summary of the chapter
1.2 Chronic Disease
1.3 Diabetes in Pakistan
1.4 Origin of diabetes
1.5 Historical background of Diabetes
1.6 Sources of blood sugar
1.7 Main symptoms of diabetes
1.8 Diagnosis of diabetes
1.9 Types of Diabetes
1.10 Complications of diabetes
1.11 Risks for developing diabetes
1.12 Flow chart of study

2.1 Summary of the Chapter
2.2 Overview of Past Literature
2.3 Objectives of the Study

3.1 Summary of the chapter
3.2 Study design
3.3 Sample size and sampling technique
3.4 Data collection technique
3.5 Study Phases
3.6 Description of variables under study
3.7 Diagnostic criteria
3.8 Regression analysis
3.9 Categorical variables
3.10 Type of observation studies
3.11 Probability Structure for contingency tables
3.12 The Odds Ratio
3.13 P-Value
3.14 Phi-Coefficient
3.15 Cramer’s V –Value
3.16 Pearson’s Statistics and Chi-Square Distribution
3.17 Preference of Logistic Regression analysis
3.18 Logistic Regression
3.19 The Multiple Logistic Regression Model
3.20 Explanation of logistic regression model
3.21 Assessment of analyzing the model
3.22 Transformations on variables
3.23 Strategy of analysis
3.24 Limitations of collecting data
3.25 Coding of data

4.1 Summary of the chapter
4.2 Descriptive Analysis for Overall sample
4.3 Analytic Section for Overall sample
4.4 City Wise Sample Analysis
4.5 Transformations on predictor variables
4.6 Summary of Conclusions
4.7 Recommendations
4.8 Discussion on the title of dissertation

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