Association of Behavioral, Genetic, and Environmental Factors with Type 2 Diabetes Mellitus Among Adults Aged 30-65 Years in Urban Areas
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The increasing prevalence of type 2 diabetes mellitus (T2DM) in urban populations reflects the complex interaction of sociodemographic, behavioral, genetic, and environmental factors. Rapid urbanization has contributed to lifestyle changes, including increased consumption of ultra-processed foods (UPFs), which may increase the risk of T2DM. This study aimed to identify factors associated with T2DM among adults aged 30-65 years in urban areas. An observational analytic study with an unmatched case-control design was conducted among 152 respondents, consisting of 76 cases and 76 controls, selected from four primary healthcare centers implementing the Free Health Check Program (Cek Kesehatan Gratis/CKG) in Denpasar City. Data were collected through structured interviews and medical record verification. Variables analyzed included age, sex, UPF consumption, physical activity, family history of diabetes mellitus, and socioeconomic status (SES). Data were analyzed using simple and multiple logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). The multivariable analysis showed that age, sex, UPF consumption, physical activity, and family history of diabetes mellitus were independently associated with T2DM and compared with participants aged 30-44 years, those aged 45-54 years had higher odds of T2DM (AOR = 4.399; 95% CI: 1.508-12.827), while those aged 55-65 years also had increased odds (AOR = 2.369; 95% CI: 0.704-7.970). Male participants had higher odds of T2DM than female participants (AOR = 3.533; 95% CI: 1.438-8.678). Frequent UPF consumption was strongly associated with T2DM (AOR = 5.408; 95% CI: 2.162-13.527), as was family history of diabetes mellitus (AOR = 6.108; 95% CI: 2.592-14.393). Low physical activity was also associated with higher odds of T2DM compared with high physical activity (AOR = 4.188; 95% CI: 1.257-13.954), whereas socioeconomic status was not significantly associated with T2DM. In conclusion, age, sex, frequent UPF consumption, low physical activity, and family history of diabetes mellitus were independently associated with T2DM among adults aged 30-65 years in urban areas. These findings highlight the importance of strengthening nutrition education, promoting physical activity, and prioritizing early diabetes screening among high-risk groups.
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