Association of Risk Factors with Diabetes Mellitus in Rural Areas of Nawabshah City: A Case-Control Study

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a growing global health concern, particularly in rural regions of low- and middle-income countries where healthcare access and preventive strategies are limited. Despite increasing prevalence, the distribution of lifestyle and metabolic risk factors in rural Pakistani populations remains underexplored. Objective: To investigate the association between modifiable lifestyle and metabolic risk factors—specifically sedentary behavior, dietary habits, smoking, alcohol use, and obesity—and the risk of T2DM among young adults in rural areas of Nawabshah. Methods: This observational case-control study was conducted among 716 participants (346 cases, 370 controls) aged 18–45 years residing in rural Nawabshah. Cases included individuals clinically diagnosed with T2DM, while age- and sex-matched controls had no diabetes history. Data were collected using structured questionnaires, anthropometric measurements, and random capillary blood glucose (RCBG) tests. Ethical approval was obtained, and the study complied with the Declaration of Helsinki. Statistical analysis was performed using SPSS Version 26, employing chi-square and t-tests to evaluate group differences. Results: A sedentary lifestyle (70.2% vs. 51.4%, p = 0.007), dietary risk (90.8% vs. 60.8%, p = 0.01), smoking (20.2% vs. 13.5%, p = 0.019), overweight (25.7% vs. 19.2%, p = 0.036), and moderate obesity (19.1% vs. 10.8%, p = 0.003) were significantly more prevalent among T2DM cases than controls, indicating clinically relevant associations. Conclusion: Sedentary behavior, unhealthy diet, smoking, and obesity were strongly linked with increased T2DM risk in rural young adults, underscoring the urgent need for community-based preventive interventions in underserved populations.