Title : Factors associated with prediabetes and diabetes among adults in the Dominican Republic: A national secondary data analysis

Background: Unhealthy behaviors—including poor diet, physical inactivity, tobacco use, and harmful alcohol consumption—are major modifiable risk factors for prediabetes and type 2 diabetes. Globally, diabetes accounts for approximately 3.4 million deaths annually, representing a substantial public health burden. In the Dominican Republic, diabetes causes an estimated 7,156 deaths per year, highlighting the urgent need for preventive strategies. Understanding the distribution of lifestyle-related risk factors and their association with prediabetes and diabetes is essential to inform targeted public health interventions.

Methods: We conducted a secondary analysis of data from the National Initiative on Diabetes in the Dominican Republic, collected between January and March 2023. The study included adults aged ≥18 years and assessed sociodemographic characteristics (sex and age), health behaviors (fruit and vegetable consumption, physical activity, alcohol consumption, and tobacco use), and clinical history (hypertension and obesity). Prediabetes and diabetes status were analyzed as outcome variables. Descriptive statistics and inferential analyses were performed using SPSS version 19, with statistical significance set at p<0.05.

Results: A total of 4,232 adults were analyzed; 60.8% were women, and 43.8% were aged 25–44 years. Daily consumption of fruits and vegetables was low (6.5% and 8.6%, respectively), and only 34.5% reported engaging in physical activity at least three times per week. Alcohol consumption was reported by 44.1% of participants, while 11.6% used tobacco at least once per week. The prevalence of prediabetes and diabetes was 22.2% and 11.6%, respectively. Prediabetes and diabetes were significantly more prevalent among men and adults aged 65 years or older (p<0.001). A higher prevalence was also observed among individuals with a history of hypertension and obesity (p<0.001). No statistically significant association was found between alcohol or tobacco use and prediabetes or diabetes.

Conclusions: Healthy lifestyle behaviors remain suboptimal among Dominican adults, particularly regarding diet quality and physical activity. The higher burden of prediabetes and diabetes among older adults, men, and individuals with hypertension or obesity underscores the need for targeted prevention strategies. Public health policies should prioritize the promotion of healthy diets, physical activity, and supportive food environments, alongside strengthened health education initiatives. Further research is needed to identify structural and behavioral barriers to the adoption of healthier lifestyles.

Dr. Nelson Martínez, MD, MSc, is a physician with a Master’s degree in Biomedical Research. He serves as Director of Health Research at the Ministry of Public Health and Social Assistance of the Dominican Republic and as Academic Coordinator of Medical Research at the Pontificia Universidad Católica Madre y Maestra (PUCMM). His research focuses on epidemiology, biostatistics, evidence-based medicine, and health research methodology. He is a certified health sciences researcher and member of the National Researcher Career (MESCYT), a member of the American Public Health Association (APHA), and the national representative to the Technical Commission for Health Research in Central America and the Dominican Republic (CTIS) and the Ibero-American Ministerial Network for Learning and Health Research (RIMAIS).