International Journal of Diabetes and Clinical Research Research Article: Open Access ClinMed International Library Citation: Peter K, Paul L, Richardson R, Ramdass B, Ali A, et al. (2015) Trends in the Occurrence of Type 2 Diabetes in Community-Dwelling Trinidadian Subjects, 1993-2014. Int J Diabetes Clin Res 2:026 Received: February 07, 2015: Accepted: March 22, 2015: Published: March 24, 2015 Copyright: © 2015 Peter K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Peter et al. Int J Diabetes Clin Res 2015, 2:2 ISSN: 2377-3634 Trends in the Occurrence of Type 2 Diabetes in Community-Dwelling Trinidadian Subjects, 1993-2014 Koreen Peter, Lilly Paul, Renee Richardson, Brandon Ramdass, Aisha Ali and Kameel Mungrue* Faculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West Indies, Trinidad *Corresponding author: Kameel Mungrue, Faculty of Medical Sciences, Department of Paraclinical Sciences, The University of the West Indies, EWMSC, Mt Hope, St Augustine, Trinidad, Tel: 868-645-2018, Fax: 868-645-2018 , E-mail: Kameel.Mungrue@sta.uwi.edu Abstract Objective: The purpose of this study is to examine secular trends in the occurrence of type 2 diabetes in community-dwelling Trinidadian subjects. Methods and design: We selected two regions in Trinidad and identifed communities where people both live and seek health care services. We used several defnitions of type 2 diabetes to recruit participants. Data on age, gender, onset of illness and educational level as a marker of socioeconomic status was collected. Findings: 301 participants were entered into the study. There was ethnic disparity but a reversal from South East to Africans. A strong inverse linear relationship (Pearson’s coeffcient r=-0.82, p ≤ 0.05) was found between BMI and age at diabetes onset. Between the 1990’s and 2004-2014 in two regions of Trinidad the number of patients with T2DM doubled, occurring more commonly among females, the obese and overweight, a tendency towards younger age groups and those of lower socioeconomic status (SES). Conclusion: We provide evidence that at the community level that the occurrence of T2DM is increasing, and shifting towards younger age groups. and quantifying the number of people afected, now and in the future, is important to allow for rational planning, allocation of resources and efective strategies for prevention and management [4]. In addition comprehensive and up-to-date survey data at the community level helps to identify potential gaps in care, and to monitor and evaluate the provision of treatment to patients in the most efcient manner. Te purpose of this study is to examine secular trends in the occurrence of type 2 diabetes in community-dwelling Trinidadian subjects. Methods We used a cross sectional study design. Te population consisted of all adult patients (>18 years) with T2DM, residing in the community and receiving care at the main primary health care facility (PHCF) serving that community. In Trinidad there are four Regional Health Authorities (RHA) that deliver care to well demarcated communities. Te communities chosen for this study came from two of these RHA, the North-Central RHA and the Eastern RHA. Te two main PHCF serving these communities were selected for the conduct of the study. Te starting point was the identifcation of all patients who met the criteria for T2DM. We defned T2DM as a physician diagnosis as well as satisfying the WHO criteria i.e. – a fasting plasma glucose ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose ≥ 11.1mmol/l (200mg/dl), or an HbA1c of >7%. [4]. Patients who met these criteria were invited to participate in the study. All patients with gestational diabetes or type 1 diabetes were excluded from the study. All data were collected using a specifcally designed data collection instrument, which include demographic data, i.e. age, gender, ethnicity, body mass index (BMI), education level and treatment. Body mass index (BMI) was based on measured height and weight on physical examination. BMI is computed as weight in kilograms divided by height in meters squared (kg/m 2 ). BMI was defned according to standard methods, normal (less than 25), overweight (25–29.99) and obese (30 or greater) [5]. Educational level was classifed into fve categories based on access to education in Trinidad. All data was stored, retrieved and analyzed using SPSS version 22. A p ≤ 0.05 was considered signifcant. Ethical approval for this study was obtained from the Ethics Committee of the University West Indies St Augustine. Introduction Type 2 diabetes (T2DM) is a global public health crisis that threatens the economies of all nations, particularly developing countries. Fueled by rapid urbanization, population growth, increasing life expectancy, nutrition transition, and increasingly sedentary lifestyles, the epidemic has grown in parallel with the worldwide rise in obesity in both adults and adolescents. [1,2]. Te burden of type 2 diabetes and its complications, including macro- and microvascular complications, are increasingly recognized as a global health priority. Te estimated prevalence of diabetes in Trinidad reported by the International Diabetes Federation is 13.9% [3], one of the highest in the region of the Americas, with the total number of cases (20-79) years at 2013, being 132 340. Te mean health care expenditure per person with diabetes is estimated at $1212 (USD). [3]. Reliable estimates of secular trends in the prevalence of T2DM