High prevalence of diabetes and intermediate hyperglycemia : the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

• Autor(a) principal: Schmidt, Maria Inês
• Data de Publicação: 2014
• Outros Autores: Hoffmann, Juliana Feliciati, Diniz, Maria de Fátima Haueisen Sander, Lotufo, Paulo Andrade, Griep, Rosane Harter, Benseñor, Isabela Judith Martins, Mill, José Geraldo, Barreto, Sandhi Maria, Aquino, Estela Maria Motta Lima Leão de, Duncan, Bruce Bartholow
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/118220
• topic: Diabetes mellitus; Estado pré-diabético; Hiperglicemia; Prevalence; Brazil

Background: The global burden of diabetes mellitus and other chronic diseases is high, and 80% of those with diabetes now live in low and middle income countries. Yet, little information is available regarding prevalence of diabetes and intermediate hyperglycemia in these countries, especially when a full range of diagnostic tests is employed. The purpose of this study is to provide a full accounting of these prevalences in a large, free-living Brazilian population. Methods: We report baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 civil servants aged 35-74 years. Diabetes mellitus was ascertained by self-report of diagnosis, medication use, fasting glucose, an oral glucose tolerance test, and/or glycated hemoglobin. Cut-offs for diabetes and intermediate hyperglycemia followed the recommendations of the World Health Organization and the American Diabetes Association. Adjusted prevalences were estimated through logistic regression. Findings: With this full accounting, 19.7% (19.0%-20.3%) had diabetes mellitus, 50.4% being previously undiagnosed. Frequencies of intermediate hyperglycemia according to various criteria ranged from 16.1% to 52.6%. Diabetes or intermediate hyperglycemia was present in 79.1% of participants when using the most comprehensive definitions. The burden was greatest in the elderly, the obese, non-whites, and those with less formal education (p < 0.001). Interpretation: That four of every five free-living individuals aged 35-74 years working in selected public institutions in six Brazilian state capitals presented either diabetes or intermediate hyperglycemia highlights the advanced stage of the obesity – diabetes epidemic in urban Brazil and indicates the need for urgent action.