The prevalence of diabetes in Brazil is comparable with that of more developed countries, where it is considered a major health problem.

The authors postulated that as Mexican Americans became more affluent and/or acculturated to "mainstream" United States life-style they would progressively lose their "obesity-related" pattern of cardiovascular risk factors which were defined as: obesity, diabetes, hypertriglyceridemia and low levels of high density lipoprotein cholesterol. This hypothesis was tested in 1979-1982 in the San Antonio Heart Study, a population-based study on 1,288 Mexican Americans and 929 Anglos living in three San Antonio neighborhoods: a low-income barrio, a middle-income transitional neighborhood, and a high-income suburb. The study population comprised 25-65-year-old men and nonpregnant women. In Mexican American women, all of the "obesity-related" risk factors fell sharply with rising socioeconomic status. In Mexican American men, by contrast, diabetes was the only "obesity-related" risk factor which fell with rising socioeconomic status. Moreover, it fell less steeply, there being an approximately twofold difference in diabetes prevalence between the barrio and the suburbs in men compared to a fourfold difference in women. Also, total and low density lipoprotein cholesterol rose with rising socioeconomic status in Mexican American men, but not in Mexican American women. "Obesity-related" risk factors were generally higher in Mexican Americans of both sexes than in their Anglo neighbors who were of similar socioeconomic status. These results suggest that cultural factors exert a stronger influence on diabetes and cardiovascular risk factors in Mexican Americans than do purely socioeconomic factors.

Diabetes treatment leads to elevated costs both to Brazilian Public Health Care System and society. Costs increased along with duration of disease, level of care and presence of chronic complications, which suggested a need to reallocate health resources focusing on primary prevention of diabetes and its complications.

Prevalence of type 2 diabetes mellitus has increased rapidly and is expected to increase even further. In Latin America countries there is an upward trend among the younger age groups, with a major negative impact on the quality of life and burden of the disease for the health care system. Increasing rates of overweight and obesity associated with lifestyle changes and aging of the population are the main contributing factors to the increasing prevalence of type 2 diabetes. Dietary shifts in the Brazilian population (low frequency of fiber-rich foods and heavy consumption of saturated fatty acids and sugars) and sedentary lifestyle are the main risk factors for obesity, type 2 diabetes, and other chronic diseases. Diabetes prevention programs are being promoted in several countries with results showing improvement in quality of life.