Burden of diabetes and hyperglycaemia in adults in the Americas, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Cousin, Ewerton; Schmidt, María Inês; Ong, Kanyin; Lozano, Rafael; Afshin, Ashkan; Abushouk, Abdelrahman Ibrahim; Agarwal, Gina; Agudelo-Botero, Marcela; Al‐Aly, Ziyad; Alcalde‐Rabanal, Jacqueline Elizabeth; Alvis‐Guzmán, Nelson; Alvis-Zakzuk, Nelson J.; Antony, Benny; Asaad, Malke; Bärnighausen, Till; Basu, Sanjay; Benseñor, Isabela M.; Butt, Zahid A; Campos-Nonato, Ismael; Chattu, Vijay Kumar; Criqui, Michael H.; Daneshpajouhnejad, Parnaz; Dávila-Cervantes, Claudio Alberto; Denova‐Gutiérrez, Edgar; Dharmaratne, Samath D; Díaz, Daniel; Filip, Irina; Gad, Mohamed M.; García-Gordillo, Miguel Ángel; Assl, Shakiba Ghasemi; Gopalani, Sameer Vali; Guimarães, Rafael Alves; Gupta, Rajat Das; Hafezi-Nejad, Nima; Hashemian, Maryam; Hay, Simon I.; Kahlon, Tanvir; Khubchandani, Jagdish; Kimokoti, Ruth W; Kısa, Adnan; Defo, Barthelemy Kuate; Landires, Iván; Miller, Ted R.; Mokdad, Ali H.; Morales, Linda; Morrison, Shane D; Nigatu, Yeshambel T.; Núñez-Samudio, Virginia; Olagunju, Andrew T; Pandi‐Perumal, Seithikurippu R.; Patel, Urvish; Radfar, Amir; Ríos-Blancas, María Jesús; Roever, Leonardo; Saadatagah, Seyedmohammad; Sanabria, Juan; Santos, Itamar S; Sathish, Thirunavukkarasu; Shabani, Mahsima; Shafaat, Omid; Sheikhbahaei, Sara; Silva, Diego Augusto Santos; Singh, Ambrish; Singh, Jasvinder A; Tovani‐Palone, Marcos Roberto; Velazquez, Diana Zuleika; Zadey, Siddhesh; Naghavi, Mohsen; Vos, Theo; Duncan, Bruce Bartholow

doi:10.1016/s2213-8587(22)00186-3

Cited by 68 publications

(25 citation statements)

References 24 publications

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“…Previous studies estimated that between 35% and 41% of global burdens of diabetes and ~28% in the Americas were attributable to poor diet 1 , 53 , 54 . Compared with these prior studies, our investigation evaluated 11 dietary factors (versus only six) and separately assessed both direct and BMI-mediated dietary effects (versus direct only).…”

Section: Discussionmentioning

confidence: 99%

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

O’Hearn

Lara-Castor

Cudhea

et al. 2023

Nat Med

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The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.

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Section: Discussionmentioning

confidence: 99%

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

O’Hearn

Lara-Castor

Cudhea

et al. 2023

Nat Med

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“…Hospitalization, incapacity to work, and loss of independent living are more common among patients with chronic kidney failure than in the general population 52 . Multimorbidity requires effective management beyond kidney failure itself 53,54 .…”

Section: Discussionmentioning

confidence: 99%

“…These can provide the elderly with appropriate living conditions without greater risks of discomfort, such as hypoglycemia, which can precede falls and other complications. In contrast, uncontrolled glycemic control can evolve into systemic problems, including kidney failure and blindness, worsening functional dependence 54 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of functional dependence and chronic diseases in the noninstitutionalized Brazilian elderly: an analysis by dependence severity and multimorbidity pattern

Reis

Ferreira

Molina‐Bastos

et al. 2023

Preprint

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Background Despite the advancements in knowledge about health care for the elderly, important gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of the severity of functional dependence in the Brazilian elderly and its association with chronic diseases and to verify the patterns of multimorbidity by dependence status.Methods This cross-sectional analytical study used data from the 2013 National Health Survey conducted in Brazil. The dependent variables were moderate and severe functional dependence in basic activities of daily living (BADLs) and instrumental ADLs (IADLs). The independent variables were defined based on the questions applied to measure each morbidity in a self-reported manner and asked as “Has a doctor ever diagnosed you as having (each disease)? Multimorbidity was considered present for the elderly with ≥ 2 chronic morbidities simultaneously. The association between functional dependence on BADLs and IADLs separately by severity and the independent variables was verified from crude and adjusted estimates of the point prevalence ratios and their 95% confidence intervals using the regression model Poisson with robust variance. To group diseases into patterns, exploratory factor analysis was used.Results BADLs with moderate dependence were prevalent in 25% of the elderly aged > 80 years. Among the severely dependent, these corresponded to > 40%. For IADLs, the percentage remained high, especially for elderly individuals at an early age, approximately 60% for moderate dependence and 70% for severe dependence. When changing the condition from moderate to severe dependence in BADLs, in the presence of other mental illnesses and stroke, the probability of dependence increased more than four times in the case of other mental illnesses and more than five times for stroke. There was a linear trend for dependence severity, both moderate and severe, whereas for severe dependence on IADLs, this same factor maintained a linear trend toward an increase in probability as the number of diseases simultaneously increased.Conclusions Chronic diseases are associated with functional dependence, with greater emphasis on mental illnesses and stroke, in severe disability, considering their acute negative effects.

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“…For instance, in 2019, in the Americas, it was estimated that 409,000 adults aged 20 years or older died from diabetes (5-9% of all deaths). Diabetes was responsible for 2266 crude disability-adjusted life-year (DALYs) per 100,000 adults in the Americas ( 2 ). Owing to the frequently long period between the onset of the disease and the onset of diabetes symptoms, a considerable proportion of type 2 diabetes cases remain undiagnosed, leading to increased mortality, diabetes-related complications, and costs ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019

et al. 2023

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BackgroundScreening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults.MethodsThe Pesquisa Nacional de Saúde (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those self-reporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals.ResultsAccess to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p<0.001) was seen for those declaring being Black (PR=0.97; 0.95-0.99) or of mixed-race (PR=0.97; 0.96-0.98), those residing in rural areas (PR=0.89; 0.87-0.90), and not having a private health insurance plan (PR=0.85; 0.84-0.86).ConclusionsAlthough access to diagnostic testing for diabetes is high in Brazil, partly due to its universal health system, social inequities are still present, demanding specific actions, particularly in rural areas and among those self-declaring as being Black or mixed-race.

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Burden of diabetes and hyperglycaemia in adults in the Americas, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Cited by 68 publications

References 24 publications

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

Prevalence of functional dependence and chronic diseases in the noninstitutionalized Brazilian elderly: an analysis by dependence severity and multimorbidity pattern

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019

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