Prevalence of diabetes mellitus, impaired glucose tolerance and cardiovascular risk factors in the urban adult population of Ribeirao Preto - SP, Brazil

Torquato, M T C G; Montenegro, Renan Magalhães; Viana, Luis Atílio Losi; Souza, Rui Augusto Hudari Gonçalves de; Lanna, Carla Márcia Moreira; Lucas, J.C.B; Durin, C.B; Foss, Maria Cristina

doi:10.1016/s0168-8227(00)81934-8

Cited by 3 publications

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“…The prevalence of diabetes was estimated to be of 7.6% in a multicenter study conducted in 1988 [ 3 ]. Although WHO has estimated a prevalence of diabetes in our country of 7.2% by the year of 2025, more recent data, though scarce and limited to some regions, showed a prevalence of 12.5% in 1999 [ 4 ]. According to Brazilian National Data Survey, diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

Gomes

Giannella-Neto

Faria

et al. 2009

Diabetol Metab Syndr

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According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country.Aimsto stratify the estimated cardiovascular risk (eCVR) in a population of type 2 diabetics (T2DM) according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease.MethodsFrom 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. The 10-year risk of developing coronary heart disease (CHD) was estimated by the prediction equations described by Wilson et al (Circulation 1998). LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead.ResultsData from 1382 patients (59.0% female) were analyzed. Median and inter-quartile range (IQ) of age and duration of diabetes were 57.4 (51-65) and 8.8 (3-13) years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p < 0.001). The overall estimated eCVR in T2DM patients was 21.4 (13.5-31.3). The eCVR was high (> 20%) in 738 (53.4%), intermediate in 202 (14.6%) and low in 442 (32%) patients. Men [25.1(15.4-37.3)] showed a higher eCVR than women [18.8 (12.4-27.9) p < 0.001]. The most common risk factor was high LDL-cholesterol (80.8%), most frequently found in women than in men (p = 0.01). The median of risk factors present was three (2-4) without gender differences. Overall we observed that 60 (4.3%) of our patients had none, 154(11.1%) one, 310 (22.4%) two, 385 (27.9%) three, 300 (21.7%) four, 149 (10.5%) five and six, (2%) six risk factors. A higher eCVR was noted in overweight or obese patients (p = 0.01 for both groups). No association was found between eCVR with age or a specific type of diabetes treatment. A correlation was found between eCVR and duration of diabetes (p < 0.001), BMI (p < 0.001), creatinine (p < 0.001) and triglycerides levels (p < 0.001) but it was not found with HbA1c, fasting blood glucose and post-prandial glucose. A higher eCVR was observed in patients with retinopathy (p < 0.001) and a tendency in patients with microalbuminuria (p = 0.06). Conclusion: our study showed that in this group of Brazilian T2DM the eCVR was correlated with the lipid profile and it was higher in patients with microvascular chronic complications. No correlation was found with glycemic control parameters. These data could explain the failure of intensive glycemic control programs aiming to reduce cardiovascular events observed in some studies.

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Section: Introductionmentioning

confidence: 99%

Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

Gomes

Giannella-Neto

Faria

et al. 2009

Diabetol Metab Syndr

View full text Add to dashboard Cite

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“…No Brasil, na década de 80, a prevalência média de DM era de 7,6% na faixa etária de 30 a 70 anos, com cerca de 30 a 50% dos casos não diagnosticados (2). Entretanto, dados recentes de Ribeirão Preto, SP, demonstram aumento de aproximadamente 79% nesta prevalência (3).…”

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Avaliação do risco cardiovascular segundo os critérios de Framingham em pacientes com diabetes tipo 2

Oliveira

Tannus

Matheus

et al. 2007

Arq Bras Endocrinol Metab

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“…Entretanto, dados mais recentes da região de Ribeirão Preto (interior do Estado de São Paulo) demonstraram que essa prevalência pode ter aumentado em aproximadamente cinco pontos porcentuais (4). De acordo com estes dados, pode-se estimar que ainda neste século nosso país terá aproximadamente 11 milhões de indivíduos com DM.…”

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Glitazonas e síndrome metabólica: mecanismos de ação, fisiopatologia e indicações terapêuticas

Gomes

2006

Arq Bras Endocrinol Metab

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RESUMOO diabetes mellitus (DM) é considerado um problema de saúde pública em países devido às suas complicações crônicas macro e microvasculares, com grande impacto na morbimortalidade dos pacientes. A doença é o estágio final de uma síndrome crônica e progressiva, cujas anormalidades fisiopatológicas iniciam-se anos antes do diagnóstico clínico da doença. A síndrome metabólica (SM) é conseqüente ao aumento mundial da prevalência de obesidade. O DM é freqüen-temente associado com condições clínicas e laboratoriais que fazem parte da SM, como a obesidade, hipertensão arterial, dislipidemia e microalbuminúria, também fatores de risco cardiovascular. Estudos populacionais demonstram aumento na prevalência de todos os fatores que compõem esta síndrome do pré-diabetes ao DM manifesto, resultando em elevada prevalência de doença cardiovascular e morbimortalidade. Estima-se que >80% dos pacientes com DM apresentem SM. As glitazonas são agonistas PPAR-γ que melhoram a sensibilidade insulínica. Estas drogas induzem à transcrição de genes relacionados ao metabolismo glicídico e lipídico e à expressão de proteínas inflamatórias e endoteliais associadas com o processo aterosclerótico, resultando em melhora da função endotelial. Entretanto, algumas questões relacionadas às glitazonas merecem mais estudos, como a causa de seus efeitos colaterais (ganho de peso, edema e desenvolvimento de insuficiência cardíaca congestiva). Diabetes mellitus (DM) is considered a major public health problem in both developed and developing countries due to its chronic complications, at the macro or microcirculation, with great impact on mortality and morbidity in all patients. The disease is considered the end of a pathophysiologic process involving peripheral and hepatic insulin resistance and reduced insulin secretion that have been started years before the clinical diagnosis. Metabolic syndrome (MS) is a disorder that results from the increasing prevalence of obesity worldwide. DM is frequently associated with clinical and laboratory features of MS, like abdominal obesity, hypertension, dyslipidemia and microalbuminuria that are also risk factors for cardiovascular disease. Populational studies have demonstrated increasing prevalence of all the features of MS from pre-diabetes to clinical DM resulting in a great risk of cardiovascular disease. The prevalence of MS in DM type 2 is estimated to be >80%. Glitazones are PPAR-γ agonists that improve insulin sensitivity. These drugs induce the transcription of genes related to glucose and lipid metabolism, and expression of inflammatory and endothelial proteins associated with atherosclerosis process resulting in an improvement in endothelial function. However several questions need to be clarified atualização

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Prevalence of diabetes mellitus, impaired glucose tolerance and cardiovascular risk factors in the urban adult population of Ribeirao Preto - SP, Brazil

Cited by 3 publications

References 0 publications

Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

Avaliação do risco cardiovascular segundo os critérios de Framingham em pacientes com diabetes tipo 2

Glitazonas e síndrome metabólica: mecanismos de ação, fisiopatologia e indicações terapêuticas

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