Trends in the prevalence of self-reported diabetes in Brazilian capital cities and the Federal District, 2006–2014

Abstract

BackgroundDiabetes is increasing globally, particularly in low and middle income countries, posing a great challenge to health systems. Brazil is currently ranked 4th in the world in terms of the absolute number of persons with diabetes. Our aim was to analyze the trend in self-reported diabetes prevalence between 2006 and 2014 in Brazilian adults.MethodsWe used data from the national telephone survey—VIGITEL. Over 40,000 individuals from probabilistic sample of subjects ≥18 years old residing in 26 state capitals and the Federal District were interviewed per year in each location. Estimates were weighted to represent the surveyed population. We analyzed trends with a linear regression model. We adjusted prevalence with a probability predictive margins model, using as reference categories: men, 18–24 years, ≥12 years of schooling and lean/normal weight.ResultsFrom 2006 to 2014, the overall prevalence increased from 5.5 to 8.0 %, a net rise of 0.26 %/year (P = 0.001). After adjustment for sex, age, schooling and BMI categories, the trend decreased only slightly to 0.25 %/year. Relatively greater adjusted increases were present in men (0.28 %/year), in those ≥65 years (0.52 %/year), with ≤8 years of schooling (0.33 %/year) and in those overweight (0.24 %/year). The most consistent upward trends were observed among men (coefficient of determination, R2 = 0.93), those with educational attainment of 0–8 years (R2 = 0.81), those > 65 years (R2 = 0.79) and those who were overweight (R2 = 0.75). There was no significant trend in diabetes prevalence for the obese. As expected, the prevalence of self-reported diabetes was always higher among those with greater age, less schooling, in women, and in those with obesity. Being obese was associated with having more than twice the prevalence of diabetes of those normal/underweight.ConclusionsPrevalence of self-reported diabetes in Brazilian adults has risen between 2006 and 2014, especially among those 65 years or older, even after taking into account the sociodemographic and nutritional changes during the period. Regardless of possible causes (higher incidence, increased diagnosis or decreased mortality), this increase in prevalence has enormous implications for the health system, representing >300,000 newly diagnosed cases of diabetes yearly requiring health care.

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“…Moreover, our clinical interview was evaluated previously and showed good reliability [47]. Indeed, diabetes frequency in our sample was similar to the rate found in the Brazilian population [48] and comparable to other neuropathological studies [21–23]. Third, previous objective measures of diabetes (e.g., glycated hemoglobin test) allowing more reliable diabetes diagnosis, including diabetes severity, were not available.…”

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“…Diabetes prevalence is 8.68% (equivalent to 11.6 million people with diabetes); with this figure Brazil is the 4 th nation in terms of number of people with diabetes in the world, just after China, India and the USA 14,15 .…”

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“…Por meio dos dados obtidos em 2016 pela VIGITEL foi observado que houve um aumento da taxa de prevalência de diabetes no Brasil de 5,5% em 2006 para aproximadamente 8,0% em 2016, sendo o aumento mais pronunciado em homens (0,28% por ano) do que em mulheres (0,23% por ano). Indivíduos mais idosos (acima de 65 anos) e acima do peso (IMC ≥ 25) tiveram taxas mais elevadas de diabetes (ISER et al, 2016), assim como na amostra obtida nesse estudo.…”

“…No Brasil, a obesidade vem crescendo demasiadamente, levantamentos apontam que mais de 50% da população está acima do peso, ou seja, na faixa de sobrepeso e obesidade. Entre crianças, estaria em torno de 15%, segundo o Instituto Brasileiro de Geografia e Estatística -IBGE para o ano de 2014 (ISER et al, 2016).…”

“…No Brasil é realizado anualmente um inquérito telefônico pelo Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico -VIGITEL, pelo qual os indivíduos acima de 18 anos são questionados sobre índice de massa corpórea (peso e altura), idade, nível educacional, aspectos socioeconômicos e hábitos alimentares (BRASIL, 2018). Porém, é um estudo que apresenta viés ao contatar apenas indivíduos que possuem linha telefônica ativa e depende da declaração de quem participa, sem dispor de meios para confirmar os dados obtidos por meio da entrevista quanto ao índice de massa corpórea (IMC) e glicemia (ISER et al, 2016).…”