The burden of diabetes and hyperglycemia in Brazil and its states: findings from the Global Burden of Disease Study 2015

Abstract

Introduction and objective:The global burden of disease (GBD) 2015 project, extends GBD analyses to include Brazilian federative units separately. We take advantage of GBD methodological advances to describe the current burden of diabetes and hyperglycemia in Brazil. Methods: Using standard GBD 2015 methods, we analyzed the burden of diabetes, chronic kidney disease due to diabetes and high fasting plasma glucose in Brazil and its states. Results: The age-standardized rate of disability-adjusted life years (DALYs) which was lost to high fasting plasma glucose, a category which encompasses burdens of diabetes and of lesser hyperglycemia, were 2448.85 (95% UI 2165.96-2778.69) /100000 for males, and 1863.90 (95% UI 1648.18-2123.47) /100000 for females in 2015. This rate was more than twice as great in states with highest burden, these being overwhelmingly in the northeast and north, compared with those with lowest rates. The rate of crude DALYs for high fasting plasma glucose, increased by 35% since 1990, while DALYs due to all noncommunicable diseases increased only by 12.7%, and DALYs from all causes declined by 20.5%. Discussion: The worldwide pandemic of diabetes and hyperglycemia now causes a major and growing disease burden in Brazil, especially in states with greater poverty and a lesser educational level. Conclusion: Diabetes and chronic kidney disease due to diabetes, as well as high fasting plasma glucose in general, currently constitute a major and growing public health problem in Brazil. Actions to date for their prevention and control have been slow considering the magnitude of this burden.

Cause-specific mortality for 249 causes in Brazil and states during 1990–2015: a systematic analysis for the global burden of disease study 2015

“…Several studies have been published with data analysis of mortality risks in Brazil, but only more recently have a few works taken into account completeness of the SIM and adjusted for variation in death certificate misclassification, and those only reported mortality for specific diseases or specific areas [ 13 – 17 ]. Thus, to our knowledge, there have been no systematic studies on causes of death by Brazilian states, with correction of underregistration and unspecified codes of cause of death.…”

Trends and predictors of non‐communicable disease multimorbidity among adults living with HIV and receiving antiretroviral therapy in Brazil

“…Brazil is an important country to study long‐term outcomes of PLHIV given its early availability of ART. Like many other middle‐income countries, the prevalence of a number of NCDs is increasing in the general population of Brazil . Whether NCD trends among PLHIV mirror temporal trends has not been well described.…”

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

“…We suppose that states with better completeness and socioeconomic standards have more hospitals, and physicians were able to ll out the DC with GCs levels 3-4 such as pneumonia, diabetes or stroke unspeci ed, instead of an R code from level 1. The growing prevalence in poorer areas of some of these GCs such as diabetes of unspeci ed type, with higher burden in the North and Northeast regions [28], could also had contributed. Another hypothesis is related to the correction of undercount of deaths in this study, as this adjustment was based on the assumption of a similar COD distribution in deaths recorded and not recorded in SIM, which is probably not correct for some causes.…”