Control of Glucose, Blood Pressure, and Cholesterol among Adults with Diabetes: The Brazilian National Health Survey

Reis, Rodrigo Citton Padilha dos; Duncan, Bruce Bartholow; Szwarcwald, Célia Landmann; Malta, Déborah Carvalho; Schmidt, María Inês

doi:10.3390/jcm10153428

Cited by 11 publications

(15 citation statements)

References 38 publications

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“…In Brazil, the smoking prevalence has been declined from 35% in 1990 to 11.3% in 2017 27 29 . The diabetes prevalence reduced 30% for men and 26% for women from 1990 to 2017 30 . This rising pancreatic cancer mortality trend of may be associated with an unknown risk factor, since there are differences in prevalence of risk factors between Brazilian regions [28][29][30][31][32] , this could be the reason in disparities of the mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Disparities on Pancreatic Cancer Mortality Trends and Human Development Index (HDI) in Brazil

Silva

Oliveira

Fernandes

et al. 2021

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Pancreatic cancer mortality is greatest in countries with a high and very high Human Development Index (HDI). The aim was to evaluate the pancreatic cancer mortality rates and trends related to HDI in Brazil by state. An ecological study was conducted on pancreatic cancer mortality in Brazilian states between 1979 and 2019. Age-standardized mortality rates (ASMR) and Annual Average Percent Change (AAPC) were calculated. Pearson´s correlation test was applied to compare rates over the 3 decades from 1986-2015 to verify correlation between change in HDI from 1991 to 2010. A total of 209,425 deaths from pancreatic cancer were reported in Brazil from 1979 to 2019. In men, ASMRs ranged from 2.9/100,000 in 1979 to 6.1/100,000 in 2019, with AAPC of 1.5% per year, and in women, ASMR ranged from 2.1/100,000 in 1979 to 4.7/100,000 in 2019, with AAPC of 1.9% per year. Mortality rates and trends increase with higher % of HDI improvement with a correlation between ASMRs and HDI above r>0.80. The mortality trends in pancreatic cancer were uneven increase in Brazil, there was an upward trend in mortality in both genders, but higher among women. Pancreatic cancer mortality trends were higher in those states where there was greatest increase in HDI, regions as North and Northeast. However, mortality rates remain higher in South, Southeast and Central-West of Brazil.

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Section: Discussionmentioning

confidence: 99%

Disparities on Pancreatic Cancer Mortality Trends and Human Development Index (HDI) in Brazil

Silva

Oliveira

Fernandes

et al. 2021

Preprint

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“…Studies demonstrating the control of multiple risk factors in diabetes are scarce in low-and middle-income countries. Based on a small subsample of a probabilistic national Brazilian survey, we demonstrated that target achievement is usually poor, except for non-smoking [6]. However, that study lacked statistical power to assess the factors related to ABC control.…”

Section: Introductionmentioning

confidence: 92%

Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil

Chwal

Reis

Schmidt

et al. 2023

Diabetol Metab Syndr

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Background Control of glucose, blood pressure, cholesterol, and smoking improves the prognosis of individuals with diabetes mellitus. Our objective was to assess the level of control of these risk factors in Brazilian adults with known diabetes and evaluate correlates of target achievement. Methods Cross-sectional sample of the Brazilian Longitudinal Study of Adult Health, composed of participants reporting a previous diagnosis of diabetes or the use oof antidiabetic medication. We measured glycated hemoglobin (HbA1c) and LDL-cholesterol at a central laboratory and blood pressure following standardized protocols. We defined HbA1c < 7% as glucose control (target A); blood pressure < 140/90 mmHg (or < 130/80 mmHg in high cardiovascular risk) as blood pressure control (target B), and LDL-c < 100 mg/dl (or < 70 mg/dl in high risk) as lipid control (target C), according to the 2022 American Diabetes Association guidelines. Results Among 2062 individuals with diabetes, 1364 (66.1%) reached target A, 1596 (77.4%) target B, and 1086 (52.7%) target C; only 590 (28.6%) achieved all three targets. When also considering a non-smoking target, those achieving all targets dropped to 555 (26.9%). Women (PR = 1.13; 95%CI 1.07–1.20), those aged ≥ 74 (PR = 1.20; 95%CI 1.08–1.34), and those with greater per capita income (e.g., greatest income PR = 1.26; 95%CI 1.10–1.45) were more likely to reach glucose control. Those black (PR = 0.91; 95%CI 0.83–1.00) or with a longer duration of diabetes (e.g., ≥ 10 years PR = 0.43; 95%CI 0.39–0.47) were less likely. Women (PR = 1.05; 95%CI 1.00–1.11) and those with private health insurance (PR = 1.15; 95%CI 1.07–1.23) were more likely to achieve two or more ABC targets; and those black (PR = 0.86; 95%CI 0.79–0.94) and with a longer duration of diabetes (e.g., > 10 years since diabetes diagnosis, PR = 0.68; 95%CI 0.63–0.73) less likely. Conclusion Control of ABC targets was poor, notably for LDL-c and especially when considering combined control. Indicators of a disadvantaged social situation were associated with less frequent control.

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“…Moreover, 34% had HbA 1c levels above 8%. These figures, and those regarding the control of other risk factors, indicate that much more is needed in diabetes mellitus management in Brazil 8 . In addition to privately financed care, Brazil has a universal health system (Sistema Único de Saúde), with a public primary care network available to all and covering 63% of the population in 2021.…”

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confidence: 99%