Epidemiologia e diferenças regionais da retinopatia diabética em Pernambuco, Brasil

Escarião, Paulo; Arantes, Tiago Eugênio Faria e; Filho, Natanael Cavalcanti Figueiroa; Urtiga, Ricardo de Deus; Florêncio, Telma Lúcia Tabosa; Arcoverde, Ana Lúcia de Andrade Lima

doi:10.1590/s0004-27492008000200008

Cited by 16 publications

(16 citation statements)

References 8 publications

(15 reference statements)

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“…The current prevalence of DR in any Brazilian Indian population is unknown. In this study, the frequency of DR among Xavante Indians was 19.3%, lower than the reported prevalence of DR in the Brazilian population of 19.5–42.9% [27–31], which was lower than that in some indigenous populations in North America and Australia [32–35]. Table 1 shows that the average DM duration was 77.1 months in patients with DR versus only 28.7 months for subjects without DR.…”

Section: Discussioncontrasting

confidence: 66%

Diabetic retinopathy among Brazilian Xavante Indians

Lima

Franco

Fabbro

et al. 2018

Diabetol Metab Syndr

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BackgroundTo describe the frequency of diabetic retinopathy (DR) and its associated variables in Brazilian Xavante Indians.MethodsA population-based survey carried out in two Xavante Reservations between 2008 and 2012, included 948 Indians aged 20 years or more, identified 246 individuals with type 2 diabetes. A non-probabilistic cluster sample of 140 diabetic individuals were submitted to ophthalmologic examination. Due to operational conditions and to optimize the field work, only the larger Xavante villages were included. Ophthalmologic examinations were performed during one trip to each reservation, in their villages and consisted of measurement visual acuity, anterior segment biomicroscopy, applanation tonometry, and direct and indirect ophthalmoscopy.ResultsThe frequency of DR was 19.3%, distributed as follows: mild non-proliferative retinopathy in nine (33.3%) subjects, moderate in nine (33.3%), severe in six (22.3%), very severe in two (7.4%), and high-risk proliferative DR in one (3.7%). The occurrence of DR was higher among those with a longer duration of diabetes, higher levels of glycated hemoglobin (HbA1c) and fasting glucose, papillary excavation ≥ 0.5, and among individuals in older age group. Using the log-binomial regression model, diabetes duration > 24 months and HbA1c ≥ 6.5% were significantly associated with the occurrence of DR.ConclusionsThe presence of DR (19.3%) in Xavante Indians is an alert for health care providers for this population, since diabetes is a new disease among them. Its association with disease duration, high levels of HbA1c and blood glucose calls attention for the necessity of more actions to improve diabetes control in this recently contacted ethnic group that needs particular attention.

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Section: Discussioncontrasting

confidence: 66%

Diabetic retinopathy among Brazilian Xavante Indians

Lima

Franco

Fabbro

et al. 2018

Diabetol Metab Syndr

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“…Asymptomatic in its early stages, retinopathy evolves over time, affecting the majority of patients who have lived with diabetes for more than 20 years [21]. It is estimated that 20 to 40% of patients with type 2 diabetes are affected by DR, based on studies among specific groups and restricted areas [38,74-76]. The narrow focus of these studies and limited geographical coverage make it difficult to estimate the national prevalence.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review

et al. 2013

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BackgroundWith an estimated 74% of all deaths attributable to non-communicable diseases (NCDs) in 2010, NCDs have become a major health priority in Brazil. The objective of the study was to conduct a comprehensive literature review on diabetes in Brazil; specifically: the epidemiology of type 2 diabetes, the availability of national and regional sources of data (particularly in terms of direct and indirect costs) and health policies for the management of diabetes and its complications.MethodsA literature search was conducted using PubMed to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government and the World Health Organization, as well as other grey literature and official government websites were also reviewed.ResultsFrom 2006 to 2010, an approximate 20% increase in the prevalence of self-reported diabetes was observed. In 2010, it was estimated that 6.3% of Brazilians aged 18 years or over had diabetes. Diabetes was estimated to be responsible for 278,778 years of potential life lost for every 100,000 people. In 2013, it is estimated that about 7% of patients with diabetes has had one or more of the following complications: diabetic foot ulcers, amputation, kidney disease, and fundus changes. The estimated annual direct cost of diabetes was USD $3.952 billion in 2000; the estimated annual indirect cost was USD $18.6 billion. The two main sources of data on diabetes are the information systems of the Ministry of Health and surveys. In the last few years, the Brazilian Ministry of Health has invested considerably in improving surveillance systems for NCDs as well as implementing specific programmes to improve diagnosis and access to treatment.ConclusionsBrazil has the capacity to address and respond to NCDs due to the leadership of the Ministry of Health in NCD prevention activities, including an integrated programme currently in place for diabetes. Strengthening the surveillance of NCDs is a national priority along with recognising the urgent need to invest in improving the coverage and quality of mortality data. It is also essential to conduct regular surveys of risk factors on a national scale in order to design effective preventive strategies.

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“…Resultado semelhante foi encontrado em estudo publicado nos Arquivos Brasileiros de Oftalmologia que avaliou a frequência de RD na população do estado de Pernambuco, comparando a população da região metropolitana, grupo I, com a população de cidades do interior do estado de Pernambuco, grupo II. Em relação à frequência junto de pacientes diabéticos Tipo 1 e 2, ou de 24,2% (16) a 48,8% (15) quando são incluídos somente os de Tipo 2. Tal fato pode ser explicado por vários fatores como a grande variação da amostra dos estudos supracitados, diferentes metodologias empregadas por tais estudos e diversidade de etnias e regiões demográficas, entre outras causas.…”

Section: Resultsunclassified

“…Tal fato pode ser explicado por vários fatores como a grande variação da amostra dos estudos supracitados, diferentes metodologias empregadas por tais estudos e diversidade de etnias e regiões demográficas, entre outras causas. Alguns autores (16) consideram que pacientes de cidades de interior do Estado estão mais propensos a desenvolver retinopatia diabética devido a três fatores: desinformação, condições menos favoráveis de transporte dos pacientes e ausência de unidades descentralizadas de atendimento especializado. Estes autores recomendam basicamente o uso da telemedicina e a descentralização de unidades de atendimento para diminuir a prevalência.…”

Section: Resultsunclassified

“…Tal fator, que é positivo do ponto de vista do desenvolvimento humano, poderia estar influenciando negativamente os hábitos da população na medida em que favorece a ingestão de alimentos com maior quantidade de substâncias hiperglicemiantes, dificultando o controle da glicemia e favorecendo o aumento da prevalência de retinopatia diabética entre os pacientes. Uma causa apontada por alguns autores (13) para um índice mais baixo de RD em seu trabalho (24%) foi a predominância de pacientes da faixa econômica mais pobre na (16) . A frequência de RDNP para o grupo I foi de 427 (21,6%) pacientes e para o grupo II, 65 (28,8%).…”

Section: Resultsunclassified

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