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

Abstract

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.

Comportamentos e comorbidades associados às complicações microvasculares do diabetes

“…(12) In this sense, a review study on the epidemiology, management and cost of complications associated with type 2 diabetes in Brazil, found increased demand for health services and assistance from women, due to greater concern with health issues they have. (2) Furthermore, prevalence can be explained by the way the sample was planned, as the calls to apply for participation in the study were performed for residences in business hours.…”

“…(2) It is estimated that the total number of people with diabetes in the world will rise from 285 million in 2010 to 439 million in 2030, indicating an increase of the disease, especially in developing countries. (3) In Brazil, in this period, this population will increase from 4.5 million, in 2000, to 11.3 million, in 2013, estimating to reach 19.2 million in 2035, becoming the eighth country in the world in number of people with diabetes mellitus.…”

“…(3) After 15-20 years of living with the disease, despite treatment to prevent the short-term effects, in long term, it can cause many acute and chronic pathological processes, such as dysfunction and kidney failure, eyes, nerves, heart and blood vessels, and it is also one of the major risk factors for cardiovascular disease. (4) The most common microvascular complications are: neuropathy, retinopathy, nephropathy and ischemia, (2,5) which are of microvascular origin and are associated with conditioning factors, which comes from the individual lifestyle, as inadequate eating habits, insufficient physical activity, consumption of alcohol and tobacco, and comorbidities. (2,6) Considering the importance of the individuals' behavior in the development of type 2 diabetes mellitus, specific interventions in lifestyle can reduce the incidence of the disease and, when already diagnosed, may prevent microvascular complications.…”

“…(4) The most common microvascular complications are: neuropathy, retinopathy, nephropathy and ischemia, (2,5) which are of microvascular origin and are associated with conditioning factors, which comes from the individual lifestyle, as inadequate eating habits, insufficient physical activity, consumption of alcohol and tobacco, and comorbidities. (2,6) Considering the importance of the individuals' behavior in the development of type 2 diabetes mellitus, specific interventions in lifestyle can reduce the incidence of the disease and, when already diagnosed, may prevent microvascular complications. With collective actions among health care professionals, individuals and families, it is possible to develop strategies to identify early risk factors, avoid them and/or control them.…”

Construção, validação e adequação cultural do protocolo COMPASSO: Adesão ao autocuidado em diabetes

“…(2,12,13) In order to prepare and organize the items that composed the structure of the protocol, in addition to a literature review, discussions with experts were conducted, based on professional experiences of the participants and on the available literature. Five professionals from the fields of Healthcare, Applied Linguistics and Statistics participated in this stage.…”