Epidemiology of Self-Reported Diabetes Mellitus in the State of Maranhão, Northeastern Brazil: Results of the National Health Survey, 2013

Abstract

Objective: To estimate the prevalence and risk factors for self-reported diabetes mellitus (DM) in adults from the State of Maranhão, Northeastern Brazil. Methods: A cross-sectional study was carried out with 1774 individuals aged ≥18 years participating in the National Health Survey of 2013 in Maranhão. The adults were selected by probabilistic sampling and interviewed face-to-face by in-home visits. The Poisson regression model was used to verify the factors associated with DM. Results: The prevalence of DM was 5.39% (95% confidence interval [95% CI]: 3.73–7.73). After adjustment of the regression model for age, gender, smoking, education, hypertension, and hypercholesterolemia, DM was statistically associated with age ≥60 years, female sex, low educational level, and self-report hypertension. Conclusion: The present study found the prevalence of self-reported DM similar to that estimated in the general population of Brazil. Public policies for prevention and control should intensify control, especially in the subgroups most vulnerable to DM.

Prevalence and Risk Factors for Self-Report Diabetes Mellitus: A Population-Based Study

“…However, hypertension is also an independent risk factor for DM [ 43 ], which is consistent with the results of this study. As the two diseases have a close pathophysiological association, actions to prevent and control hypertension can reduce the diabetes burden reciprocally [ 18 , 42 ].…”

“…These variables included the following: age, stratified into groups of 18–29, 30–39, 40–59, or ≥60 years [ 18 ]; sex (male or female), used as a gender proxy; educational level (no education/incomplete or equivalent elementary school/complete or equivalent elementary school/incomplete high school or equivalent/complete high school or equivalent/incomplete higher education or equivalent/complete higher education or equivalent) [ 7 ]; self-declared race/color (white, black, brown, or others [yellow or indigenous]), according to the IBGE classification [ 19 ]; marital status (with or without a spouse); and area of residence (urban or rural) [ 17 ].…”

“…Eating habit variables included the following: Recommended vegetable or fruit consumption (yes or no), defined as a daily consumption of at least 400 g of fruit and vegetables, equivalent to a minimum of 5 servings per day [ 20 ]. Information regarding vegetable or fruit consumption was assessed by asking the following questions about the daily frequency of eating vegetables, cooked vegetables, and fruits: “In general, how many times a day do you usually eat lettuce salad, tomatoes, salads, or any other vegetables or raw vegetables (once a day, once a day (lunch or dinner), twice a day (lunch and dinner), or thrice or more a day)?”; “In general, how many times a day do you usually eat cooked vegetables such as kale, carrot, chayote, eggplant, and zucchini (except potatoes, cassava, or yam) (once a day, once a day (lunch or dinner), twice a day (lunch and dinner), or thrice or more a day)?”; and “In general, how many times a day do you eat fruits (once a day, twice a day, or thrice or more a day)?” To estimate this variable, the sum of the vegetable consumption and fruit consumption variables was obtained [ 18 ]. Information regarding the consumption of excess fat meat or skin of the chicken (yes or no), defined as a participant who reported consuming fatty meat and/or chicken including the skin [ 21 ], was obtained by asking the following questions: “When you eat red meat, do you usually (1) remove or (2) eat the excess visible fat?” and “When you eat chicken, do you usually (1) remove or (2) eat the skin of the chicken?” Information regarding the regular consumption of soda or artificial juice (yes or no), defined as a participant who reported consuming soda or artificial juice 5 days or more per week [ 21 ], was obtained by asking the following question: “How many days in a week do you usually drink soda (or artificial juice)?”.…”

“…Recommended vegetable or fruit consumption (yes or no), defined as a daily consumption of at least 400 g of fruit and vegetables, equivalent to a minimum of 5 servings per day [ 20 ]. Information regarding vegetable or fruit consumption was assessed by asking the following questions about the daily frequency of eating vegetables, cooked vegetables, and fruits: “In general, how many times a day do you usually eat lettuce salad, tomatoes, salads, or any other vegetables or raw vegetables (once a day, once a day (lunch or dinner), twice a day (lunch and dinner), or thrice or more a day)?”; “In general, how many times a day do you usually eat cooked vegetables such as kale, carrot, chayote, eggplant, and zucchini (except potatoes, cassava, or yam) (once a day, once a day (lunch or dinner), twice a day (lunch and dinner), or thrice or more a day)?”; and “In general, how many times a day do you eat fruits (once a day, twice a day, or thrice or more a day)?” To estimate this variable, the sum of the vegetable consumption and fruit consumption variables was obtained [ 18 ].…”

Negative Self-Assessment of Health in Women: Association with Sociodemographic Characteristics, Physical Inactivity and Multimorbidity

“…The following independent variables were taken into account: (i) Sociodemographic Age group, stratified in the following groups: 18-39 years, 40-59 years and >60 years [31]; schooling (without schooling/incomplete elementary school, complete elementary school/incomplete high school, complete high school/incomplete higher education or complete higher education or higher) [19]; self-reported race/skin color, categorized as white, black, brown or others that included the indigenous and yellow categories due to the small number of observations in the sample [32]; marital status (with spouse or without spouse); residence area (rural or urban) and; state of residence (Goiás, Mato Grosso, Mato Grosso do Sul or Distrito Federal).…”