Trends in prevalence of diabetes mellitus and mean fasting glucose in Portugal (1987–2009): a systematic review

Pereira, Marta; Carreira, Helena; Lunet, Nuno; Azevedo, Ana

doi:10.1016/j.puhe.2013.12.009

Cited by 16 publications

(14 citation statements)

References 24 publications

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“…In Portugal, the prevalence of DM in middle-aged and senior adults has increased 2–3 fold in the last two decades. In the same period of time, the mean fasting glucose level was increased 8 mg/dL and 7 mg/dL, respectively, in men and women [ 7 ]. These epidemiological studies indicate a growing medical burden of diabetes, particularly in developing countries [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China

Yin

Han

Wang

et al. 2015

IJERPH

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Background: Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to explore risk factors affecting IFG and diabetes in patients from Northeast China. Methods: A population-based, cross-sectional survey of chronic diseases and related risk factors was conducted in Jilin Province of Northeast China. All adult residents, aged 18–79, were invited to participate in this survey using the method of multistage stratified random cluster sampling. One hundred thirty-four patients with IFG or DM and 391 healthy control subjects were recruited. We compared demographic factors, body size measurements, healthy-related behaviors, and hair metallic element contents between IFG/diabetes patients and healthy individuals. Results: IFG/diabetes patients had a greater weight, waist, hip, and body mass index (BMI) than control subjects. Significant differences in the content of zinc (Zn), potassium (K), copper (Ca), and sodium (Na) as well as Cu/Zn ratios between IFG or DM patients and control subjects (p < 0.05) were also observed. Hair Cu, selenium (Se), and Na contents were positively correlated with blood glucose levels (Cu: rs = 0.135, p = 0.002; Se: rs = 0.110, p = 0.012; Na: rs = 0.091, p = 0.038). Polytomous logistic regression adjusting for age, sex, family history of diabetes and BMI, showed that subjects with high BMI were more likely to develop IFG and DM (IFG: OR = 1.15, OR 95% CI = 1.02–1.29; DM: OR = 1.15, OR 95% CI = 1.01–1.33). Moreover, rarely or never eating fruits was a risk factor for DM (OR = 5.46, OR 95% CI = 1.87–15.98) but not for IFG (OR = 1.70, OR 95% CI = 0.72–4.02). Subjects with abdominal obesity or DM history were more susceptible to DM (abdominal obesity: OR = 2.99, OR 95% CI = 1.07–8.37; DM history: OR = 2.69, OR 95% CI = 1.01–7.20). We found that subjects living in Changling County had a significantly lower chance to suffer from IFG (OR and 95% CI for OR: 0.25, 0.08–0.74). Men and 60–69 years old subjects were at increased risk for IFG (male: OR = 3.51, OR 95% CI = 1.34–9.18; age 60–69: OR = 6.64, OR 95% CI = 1.36–32.47). We did not find significant associations of IFG or DM with certain lifestyles (such as eating more meat, exercise or physical activity, smoking, or alcohol drinking) or the content of some metallic elements (such as iron (Fe), Zn , K, calcium (Ca), Na, or magnesium (Mg)). Conclusions: This study demonstrated that less or no fruit eating, DM family history, abdominal obesity conferred vulnerability to DM. Living in Changling County, men and 60–69 years old subjects were found to be risk factors for IFG. Subjects with high BMI were more likely to develop IFG and DM.

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Section: Introductionmentioning

confidence: 99%

Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China

Yin

Han

Wang

et al. 2015

IJERPH

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“…This increase may at least in part be attributed to increasing awareness of the campaign among individuals with known or suspected diabetes, and thus may not reflect a factual increase in the prevalence of diabetes of the same magnitude. However, there are several reports on a similar increase in the prevalence of T2D in the general population including such different countries as Sweden 11, Portugal 12, and Iran 13 and even in children 14. Consequently, the prevalence of prediabetes was also reported to increase, for example, in the UK from 2003 to 2011 15.…”

Section: Discussionmentioning

confidence: 95%

‘Knowing what matters in diabetes

Jacob¹,

Klimke-Hübner

Dippel

et al. 2016

Cardiovascular Endocrinology

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IntroductionDuring the ‘Knowing what matters in diabetes: healthier below 7’ diabetes campaign, more than 30 000 randomly participating individuals underwent an occasional, voluntary diabetes risk check between 2005 and 2014.MethodsThis campaign aimed to inform individuals in Germany about diabetes mellitus and its complications, the established risk factors for development of type 2 diabetes (T2D), their prevalence and management in the real-life population, the quality of risk factor control and actual disease management in participants with a history of established diabetes mellitus [people with diabetes (PWD)]. Besides demographic characteristics (e.g. sex, age) and anamnestic information (antihypertensive treatment, history of elevated plasma glucose levels, genetic disposition), risk factor assessment included BMI, waist circumference, and lifestyle (physical activity, nutritional habits). The requested information was complemented by direct measurements of blood pressure (BP) (routine), plasma glucose, and HbA1c (voluntary). Between 2005 and 2014, more than 31 000 individuals participated in 45 single campaigns in numerous German cities. Here, we report on the results of the subgroup of participants with known diabetes mellitus.ResultsAmong the 26 522 individuals with a completed questionnaire participating in the years 2006–2014, 21 055 participants (79.4%) did not have a history of diabetes and 5098 individuals (19.2%) reported being diagnosed with T2D, 369 (1.4%) with type 1 diabetes. The proportion of participants with T2D increased markedly over the years from 13.3 (2006) to 21.7% (2014). The age group older than 64 years was the largest within this subgroup (67.3%), 48.4% men and 51.6% women. The prevalence of overweight or obesity was found in 78% and 69.2% of the PWD. More than 40% of individuals with T2D had no regular physical exercise and more than 15% had unfavorable nutritional habits. In all, 69.9% of participants with T2D had elevated BP as assessed during the campaign or reported treatment with antihypertensive drugs at any time. On average, almost half of PWD (46.3%) had an HbA1c above 7.0%; a significant trend toward higher values over the 10-year period was observed.ConclusionThe analysis of PWD participating in the ‘Knowing what matters in diabetes: healthier below 7’ campaign showed that despite huge efforts in the past, important aspects for progression and complications of T2D mellitus are still not well controlled. This includes lifestyle habits as well as pharmaceutical treatment. Although the participants in this study cannot be considered a representative sample of the German population and occasional measurements without standardization further limit firm conclusions, the BP, plasma glucose, and HbA1c results indicate that a major proportion of PWD have insufficient metabolic and BP control. The marked increase in the proportion of T2D among all participants over time is consistent with the increasing prevalence of T2D mellitus found in many other countries worldwide in the rece...

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“…In the last decades there was a decrease in blood pressure levels, observed in middleaged and older adults, while among young adults the levels remained approximately constant [18]. Self-reported diabetes and overweight/ obesity, on the other hand, increased in both sexes; while smoking prevalence increased only among women [17,[19][20][21]. These estimates, very important to understand the main determinants of the CHD mortality decline in Portugal, certainly conceal different proportions across geographic regions.…”

Section: Discussionmentioning

confidence: 99%

“…The contribution of the reduction in risk factors to the decline of Portuguese CHD mortality from 1995 to 2008 was estimated to be 42% and the increase in the uptake of treatments contributed approximately 50% [17]. Previous studies have analysed trends in the prevalence or means of cardiovascular risk factors in Portugal [18][19][20]. In the last decades there was a decrease in blood pressure levels, observed in middleaged and older adults, while among young adults the levels remained approximately constant [18].…”

Section: Discussionmentioning

confidence: 99%

Regional variation in coronary heart disease mortality trends in Portugal, 1981–2012

Araújo

Pereira

Viana

et al. 2016

International Journal of Cardiology

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Trends in prevalence of diabetes mellitus and mean fasting glucose in Portugal (1987–2009): a systematic review

Abstract: The prevalence of self-reported diabetes and mean fasting glucose increased in the last two decades, demanding for effective strategies to reverse this tendency and to manage the increasing number of people with diabetes in the Portuguese population.

Cited by 16 publications

References 24 publications

Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China

Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China

‘Knowing what matters in diabetes

Regional variation in coronary heart disease mortality trends in Portugal, 1981–2012

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