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PLoS One. 2016 Feb 25;11(2):e0149616. doi: 10.1371/journal.pone.0149616. eCollection 2016.

The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

Author information

1
Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela.
2
Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic.
3
Universidade Fedral de São Paulo, Department of Psychobiology, Sao Paulo, Brasil.
4
Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi", Lima, Peru.
5
Peking University, Institute of Mental Health, Beijing, China.
6
Christian Medical College, Vellore, India.
7
Internal Medicine Dept., Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
8
Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba.
9
National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico.
10
Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
11
Department of Community Health, Voluntary Health Services, Chennai, India.
12
Public Health Foundation of India, New Delhi, India.
13
Policlinico 19 de abril, Plaza, La Habana, Cuba.
14
King's College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom.

Abstract

BACKGROUND:

Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria.

METHODS:

Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L).

RESULTS:

Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes.

CONCLUSIONS:

Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

PMID:
26913752
PMCID:
PMC4767439
DOI:
10.1371/journal.pone.0149616
[Indexed for MEDLINE]
Free PMC Article

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