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Prevalence of diabetes in Brazil over time: a systematic review with meta-analysis

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ABSTRACT

Diabetes is one of the most important epidemic diseases of this century and the number of people with diabetes has more than doubled over the past three decades. Our aim was to estimate the prevalence of diabetes in the adult Brazilian population and analyze the trends for the last three decades through a systematic review with meta-analysis. This review included observational studies published between 1980 and 2015, which were independently identified by two reviewers in five databases. Random effect models were used to estimate the prevalence and trends of diabetes. In total, 50 articles were included in this review. Three different patterns for diabetes diagnosis were identified: self-report (36 studies), fasting glucose (7 studies), and complex diagnosis (fasting glucose, oral glucose tolerance test, and self-report; 7 studies). The prevalence of diabetes was 5.6 % (95 % CI 5.0–6.3; I2 = 100 %) by self-report, 6.6 % (95 % CI 4.8–8.9; I2 = 94 %) by fasting glucose, and 11.9 % (95 % CI 7.7–17.8 I2 = 100 %) by complex diagnosis. In trend analyses, we observed an increase in the prevalence of diabetes over time. The biggest increase was detected in studies using complex diagnosis: 7.4 % (95 % CI 7.1–7.7) in the 1980s to 15.7 % (95 % CI 9.8–24.3) in the 2010s. In conclusion, despite high heterogeneity, this study observed a high prevalence of diabetes in Brazilian adults over time and with a progressive increase in the last 35 years.

Electronic supplementary material: The online version of this article (doi:10.1186/s13098-016-0181-1) contains supplementary material, which is available to authorized users.

No MeSH data available.


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Forest plot representing diabetes prevalence rates by complex diagnosis and decades
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Fig3: Forest plot representing diabetes prevalence rates by complex diagnosis and decades

Mentions: A meta-analysis was conducted according to the diagnosis pattern. Prevalence rates are presented in Figs. 1 (self-reported), 2 (fasting glucose) and 3 (complex diagnosis), respectively. The prevalence of diabetes was 5.6 % (95 % CI 5.0–6.3) by self-report, 6.6 % (95 % CI 4.8–8.9) by fasting glucose, and 11.9 % (95 % CI 7.7–17.8) by complex diagnosis. In trend analyses, we observed an increase in the prevalence of diabetes in studies using a self-reported diagnosis [3.2 % (95 % CI 2.6–4.1) in the 1990s, 5.7 % (95 % CI 5.1–6.4) in the 2000s, and 6.9 % (95 % CI 6.2–7.6) in the 2010s] and studies using a complex diagnosis [7.4 % (95 % CI 7.1–7.7) in the 1980s, 12.1 % (95 % CI 10.5–13.8) in the 1990s, 14.5 % (95 % CI 13.1–16.0) in the 2000s, and 15.7 % (95 % CI 9.8–24.3) in the 2010s]. Only one study evaluated the prevalence of diabetes by fasting glucose in the 1990s (10.3 %; 95 % CI 9.1–11.6); the other six studies were conducted in the 2000s (6.0 %; 95 % CI 4.2–8.6). High statistical heterogeneity was identified in all analyses (data presented in Figs. 1, 2, 3).Fig. 2


Prevalence of diabetes in Brazil over time: a systematic review with meta-analysis
Forest plot representing diabetes prevalence rates by complex diagnosis and decades
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5015260&req=5

Fig3: Forest plot representing diabetes prevalence rates by complex diagnosis and decades
Mentions: A meta-analysis was conducted according to the diagnosis pattern. Prevalence rates are presented in Figs. 1 (self-reported), 2 (fasting glucose) and 3 (complex diagnosis), respectively. The prevalence of diabetes was 5.6 % (95 % CI 5.0–6.3) by self-report, 6.6 % (95 % CI 4.8–8.9) by fasting glucose, and 11.9 % (95 % CI 7.7–17.8) by complex diagnosis. In trend analyses, we observed an increase in the prevalence of diabetes in studies using a self-reported diagnosis [3.2 % (95 % CI 2.6–4.1) in the 1990s, 5.7 % (95 % CI 5.1–6.4) in the 2000s, and 6.9 % (95 % CI 6.2–7.6) in the 2010s] and studies using a complex diagnosis [7.4 % (95 % CI 7.1–7.7) in the 1980s, 12.1 % (95 % CI 10.5–13.8) in the 1990s, 14.5 % (95 % CI 13.1–16.0) in the 2000s, and 15.7 % (95 % CI 9.8–24.3) in the 2010s]. Only one study evaluated the prevalence of diabetes by fasting glucose in the 1990s (10.3 %; 95 % CI 9.1–11.6); the other six studies were conducted in the 2000s (6.0 %; 95 % CI 4.2–8.6). High statistical heterogeneity was identified in all analyses (data presented in Figs. 1, 2, 3).Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Diabetes is one of the most important epidemic diseases of this century and the number of people with diabetes has more than doubled over the past three decades. Our aim was to estimate the prevalence of diabetes in the adult Brazilian population and analyze the trends for the last three decades through a systematic review with meta-analysis. This review included observational studies published between 1980 and 2015, which were independently identified by two reviewers in five databases. Random effect models were used to estimate the prevalence and trends of diabetes. In total, 50 articles were included in this review. Three different patterns for diabetes diagnosis were identified: self-report (36 studies), fasting glucose (7 studies), and complex diagnosis (fasting glucose, oral glucose tolerance test, and self-report; 7 studies). The prevalence of diabetes was 5.6 % (95 % CI 5.0–6.3; I2 = 100 %) by self-report, 6.6 % (95 % CI 4.8–8.9; I2 = 94 %) by fasting glucose, and 11.9 % (95 % CI 7.7–17.8 I2 = 100 %) by complex diagnosis. In trend analyses, we observed an increase in the prevalence of diabetes over time. The biggest increase was detected in studies using complex diagnosis: 7.4 % (95 % CI 7.1–7.7) in the 1980s to 15.7 % (95 % CI 9.8–24.3) in the 2010s. In conclusion, despite high heterogeneity, this study observed a high prevalence of diabetes in Brazilian adults over time and with a progressive increase in the last 35 years.

Electronic supplementary material: The online version of this article (doi:10.1186/s13098-016-0181-1) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus