A new Brazilian regional scenario of Type 2 diabetes risk in the next ten years

Published:August 04, 2021DOI:https://doi.org/10.1016/j.pcd.2021.07.011

      Abstract

      Aims

      According to a recent national diabetes screening performed by our group in 2018, 18.4% of the Brazilians were found to have high blood glucose. The objective of the present study was to estimate the risk of developing type 2 DM (T2DM) in the next ten years in Brazilian population.

      Methods

      A cross-sectional study was carried out in community pharmacies across Brazil, in 2018, where pharmacists applied the FINDRISC questionnaire to estimate the population's risk of developing T2DM within a ten-year period.

      Results

      The study included 977 pharmacists from 345 municipalities distributed across the five geographical regions of Brazil. Of the 17,580 people evaluated, the South region was found to have the highest frequency (59.6%) among people at very low and/or low risk of developing T2DM, while the North region, the most underserved, presented the highest and/or very highest T2DM risk (24.1%). The factors that mostly and importantly impacted these regional differences were body mass index; the highest daily consumption of vegetables and fruits; history of high blood glucose and family history of T1DM/T2DM.

      Conclusion

      These results showed an impressive change of direction concerning diabetes numbers between the most underserved region in public health care and one of the most developed and best organized regions concerning health assistance, the North and the South, respectively.

      Abbreviations:

      BMI (Body Mass Index), CI (Confidence Interval), DM (Diabetes Mellitus), FINDRISC (Finnish Diabetes Risk Score), HCP (Health Care Professional), NCD (Non-Communicable Disease), T1DM (Type 1 Diabetes Mellitus), T2DM (Type 2 Diabetes Mellitus)

      Keywords

      To read this article in full you will need to make a payment
      Subscribe to Primary Care Diabetes
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Saeedi P.
        • et al.
        Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9.
        Diabetes Res Clin Pract. 2019; 157107843
        • IDF
        International Diabetes Federation, Diabetes Atlas.
        Ninth edition. 2019 (. Accessed 16 Jun 2020)
        • Atayoglu A.T.
        • et al.
        Evaluation of the Finnish Diabetes Risk Score (FINDRISC) for diabetes screening in Kayseri, Turkey.
        Prim Care Diabetes. 2020; 14: 488-493
        • Barim E.M.
        • et al.
        Translation and cultural adaptation into Brazilian Portuguese of the Finnish Diabetes Risk Score (FINDRISC) and reliability assessment.
        Rev Bras Epidemiol. 2020; 23e200060
        • Carrillo-Larco R.M.
        • et al.
        FINDRISC in Latin America: a systematic review of diagnosis and prognosis models.
        BMJ Open Diabetes Res Care. 2020; 8
        • Zhang L.
        • et al.
        Evaluation of Finnish Diabetes Risk Score in screening undiagnosed diabetes and prediabetes among U.S. adults by gender and race: NHANES 1999-2010.
        PLoS One. 2014; 9e97865
        • SBD
        Diretrizes da Sociedade Brasileira de Diabetes 2019-2020.
        2019
        • Correr C.J.
        • et al.
        Prevalence of people at risk of developing type 2 diabetes mellitus and the involvement of community pharmacies in a national screening campaign: a pioneer action in Brazil.
        Diabetol Metab Syndr. 2020; 12: 89
        • Barone M.T.U.
        • et al.
        The impact of COVID-19 on people with diabetes in Brazil.
        Diabetes Res Clin Pract. 2020; 166108304
        • IBGE
        Projection of the Brazilian population.
        (Acessed in)2017
        • Lindström J.
        • Tuomilehto J.
        The diabetes risk score: a practical tool to predict type 2 diabetes risk.
        Diabetes Care. 2003; 26: 725-731
        • ABESO
        Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica Diretrizes brasileiras de obesidade.
        (Acessed in 10 jan 2018 in)2016
        • Dunn O.J.
        Multiple Comparisons Among Means.
        Journal of the American Statistical Association. 1961; 56: 52-64
        • WHO
        Global Report on Diabetes.
        (Acessed in)2016
        • Malerbi D.A.
        • Franco L.J.
        Multicenter study of the prevalence of diabetes mellitus and impaired glucose tolerance in the urban Brazilian population aged 30-69 yr. The Brazilian Cooperative Group on the Study of Diabetes Prevalence.
        Diabetes Care. 1992; 15: 1509-1516
        • Duncan B.B.
        • et al.
        The burden of diabetes and hyperglycemia in Brazil: a global burden of disease study 2017.
        Popul Health Metr. 2020; 18: 9
        • IBGE
        Pesquisa nacional de saúde, 2019 Atenção primária à saúde e informações antropométricas.
        (Acessed in)2020
        • Galvao T.F.
        • et al.
        Inequity in utilizing health services in the Brazilian Amazon: A population-based survey, 2015.
        Int J Health Plann Manage. 2019; 34: e1846-e1853
        • Ferrante L.
        • et al.
        Brazil’s policies condemn Amazonia to a second wave of COVID-19.
        Nat Med. 2020; 26: 1315
        • Orellana J.
        • et al.
        Explosion in mortality in the Amazonian epicenter of the COVID-19 epidemic.
        Cad. Saúde Pública, 2020
        • IBGE
        Pesquisa de orçamentos familiares 2017-2018: Análise do consumo alimentar pessoal no Brasil.
        (Acessed in)2020
        • Leon B.M.
        • Maddox T.M.
        Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research.
        World J Diabetes. 2015; 6: 1246-1258
        • Schmidt T.J.
        • et al.
        Cardiovascular Disease Prevention in Rheumatoid Arthritis: Compliance with Diabetes Screening Guidelines.
        J Rheumatol. 2018; 45: 1367-1374
        • WHO
        Global action plan for the prevention and control of noncommunicable diseases 2013-2020.
        2013 (. Acessed in April 2021)
        • Brasil
        Vigitel, Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2018.
        2019
        • Padayatty S.J.
        • et al.
        Vitamin C as an antioxidant: evaluation of its role in disease prevention.
        J Am Coll Nutr. 2003; 22: 18-35
        • Boeing H.
        • et al.
        Critical review: vegetables and fruit in the prevention of chronic diseases.
        Eur J Nutr. 2012; 51: 637-663
        • Association, A.D
        5. Prevention or Delay of Type 2 Diabetes.
        Diabetes Care. 2017; 40: S44-S47
        • Khan R.M.M.
        • et al.
        From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research.
        Medicina (Kaunas). 2019; 55
        • Tuso P.
        Prediabetes and lifestyle modification: time to prevent a preventable disease.
        Perm J. 2014; 18: 88-93
        • Papaetis G.S.
        Incretin-based therapies in prediabetes: Current evidence and future perspectives.
        World J Diabetes. 2014; 5: 817-834
        • Tuomilehto H.
        • Uusitupa M.
        Lifestyle changes aiming at weight loss should always be included in the treatment of obese patients with obstructive sleep apnea.
        Sleep. 2014; 37: 1021
        • Li G.
        • et al.
        The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study.
        Lancet. 2008; 371: 1783-1789
        • Hitman G.A.
        • Niven M.J.
        Genes and diabetes mellitus.
        Br Med Bull. 1989; 45: 191-205
        • DeFronzo R.A.
        Pathogenesis of type 2 diabetes mellitus.
        Med Clin North Am. 2004; 88 (ix): 787-835
        • Paim J.
        Thirty years of the Unified Health System (SUS).
        Ciênc. saúde coletiva, 2018
        • Garnelo L.
        • Sousa A.
        • Silva C.
        Health regionalization in Amazonas: progress and challenges.
        Ciência & Saúde Coletiva, 2017: 1225-1234
        • CFF
        Serviços farmacêuticos diretamente destinados ao paciente, à família e à comunidade: contextualização e arcabouço conceitua.
        (Acessed in)2016
        • Krass I.
        • et al.
        Pharmacy diabetes care program: analysis of two screening methods for undiagnosed type 2 diabetes in Australian community pharmacy.
        Diabetes Res Clin Pract. 2007; 75: 339-347
        • Fikri-Benbrahim N.
        • et al.
        Assessment of a screening protocol for type 2 diabetes in community pharmacy. The DiabNow Study.
        Diabetes Res Clin Pract. 2015; 108: e49-52
        • Hersberger K.E.
        • et al.
        Sequential screening for diabetes--evaluation of a campaign in Swiss community pharmacies.
        Pharm World Sci. 2006; 28: 171-179
        • Papastergiou J.
        • Folkins C.
        • Li W.
        Community pharmacy-based A1c screening: a Canadian model for diabetes care.
        Int J Pharm Pract. 2016; 24: 189-195
        • Sookaneknun P.
        • et al.
        Economic analysis of the diabetes and hypertension screening collaboration between community pharmacies and a Thai government primary care unit.
        Prim Care Diabetes. 2010; 4: 155-164
        • Willis A.
        • et al.
        The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting.
        PLoS One. 2014; 9e91157