The burden of diabetes and hyperglycemia in Brazil: a global burden of disease study 2017.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Population Health Metrics Pub Date : 2020-09-30 DOI:10.1186/s12963-020-00209-0

Bruce Bartholow Duncan, Ewerton Cousin, Mohsen Naghavi, Ashkan Afshin, Elisabeth Barboza França, Valéria Maria de Azeredo Passos, Deborah Malta, Bruno R Nascimento, Maria Inês Schmidt

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引用次数: 18

Abstract

Background: The Global Burden of Diseases (GBD) 2017 database permits an up-to-date evaluation of the frequency and burden of diabetes at the state level in Brazil and by type of diabetes. The objective of this report is to describe, using these updated GBD data, the current and projected future burden of diabetes and hyperglycemia in Brazil, as well as its variation over time and space.

Methods: We derived all estimates using the GBD 2016 and 2017 databases to characterize disease burden related to diabetes and hyperglycemia in Brazil, from 1990 to 2040, using standard GBD methodologies.

Results: The overall estimated prevalence of diabetes in Brazil in 2017 was 4.4% (95%UI 4.0-4.9%), with 4.0% of those with diabetes being identified as having type 1 disease. While the crude prevalence of type 1 disease has remained relatively stable from 1990, type 2 prevalence has increased 30% for males and 26% for females. In 2017, approximately 3.3% of all disability-adjusted life years lost were due to diabetes and 5.9% to hyperglycemia. Diabetes prevalence and mortality were highest in the Northeast region and growing fastest in the North, Northeast, and Center-West regions. Over this period, despite a slight decrease in age-standardized incidence of type 2 diabetes, crude overall burden due to hyperglycemia has increased 19%, with population aging being a main cause for this rise. Cardiovascular diseases, responsible for 38.3% of this burden in 1990, caused only 25.9% of it in 2017, with premature mortality attributed directly to diabetes causing 31.6% of the 2017 burden. Future projections suggest that the diabetes mortality burden will increase 144% by 2040, more than twice the expected increase in crude disease burden overall (54%). By 2040, diabetes is projected to be Brazil's third leading cause of death and hyperglycemia its third leading risk factor, in terms of deaths.

Conclusions: The disease burden in Brazil attributable to diabetes and hyperglycemia, already large, is predicted by GBD estimates to more than double to 2040. Strong actions by the Ministry of Health are necessary to counterbalance the major deleterious effects of population aging.

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巴西糖尿病和高血糖负担:2017年全球疾病负担研究。

背景:全球疾病负担(GBD) 2017数据库允许对巴西州一级和糖尿病类型的糖尿病频率和负担进行最新评估。本报告的目的是利用这些最新的GBD数据，描述巴西目前和预计的未来糖尿病和高血糖负担，以及其随时间和空间的变化。方法:我们使用GBD 2016和2017数据库，采用标准GBD方法，得出1990年至2040年巴西糖尿病和高血糖相关疾病负担的所有估计值。结果:2017年巴西糖尿病的总体估计患病率为4.4% (95%UI 4.0-4.9%)，其中4.0%的糖尿病患者被确定为1型疾病。虽然1型疾病的粗流行率自1990年以来保持相对稳定，但2型患病率在男性中增加了30%，在女性中增加了26%。2017年，大约3.3%的残疾调整生命年损失是由于糖尿病，5.9%是由于高血糖。糖尿病患病率和死亡率在东北地区最高，在北部、东北和中西部地区增长最快。在此期间，尽管2型糖尿病的年龄标准化发病率略有下降，但由于高血糖引起的粗总负担增加了19%，人口老龄化是这一增长的主要原因。心血管疾病在1990年占这一负担的38.3%，但在2017年仅占25.9%，其中糖尿病直接导致的过早死亡占2017年负担的31.6%。未来预测表明，到2040年，糖尿病死亡率负担将增加144%，是粗疾病负担总体预期增幅(54%)的两倍多。预计到2040年，糖尿病将成为巴西第三大死亡原因，高血糖将成为第三大死亡风险因素。结论:巴西由糖尿病和高血糖引起的疾病负担已经很大，根据GBD估计，到2040年将增加一倍以上。卫生部必须采取强有力的行动，以抵消人口老龄化的主要有害影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.