Author:
Chwal Bruna Cristine,dos Reis Rodrigo Citton Padilha,Schmidt Maria Inês,Duncan Bruce B.,Barreto Sandhi Maria,Griep Rosane Harter
Abstract
Abstract
Background
Control of glucose, blood pressure, cholesterol, and smoking improves the prognosis of individuals with diabetes mellitus. Our objective was to assess the level of control of these risk factors in Brazilian adults with known diabetes and evaluate correlates of target achievement.
Methods
Cross-sectional sample of the Brazilian Longitudinal Study of Adult Health, composed of participants reporting a previous diagnosis of diabetes or the use oof antidiabetic medication. We measured glycated hemoglobin (HbA1c) and LDL-cholesterol at a central laboratory and blood pressure following standardized protocols. We defined HbA1c < 7% as glucose control (target A); blood pressure < 140/90 mmHg (or < 130/80 mmHg in high cardiovascular risk) as blood pressure control (target B), and LDL-c < 100 mg/dl (or < 70 mg/dl in high risk) as lipid control (target C), according to the 2022 American Diabetes Association guidelines.
Results
Among 2062 individuals with diabetes, 1364 (66.1%) reached target A, 1596 (77.4%) target B, and 1086 (52.7%) target C; only 590 (28.6%) achieved all three targets. When also considering a non-smoking target, those achieving all targets dropped to 555 (26.9%). Women (PR = 1.13; 95%CI 1.07–1.20), those aged ≥ 74 (PR = 1.20; 95%CI 1.08–1.34), and those with greater per capita income (e.g., greatest income PR = 1.26; 95%CI 1.10–1.45) were more likely to reach glucose control. Those black (PR = 0.91; 95%CI 0.83–1.00) or with a longer duration of diabetes (e.g., ≥ 10 years PR = 0.43; 95%CI 0.39–0.47) were less likely. Women (PR = 1.05; 95%CI 1.00–1.11) and those with private health insurance (PR = 1.15; 95%CI 1.07–1.23) were more likely to achieve two or more ABC targets; and those black (PR = 0.86; 95%CI 0.79–0.94) and with a longer duration of diabetes (e.g., > 10 years since diabetes diagnosis, PR = 0.68; 95%CI 0.63–0.73) less likely.
Conclusion
Control of ABC targets was poor, notably for LDL-c and especially when considering combined control. Indicators of a disadvantaged social situation were associated with less frequent control.
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
2 articles.
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