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Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil
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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817330/ https://www.ncbi.nlm.nih.gov/pubmed/36604768 http://dx.doi.org/10.1186/s13098-022-00961-3 |
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author | Chwal, Bruna Cristine dos Reis, Rodrigo Citton Padilha Schmidt, Maria Inês Duncan, Bruce B. Barreto, Sandhi Maria Griep, Rosane Harter |
author_facet | Chwal, Bruna Cristine dos Reis, Rodrigo Citton Padilha Schmidt, Maria Inês Duncan, Bruce B. Barreto, Sandhi Maria Griep, Rosane Harter |
author_sort | Chwal, Bruna Cristine |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9817330 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98173302023-01-07 Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil Chwal, Bruna Cristine dos Reis, Rodrigo Citton Padilha Schmidt, Maria Inês Duncan, Bruce B. Barreto, Sandhi Maria Griep, Rosane Harter Diabetol Metab Syndr Research 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. BioMed Central 2023-01-05 /pmc/articles/PMC9817330/ /pubmed/36604768 http://dx.doi.org/10.1186/s13098-022-00961-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chwal, Bruna Cristine dos Reis, Rodrigo Citton Padilha Schmidt, Maria Inês Duncan, Bruce B. Barreto, Sandhi Maria Griep, Rosane Harter Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title | Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title_full | Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title_fullStr | Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title_full_unstemmed | Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title_short | Levels and correlates of risk factor control in diabetes mellitus –ELSA-Brasil |
title_sort | levels and correlates of risk factor control in diabetes mellitus –elsa-brasil |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817330/ https://www.ncbi.nlm.nih.gov/pubmed/36604768 http://dx.doi.org/10.1186/s13098-022-00961-3 |
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