Article
Levels and correlates of risk factor control in diabetes mellitus –ELSA‑Brasil
Registro en:
CHWAL, Bruna Cristine et al. Levels and correlates of risk factor control in diabetes mellitus –ELSA‑Brasil. Diabetology & Metabolic Syndrome, p. 1 - 9, 2023.
1758-5996
10.1186/s13098-022-00961-3
Autor
Chwal, Bruna Cristine
Reis, Rodrigo Citton Padilha dos
Schmidt, Maria Inês
Duncan, Bruce B.
Barreto, Sandhi Maria
Griep, Rosane Harter
Resumen
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.