Abstract
Diabetes is one of the most important epidemic diseases of this century and the number of people with diabetes has more than doubled over the past three decades. Our aim was to estimate the prevalence of diabetes in the adult Brazilian population and analyze the trends for the last three decades through a systematic review with meta-analysis. This review included observational studies published between 1980 and 2015, which were independently identified by two reviewers in five databases. Random effect models were used to estimate the prevalence and trends of diabetes. In total, 50 articles were included in this review. Three different patterns for diabetes diagnosis were identified: self-report (36 studies), fasting glucose (7 studies), and complex diagnosis (fasting glucose, oral glucose tolerance test, and self-report; 7 studies). The prevalence of diabetes was 5.6 % (95 % CI 5.0–6.3; I2 = 100 %) by self-report, 6.6 % (95 % CI 4.8–8.9; I2 = 94 %) by fasting glucose, and 11.9 % (95 % CI 7.7–17.8 I2 = 100 %) by complex diagnosis. In trend analyses, we observed an increase in the prevalence of diabetes over time. The biggest increase was detected in studies using complex diagnosis: 7.4 % (95 % CI 7.1–7.7) in the 1980s to 15.7 % (95 % CI 9.8–24.3) in the 2010s. In conclusion, despite high heterogeneity, this study observed a high prevalence of diabetes in Brazilian adults over time and with a progressive increase in the last 35 years.Electronic supplementary materialThe online version of this article (doi:10.1186/s13098-016-0181-1) contains supplementary material, which is available to authorized users.
Highlights
Diabetes is one of the most important epidemic diseases of this century
Decades ago, the global epidemic of diabetes was predicted by epidemiologists who observed large and rapid increases in the prevalence of type 2 diabetes related to Western lifestyle [65]
In the present systematic review with meta-analysis of cross-sectional and baseline of cohort studies, which included more than one million individuals, it was possible to estimate the prevalence of diabetes in Brazil by decades, sex, macro-region, diagnosis criteria, and methods of assessment
Summary
The global prevalence of type 2 diabetes is increasing worldwide as a result of population ageing [1], rising rates of overweight and obesity in adults as well as youth [2], and reduced risk of mortality among patients with diabetes [3]. All the Latin American countries have undergone rapid demographic, epidemiological and nutritional transitions [9], which strongly contributed to the increasing prevalence of diabetes. Brazil is one of the most important examples of this alarming problem in less developed societies with the fourth largest number of people with type 2 diabetes [10]. In the South and Central America region, 8.0–11.3 % of the adult population have diabetes. Brazil has the highest number of people with diabetes in the region. In 2015, in Latin America, almost 250,000 adults died as
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