Programa de Pós-graduação em Epidemiologia e Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2600 Sala 414, Porto Alegre, RS, 90035-003, Brazil.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
Popul Health Metr. 2020 Sep 30;18(Suppl 1):9. doi: 10.1186/s12963-020-00209-0.
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.
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.
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.
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.
全球疾病负担（GBD）2017 数据库允许对巴西州一级的糖尿病发病率和负担以及糖尿病类型进行最新评估。本报告的目的是使用这些更新的 GBD 数据，描述巴西目前和未来糖尿病和高血糖的负担，以及其随时间和空间的变化。
我们使用 GBD 2016 和 2017 数据库中的所有估计值来描述巴西与糖尿病和高血糖相关的疾病负担，从 1990 年到 2040 年，使用 GBD 的标准方法。
2017 年巴西糖尿病的总估计患病率为 4.4%（95%置信区间为 4.0-4.9%），其中 4.0%的糖尿病患者被确认为患有 1 型糖尿病。虽然 1 型糖尿病的粗患病率从 1990 年以来相对稳定，但男性 2 型糖尿病的患病率增加了 30%，女性增加了 26%。2017 年，所有伤残调整生命年损失的约 3.3%归因于糖尿病，5.9%归因于高血糖。在东北部地区，糖尿病的患病率和死亡率最高，北部、东北部和中西部地区的增长最快。在此期间，尽管 2 型糖尿病的年龄标准化发病率略有下降，但由于人口老龄化，高血糖的总负担增加了 19%。心血管疾病在 1990 年占该负担的 38.3%，而在 2017 年仅占 25.9%，直接归因于糖尿病的过早死亡率占 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%，是总体粗疾病负担预计增加的两倍多（54%）。到 2040 年，糖尿病预计将成为巴西第三大死因，高血糖将成为第三大死亡风险因素。
GBD 估计，巴西归因于糖尿病和高血糖的疾病负担已经很大，预计到 2040 年将增加一倍以上。卫生部需要采取强有力的行动，以抵消人口老龄化的主要不利影响。
