1Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida.
2Emerging Pathogens Institute, University of Florida, Gainesville, Florida.
Am J Trop Med Hyg. 2021 Jun 2;104(6):2241-2250. doi: 10.4269/ajtmh.19-0942.
This study examined the prevalence and risk factors of prediabetes and type 2 diabetes among residents of agricultural settlement villages (bateyes) in the Dominican Republic. From March to April 2016, a cross-sectional, multi-stage cluster survey was conducted across the country's three agricultural regions (southwest, east, and north). At selected households, an adult completed a questionnaire to assess demographics, diabetes knowledge, and care, and two household residents of any age provided finger-prick blood samples that were analyzed for hemoglobin A1c (HbA1c). HbA1c was categorized as normal (< 5.7%), prediabetic (5.7-6.4%), or diabetic (≥ 6.5%). The prevalence rates of diabetes and prediabetes were 8.6% (95% confidence interval [CI], 6.2-11.8%) and 20.4% (95% CI, 17.9-23.2%), respectively, among all participants (N = 1293; median age, 35 years; range, 2-96 years), and 10.0% (95% CI, 7.2-13.8%) and 20.0% (95% CI, 17.4-23.0%), respectively, among adults 18 years or older (N = 730). The average age of participants with diabetes was 47.2 years. The average age of participants with prediabetes was 40.7 years. Among adult questionnaire respondents, 64.8% of all participants and 39.4% of patients with diabetes had not been tested for diabetes previously. Among patients with diabetes, 28.4% were previously diagnosed; 1.2% of prediabetes patients were previously diagnosed. Half (50.7%) of the respondents had heard of diabetes. The majority (94.1%) of patients previously diagnosed with diabetes reported using diabetes medication. Among both undiagnosed and previously diagnosed patients with diabetes, diabetes knowledge, previous diabetes testing, and diabetes care-seeking were lowest among Haitian-born participants. A high burden of undiagnosed diabetes and deficiencies in diabetes knowledge, access to care, and diagnosis exist among all batey inhabitants, but most acutely among Haitians. Improvements will require a multi-sectoral approach.
本研究旨在探讨多米尼加共和国农业定居村（bateyes）居民中糖尿病前期和 2 型糖尿病的患病率和危险因素。2016 年 3 月至 4 月，在全国三个农业区（西南部、东部和北部）进行了一项横断面、多阶段聚类调查。在选定的家庭中，一名成年人完成了一份调查问卷，以评估人口统计学、糖尿病知识和护理情况，两名任何年龄的家庭居民提供指尖采血样本，用于分析糖化血红蛋白（HbA1c）。HbA1c 分为正常（<5.7%）、糖尿病前期（5.7-6.4%）或糖尿病（≥6.5%）。所有参与者（N=1293；中位年龄 35 岁；范围 2-96 岁）的糖尿病和糖尿病前期患病率分别为 8.6%（95%置信区间 [CI]，6.2-11.8%）和 20.4%（95% CI，17.9-23.2%），18 岁及以上成年人（N=730）的患病率分别为 10.0%（95% CI，7.2-13.8%）和 20.0%（95% CI，17.4-23.0%）。糖尿病患者的平均年龄为 47.2 岁。糖尿病前期患者的平均年龄为 40.7 岁。在成年问卷受访者中，64.8%的参与者和 39.4%的糖尿病患者之前未接受过糖尿病检测。在糖尿病患者中，28.4%的患者之前被诊断过；1.2%的糖尿病前期患者之前被诊断过。有一半（50.7%）的受访者听说过糖尿病。大多数（94.1%）之前被诊断患有糖尿病的患者报告说使用了糖尿病药物。在未被诊断和之前被诊断患有糖尿病的患者中，海地出生的参与者的糖尿病知识、之前的糖尿病检测、以及寻求治疗的情况最低。所有 batey 居民都存在大量未被诊断的糖尿病以及糖尿病知识、获得护理和诊断方面的不足，但海地人最为严重。需要采取多部门的方法来改善这一情况。
