Gorgas Memorial Institute for Health Studies, Panama, Panama.
Ministerio de Salud de Panamá, Panama, Panama.
Medicine (Baltimore). 2023 Aug 11;102(32):e34600. doi: 10.1097/MD.0000000000034600.
Diabetes mellitus (DM) represents an important global burden of disease. In Panama, DM was investigated in 1 study utilizing questionnaires and in another using biomarkers, but at subnational level. Using data from a recent cross-sectional country-wide population-based study that included biomarkers, we estimated the prevalence of DM, its awareness, and control; evaluating possible risk factors. We used data from 4400 participants aged 18 years or older from the National Health Study of Panama (ENSPA) study conducted in 2019 at a national level. Weighted prevalence and 95% confidence intervals for DM, awareness, and control were estimated by sociodemographic factors, family history of DM, tobacco and alcohol use, nutritional status, and hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression models to assess the possible risk factors associated with DM prevalence and awareness. We generated OR estimates by pooling ENSPA data with a previous regional study, prevalence of cardiovascular risk factors. The prevalence of DM was estimated to be 12.4% (10.9%-14.05%). In both men and women, age, family history of diabetes (OR in men: 4.0 ([2.4-6.7]; OR in women 3.5 [2.5-4.8]), and obesity (OR in men: 2.6 [1.4-5.1]; OR in women: 2.0 [0.9-4.5]) were associated with DM. Diagnosed and controlled hypertension was associated with DM only in women (OR: 2.1 [1.2-3.6]). DM awareness was estimated to be 62.6% (56.3%-68.9%). In both men and women, DM awareness was associated with age and a family history of diabetes (OR in men: 6.6 [2.4-18.4]; OR in women 1.9 ([1.1-3.6]). In women, having secondary education (OR: 1.9 [0.9-3.9]) and being diagnosed with uncontrolled hypertension (OR: 3.3 [1.2-9.5]) was also associated to DM awareness. Men in the ENSPA study were less likely to be aware of DM than those in the prevalence of cardiovascular risk factors (OR: 0.2 [0.0-0.7]). Less than half of the individuals diagnosed with DM had their condition controlled (39.6% [31.4%-47.8%]). This study revealed that the prevalence, awareness, and control of DM were similar to recent estimates reported in other Latin American countries. It also provides a baseline regarding DM and associated risk factors in Panama at a country-level knowledge that is essential for health policy development and useful in clinical practice.
糖尿病（DM）是全球重要的疾病负担之一。在巴拿马，有 1 项研究利用问卷调查了 DM，另一项研究则利用生物标志物进行了研究，但均未涉及到国家以下层面。本研究利用最近一项全国范围的基于人群的横断面研究的数据，该研究使用了生物标志物，旨在评估可能的危险因素，估计糖尿病的患病率、知晓率和控制率。我们使用了 2019 年在全国范围内开展的巴拿马国家健康研究（ENSPA）中 4400 名 18 岁及以上参与者的数据。采用社会人口学因素、糖尿病家族史、烟草和酒精使用、营养状况和高血压来评估糖尿病、知晓率和控制率的加权患病率和 95%置信区间。采用逻辑回归模型计算比值比（OR）和 95%置信区间，以评估与糖尿病患病率和知晓率相关的可能危险因素。我们通过将 ENSPA 数据与之前的区域性心血管危险因素患病率研究进行汇总，生成了 OR 估计值。糖尿病的患病率估计为 12.4%（10.9%-14.05%）。在男性和女性中，年龄、糖尿病家族史（男性：4.0[2.4-6.7]；女性：3.5[2.5-4.8]）和肥胖（男性：2.6[1.4-5.1]；女性：2.0[0.9-4.5]）与糖尿病相关。诊断和控制不佳的高血压仅与女性的糖尿病相关（OR：2.1[1.2-3.6]）。糖尿病的知晓率估计为 62.6%（56.3%-68.9%）。在男性和女性中，糖尿病的知晓率与年龄和糖尿病家族史相关（男性：6.6[2.4-18.4]；女性：1.9[1.1-3.6]）。在女性中，接受中等教育（OR：1.9[0.9-3.9]）和诊断为未控制的高血压（OR：3.3[1.2-9.5]）也与糖尿病的知晓率相关。与心血管危险因素患病率研究中的男性相比，ENSPA 研究中的男性更不可能知晓糖尿病（OR：0.2[0.0-0.7]）。不到一半的糖尿病患者病情得到了控制（39.6%[31.4%-47.8%]）。这项研究表明，糖尿病的患病率、知晓率和控制率与最近在其他拉丁美洲国家报告的估计值相似。它还提供了有关糖尿病及其在巴拿马国家层面相关危险因素的基线信息，这是制定卫生政策所必需的，并且在临床实践中也很有用。
