Guerra Valencia Jamee, Hernández-Vásquez Akram, Rojas-Roque Carlos, Vargas-Fernández Rodrigo
Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima 15314, Peru.
Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru.
Epidemiologia (Basel). 2025 May 3;6(2):20. doi: 10.3390/epidemiologia6020020.
BACKGROUND/OBJECTIVES: Significant disparities in access to diabetes screening persist, particularly among populations with limited healthcare access. We aimed to estimate the proportion of overweight-obese Peruvian adults who underwent blood glucose testing (BGT) in the past year and to analyse the socioeconomic and geographic inequalities associated with access to this preventive intervention.
We conducted a cross-sectional study using data from the Demographic and Family Health Survey 2023. We included adults aged 35-70 years diagnosed with overweight or obesity, according to the United States Preventive Services Task Force screening recommendation. We used concentration curves (CC) and concentration indices (CI) to assess socioeconomic inequalities in BGT. BGT was ascertained using a self-reported question, while the wealth index was used as the variable to measure inequality. We also conducted a decomposition analysis to determine the relative contributions of covariates to socioeconomic inequalities in BGT.
A total of 9499 individuals were included in the analysis. A pro-rich concentration of BGT uptake was observed in CC and CI (0.2090; < 0.001). Notably, a 27-point prevalence difference was reported between the lowest and highest wealth index. The decomposition analysis showed that higher education (+64%) and rural areas (+10.6%) were the main contributors to this pro-rich concentration. In contrast, secondary education (-4.7%) and female gender (-3.4%) reduced this pro-rich concentration.
The results underscore the need for targeted strategies, such as enhancing healthcare infrastructure and implementing localized screening initiatives, to close the gap and address the burden of undiagnosed diabetes in high-risk populations.
背景/目的：在获得糖尿病筛查方面存在显著差异，尤其是在医疗保健机会有限的人群中。我们旨在估计过去一年中接受血糖检测（BGT）的超重肥胖秘鲁成年人的比例，并分析与获得这种预防性干预措施相关的社会经济和地理不平等情况。
我们使用2023年人口与家庭健康调查的数据进行了一项横断面研究。根据美国预防服务工作组的筛查建议，我们纳入了年龄在35 - 70岁之间被诊断为超重或肥胖的成年人。我们使用浓度曲线（CC）和浓度指数（CI）来评估血糖检测中的社会经济不平等。血糖检测通过自我报告的问题确定，而财富指数被用作衡量不平等的变量。我们还进行了分解分析，以确定协变量对血糖检测中社会经济不平等的相对贡献。
共有9499人纳入分析。在浓度曲线和浓度指数中观察到血糖检测的摄取呈有利于富人的集中趋势（0.2090；<0.001）。值得注意的是，最低和最高财富指数之间的患病率差异为27个百分点。分解分析表明，高等教育（+64%）和农村地区（+10.6%）是这种有利于富人集中趋势的主要贡献因素。相比之下，中等教育（-4.7%）和女性（-3.4%）减少了这种有利于富人的集中趋势。
结果强调需要采取有针对性的策略，如加强医疗保健基础设施和实施本地化筛查举措，以缩小差距并解决高危人群中未诊断糖尿病的负担。
