Oliveira J E, Milech A, Franco L J
Department of Internal Medicine, Federal University of Rio de Janeiro, Brazil.
Diabetes Care. 1996 Jun;19(6):663-6. doi: 10.2337/diacare.19.6.663.
To assess the prevalence of diabetes and impaired glucose tolerance (IGT) in the adult population of Rio de Janeiro, a two-stage cross-sectional survey was carried out in a random sample of 2,051 individuals aged 30-69 years from Rio de Janeiro city in Brazil.
Subjects were first screened by fasting capillary glycemia (FCG). All individuals who screened positive (FCG > 5.6 mmol/l) and every sixth consecutive person who screened negative (FCG < 5.6 mmol/l) were subjected to a 75-g glucose load. Diagnoses of diabetes and IGT were based on World Health Organization criteria.
Results from every sixth individual who screened negative were extrapolated to all individuals who screened negative after adjustment for some potential bias in the subsample. Age-adjusted prevalence rates for diabetes and IGT were 7.1 and 9.0%, respectively. The rates were higher (P < 0.01) among women than among men (8.7 vs. 5.2% for diabetes and 11.7 vs. 5.8% for IGT), among obese individuals than among nonobese individuals (7.9 vs. 6.2% for diabetes and 11.4 vs. 7.3% for IGT), and among those with family history of diabetes than among those without family history of diabetes (12.4 vs. 4.8% for diabetes and 13.8 vs. 6.7% for IGT). The rates for diabetes and IGT increased with age, being 1.7 and 4.5%, respectively, for the age-group of 30-39 years, 3.9 and 8.5% for the age-group of 40-49 years, 13.6 and 13% for the age-group of 50-59 years, and 17.3 and 15.3% for the age-group of 60-69 years (P < 0.01). The prevalence of diabetes was higher among individuals with low educational levels than among those with high educational levels (7.3 vs 4.2%). For IGT, the rates increased from the group with intermediate level of education (8.3%) to the low- (11.3%) and high-education group (12.6%). Differences in the rates for whites and non-whites (6.9 vs. 7.1% for diabetes and 8.8 vs. 9.6% for IGT) were not statistically significant. Among those with confirmed diabetes in the survey, 27.6% did not know of their diabetic condition. Among previously diagnosed diabetes (self-reported diabetes), 19.5% were not being treated, 31.8% were on diet only, 40.7% were on oral hypoglycemic drugs, and 8.0% were on insulin. Self-reported prevalence of diabetes was 0.1% for the population < 30 years of age, 4.3% for the 30-69 year old age-group, and 16.6% for those > 70 years of age.
The numbers found for Rio de Janeiro are similar to those for more developed countries and lead us to conclude that the impact of diabetes on public health is the same as in those countries where this disease is considered an important health problem.
为评估里约热内卢成年人口中糖尿病和糖耐量受损（IGT）的患病率，在巴西里约热内卢市2051名年龄在30 - 69岁的随机样本中开展了一项两阶段横断面调查。
首先通过空腹毛细血管血糖（FCG）对受试者进行筛查。所有筛查呈阳性（FCG > 5.6 mmol/l）的个体以及每连续第六名筛查呈阴性（FCG < 5.6 mmol/l）的个体均接受75克葡萄糖耐量试验。糖尿病和IGT的诊断基于世界卫生组织标准。
在对该子样本中的一些潜在偏倚进行调整后，将每连续第六名筛查呈阴性个体的结果外推至所有筛查呈阴性的个体。经年龄调整后的糖尿病和IGT患病率分别为7.1%和9.0%。女性患病率高于男性（糖尿病：8.7%对5.2%；IGT：11.7%对5.8%，P < 0.01），肥胖个体高于非肥胖个体（糖尿病：7.9%对6.2%；IGT：11.4%对7.3%），有糖尿病家族史的个体高于无糖尿病家族史的个体（糖尿病：12.4%对4.8%；IGT：13.8%对6.7%）。糖尿病和IGT的患病率随年龄增长而升高，30 - 39岁年龄组分别为1.7%和4.5%，40 - 49岁年龄组分别为3.9%和8.5%，50 - 59岁年龄组分别为13.6%和13%，60 - 69岁年龄组分别为17.3%和15.3%（P < 0.01）。受教育程度低的个体中糖尿病患病率高于受教育程度高的个体（7.3%对4.2%）。对于IGT，患病率从中等教育水平组（8.3%）升至低教育水平组（11.3%）和高教育水平组（12.6%）。白人和非白人的患病率差异（糖尿病：6.9%对7.1%；IGT：8.8%对9.6%）无统计学意义。在本次调查中确诊的糖尿病患者中，27.6%不知道自己患有糖尿病。在先前诊断的糖尿病患者（自我报告的糖尿病）中，19.5%未接受治疗，31.8%仅采用饮食控制，40.7%使用口服降糖药，8.0%使用胰岛素。自我报告的糖尿病患病率在年龄小于30岁的人群中为0.1%，30 - 69岁年龄组中为4.3%，70岁以上人群中为16.6%。
里约热内卢的调查结果与较发达国家的结果相似，这使我们得出结论，糖尿病对公共卫生的影响与在那些将该疾病视为重要健康问题的国家相同。
