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Randomized Controlled Trial
. 2018 Aug 9;13(8):e0200434.
doi: 10.1371/journal.pone.0200434. eCollection 2018.

Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized cross-sectional analysis of risk

Kent D W Bream  1   2   3   4   5 , Amelia Breyre  2   6 , Kristian Garcia  4   7 , Erwin Calgua  4   5 , Juan M Chuc  8 , Lynne Taylor  9
Affiliations
Randomized Controlled Trial

Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized cross-sectional analysis of risk

Kent D W Bream et al. PLoS One. .

Abstract

Background: Developing countries and Indigenous populations are disproportionately affected by global trends in diabetes (T2DM), but inconsistent data are available to corroborate this pattern in Guatemala and indigenous communities in Central America. Historic estimates of T2DM, using a variety of sampling techniques and diagnostic methods, in Guatemala include a T2DM prevalence of: 4·2% (1970) and 8·4% (2003). Objectives of this geographically randomized, cross-sectional analysis of risk include: (1) use HbA1c to determine prevalence of T2DM and prediabetes in rural Indigenous community of Atitlán (2) identify risk factors for T2DM including age, BMI and gender.

Methods: A spatially random sampling method was used to identify 400 subjects. Prevalence was compared using the confidence interval method, and logistic regression and linear regression were used to assess association between diabetes and risk factors.

Findings: The overall prevalence of T2DM using HbA1c was 13·81% and prediabetes was also 13·81% in Atitlán, representing a tripling in diabetes from historic estimates and a large population with pre-diabetes. The probability of diabetes increased dramatically with increasing age, however no significant overall relationship existed with gender or BMI.

Conclusions: Diabetes is a larger epidemic than previously expected and appears to be related to ageing rather than BMI. Our proposed explanations for these findings include: possible Indigenous unique genetic susceptibility to T2DM, shortcomings in BMI as a metric for adiposity in assessing risk, changes in lifestyle and diet, and an overall aging population. The conclusion of this study suggest that (1) T2DM in rural regions of Guatemala may be of epidemic proportion. With pre-diabetes, more than 25% of the population will be diabetic in the very near future; (2) Age is a significant risk factor in the Indigenous population but BMI is not. This suggests that in some populations diabetes may be a disease of ageing.

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Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Wild S, Roglic J, Green A, Sicree R, King H. Global Prevalence of Diabetes Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53. - PubMed
    1. World Health Organization. Diabetes action now 2004. 2004.
    1. Yu CH, Zinman B. Type 2 diabetes and impaired glucose tolerance in aboriginal populations: a global perspective. Diabetes Res Clin Pract. 2007;78(2):159–70. 10.1016/j.diabres.2007.03.022 - DOI - PubMed
    1. West K, Kalbfleish JM. Diabetes in Central America. Diabetes. 1970;17(9):656–63. - PubMed
    1. Chary A, Greiner M, Bowrs C, Rohloff P. Determining adult type 2 diabetes-reated health care needs in an indigenous population in Guatemala: a mixed-methods prelimiary study. BMC Health Services Research. 2012;12(476). - PMC - PubMed

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