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. 2021 Jul 3:11:04041.
doi: 10.7189/jogh.11.04041. eCollection 2021.

Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil

Paula A Bracco  1 , Edward W Gregg  2 , Deborah B Rolka  3 , Maria Inês Schmidt  1 , Sandhi M Barreto  4 , Paulo A Lotufo  5 , Isabela Bensenor  5 , Bruce B Duncan  1
Affiliations

Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil

Paula A Bracco et al. J Glob Health. .

Abstract

Background: Given the paucity of studies for low- or middle-income countries, we aim to provide the first ever estimations of lifetime risk of diabetes, years of life spent and lost among those with diabetes for Brazilians. Estimates of Brazil´s diabetes burden consist essentially of reports of diabetes prevalence from national surveys and mortality data. However, these additional metrics are at times more meaningful ways to characterize this burden.

Methods: We joined data on incidence of physician-diagnosed diabetes from the Brazilian risk factor surveillance system, all-cause mortality from national statistics, and diabetes mortality rate ratios from ELSA-Brasil, an ongoing cohort study. To calculate lifetime risk of developing diabetes, we applied an illness-death state model. To calculate years of life lost for those with diabetes and years lived with the disease, we additionally calculated the mortality rates for those with diabetes.

Results: A 35-year-old white adult had a 23.4% (95% CI = 22.5%-25.5%) lifetime risk of developing diabetes by age 80 while a same-aged black/brown adult had a 30.8% risk (95% confidence interval (CI) = 29.6%-33.2%). Men diagnosed with diabetes at age 35 would live 32.9 (95% CI = 32.4-33.2) years with diabetes and lose 5.5 (95% CI = 5.1-6.1) years of life. Similarly-aged women would live 38.8 (95% CI = 38.3-38.9) years with diabetes and lose 2.1 (95% CI = 1.9-2.6) years of life.

Conclusions: Assuming maintenance of current rates, one-quarter of young Brazilians will develop diabetes over their lifetimes, with this number reaching almost one-third among young, black/brown women. Those developing diabetes will suffer a decrease in life expectancy and will generate a considerable cost in terms of medical care.

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Conflict of interest statement

Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Incidence and prevalence of diagnosed diabetes for Brazilian men and women, self-reported either as white or as black/brown, aged 35-80 years. Panel A. Incidence (per 1000 people). Panel B. Prevalence (%).
Figure 2
Figure 2
Mortality rate (per 1000 people) of individuals aged 35-80 years with (solid lines) and without (dashed lines) known diabetes. For men and women, self-reported as either white or as black/brown.
See this image and copyright information in PMC

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