Evolution of diabetes in Brazil: prevalence data from the 2013 and 2019 Brazilian National Health Survey

Abstract

The prevalence of diabetes has been growing worldwide. This study aimed to estimate the prevalence of self-reported diabetes in Brazil in 2019, to describe its evolution from 2013, and to evaluate the role of population growth, aging, and other factors in the changes found. The 2019 Brazilian National Health Survey, a nationally representative cross-sectional survey, queried a physician diagnosis of diabetes in a probabilistic multistage cluster sample. The crude prevalence of known diabetes in 2019 was 7.7% (7.4%-8.0%), a 24% relative increase to the prevalence of 2013. Though this increase was greater in men (30%) than women (20%), 2019 prevalence remained higher in women (8.4%) than in men (6.9%). Age-adjusted prevalence was uniformly lower in the North region, and uniformly higher in the Southeast and Central-West regions. In 2019, 12.3 million cases of diabetes were found, a 36.4% increase from the 9.0 million in 2013. Drivers of this rise include increase in size (9.9%) and aging (1.8%) of the Brazilian population, and to all other factors, including increased case-detection and incidence, as well as decreased diabetes mortality (24.7%). Main correlates of greater prevalence - adjusted by the Poisson regression with robust variance - were older age (PR = 27.2, 95%CI: 1.2-42.9 for ≥ 65 years vs. 18-24 years), hypertension (PR = 2.6, 95%CI: 2.4-2.8 vs. normotension), and obesity (PR = 2.3, 95%CI: 2.1-2.5 vs. BMI < 25kg/m2). Those with a complete higher education had a 40% lower prevalence (PR = 0.6; 95%CI: 0.54-0.70 vs. incomplete elementary education). In conclusion, accompanying a worldwide trend, Brazil presents an increasing prevalence of diabetes throughout its regions, posing a huge burden to its population and health systems.