Incidence of type 2 diabetes in a marginal urban area of ​​Costa Rica
DOI:
https://doi.org/10.51481/amc.v50i1.349Keywords:
diabetes mellitus type 2, risk factors, incidence, urban marginalAbstract
Objective: Diabetes is now a global epidemic. Once thought to be a disease primarily affecting developed nations, diabetes is growing rapidly and exponentially in developing nations, seriously impacting the health systems and environments of these countries. Costa Rica has collected some diabetes prevalence data, but little is known of its incidence. Epidemiological studies of prevalence and incidence of diabetes are needed for the planning of prevention strategies in Costa Rica. This study was conducted to determine the percentage of the population at risk of developing diabetes within a health district located in a poor, urban marginal community of Costa Rica and to estimate the incidence rate of diabetes type 2.
Methodology: Of the 7039 persons 20 years or older receiving primary care in four marginal urban primary health care centers of Desamparados 3 of Costa Rica in the year 2000, 4228 ( 60%) had at least one risk factor for developing diabetes using the 1997 ADA risk criteria. This cohort was followed for 4 years and the incidence rate of diabetes was determined, using the ADA 2000 criteria for diabetes with fasting plasma glucose to identify new cases.
Results: Approximately sixty percent of the reference population had at least one risk factor for diabetes. Among these, the most prevalent risk factors were dyslipidemia (67.3%), Body Mass Index ≥ 27 (60,8%), age ≥45 years (41,8%), family with diabetes (34.9%), and hypertension (19.7%) The crude cumulative incidence for diabetes in four years was 4.77% (IC95%: 4.09%- 5.45%) with an average of 1.19% per year. The incidence rate was 1.62 per 100 person-years (IC95%:1.38-1.86); for women 1.5 and for men 1.93. There were no significant differences between the genders.
Conclusion: This study provides Costa Rica with its first glance at the incidence rate of diabetes, being between the range of 1- 2% per year in an urban marginal community. The prevalence of obesity, dyslipidemia and hypertension are very high in this community. All these risk factors can be modified with lifestyle interventions that promote proper diet and physical activity. The studied Health Area, Desamparados 3, now has a baseline measurement to evaluate its outcomes in future preventive interventions
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