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de Almeida Maia M, Saporito FMF, dos Santos Figueiredo FW. Regional inequalities in type 2 diabetes epidemiologic indices in Brazil. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-021-01042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Cardoso LSDM, Teixeira RA, Ribeiro ALP, Malta DC. Premature mortality due to non-communicable diseases in Brazilian municipalities estimated for the three-year periods of 2010 to 2012 and 2015 to 2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210005. [PMID: 33886878 DOI: 10.1590/1980-549720210005.supl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/12/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To estimate premature mortality due to noncommunicable diseases (NCDs) in Brazilian municipalities. METHODS This ecological study estimated premature mortality rates due to cardiovascular diseases, chronic respiratory diseases, cancer and diabetes in Brazilian municipalities, for the three-year periods of 2010 to 2012 and 2015 to 2017, and it analyzed the spatial and temporal distribution of these rates. Data treatment combined proportional redistribution of the missing data and ill-defined causes, and the application of coefficients for under-registration correction. The local empirical Bayesian estimator was used to calculate municipal mortality rates. RESULTS Rates for the set of chronic diseases decreased in Brazil between the three-year periods. The mean rates for total NCDs declined in the South, Southeast and Central-West regions, remained stable in the North and increased in the Northeast. Mortality rates due to cardiovascular diseases were the highest in all regions but showed the greatest declines between the periods. Cancers were the second leading cause of death. The North and Northeast regions stood out as having increased mean rates of cancer between the periods analyzed and showing the highest mean premature mortality rates due to diabetes in the 2015 to 2017 period. CONCLUSION Spatial and temporal distribution of premature mortality rates due to NCDs differed between Brazilian municipalities and regions in the three-year periods evaluated. The South and Southeast had decreased rates of deaths due to cardiovascular and chronic respiratory diseases, as well as diabetes. The North and Northeast had increased rates of deaths due to cancer. There was an increase in the rate of deaths due to diabetes in the Central-West.
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Affiliation(s)
| | - Renato Azeredo Teixeira
- Post-Graduation Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Research Group in Epidemiology and Health Evaluation, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Deborah Carvalho Malta
- Department of Maternal-Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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Bôas NCRV, Salomé GM, Ferreira LM. Frailty syndrome and functional disability among older adults with and without diabetes and foot ulcers. J Wound Care 2018; 27:409-416. [DOI: 10.12968/jowc.2018.27.7.409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Geraldo Magela Salomé
- Affiliate Professor; Professional Master's Program in Applied Health Sciences, UNIVÁS, Pouso Alegre, MG, Brazil, Pouso Alegre, MG, Brazil
| | - Lydia Masako Ferreira
- Full Professor and Head; Division of Plastic Surgery, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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Hernández H, Macías G. Análisis de la tendencia temporal de la mortalidad por diabetes mellitus en Argentina, 1990-2013. Rev Panam Salud Publica 2017. [PMID: 28614482 PMCID: PMC6645251 DOI: 10.26633/rpsp.2017.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objetivos El objetivo de este trabajo es describir la tendencia temporal de la mortalidad por Diabetes Mellitus (DM) en la Argentina en el período comprendido entre 1990 y 2013, por edad y sexo. Métodos Se calcularon las tasas brutas, específicas por edad y ajustadas por edad de mortalidad por DM en la Argentina para el período 1990-2013. Los datos de mortalidad se obtuvieron del Informe Estadístico de Defunción de la Dirección de Estadísticas e Información de Salud. Se realizó un análisis de la tendencia mediante modelos de regresión joinpoint. Resultados El análisis de la tendencia de las tasas brutas y ajustadas por edad de mortalidad por DM muestra un modelo estadísticamente significativo en el que se produce un incremento en la mortalidad entre 1990 y 2001, momento a partir del cual puede observarse un descenso. Asimismo, para las tasas ajustadas por edad se encuentra una tendencia significativa de descenso de la mortalidad para mujeres (AAPC: -1,10, IC 95%: -1,70; -0,50). Las tasas de mortalidad específicas por edad se multiplican cada 10 años de edad. Todos los grupos de edad mayores de 50 años muestran una tendencia creciente entre 1990 y 2001. Conclusiones La mortalidad por DM afecta principalmente a personas mayores de 50 años y a hombres. Es significativa la tendencia decreciente en las tasas ajustadas de mortalidad por DM para mujeres. Se subraya la importancia de desarrollar políticas de prevención y de detección temprana, como así también la codificación de la muerte por múltiples causas.
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Affiliation(s)
- Hernán Hernández
- Universidad Nacional de La Matanza (UNLaM), Buenos Aires, Argentina
| | - Guillermo Macías
- Universidad Nacional de La Matanza (UNLaM), Buenos Aires, Argentina
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Alves CG, de Morais Neto OL. Trends in premature mortality due to chronic non-communicable diseases in Brazilian federal units. CIENCIA & SAUDE COLETIVA 2017; 20:641-54. [PMID: 25760106 DOI: 10.1590/1413-81232015203.15342014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/02/2014] [Indexed: 08/11/2023] Open
Abstract
Chronic non-communicable diseases (NCDs) have a high mortality rate, mainly in lower and middle income countries. The major groups are cardiovascular disease (CVD), chronic respiratory disease (CRD), cancer and diabetes. The Action Plan to reduce NCDs in Brazil, 2011-2022 established a 2% yearly reduction in the NCD premature mortality rate as a goal. The aim of the study was to analyze trends in premature mortality rates and also show goal achievement scenarios for each Federal Unit (FU). A time series analysis of the standardized mortality rate between 2000-2011 was performed using the linear regression model. The average annual rate of increase and the 95% confidence interval were estimated. Each FU was classified as being likely or unlikely to achieve the goal. The FUs likely to achieve the goal were: for CVD - Federal District, Santa Catarina, Mato Grosso, Rio Grande do Sul, Minas Gerais, Bahia, Espírito Santo and Paraná states; for CRD - Amazonas, Federal District and Paraná. For neoplasms and diabetes, none of the FUs are likely to achieve the goal. The articulation of the three levels of government will allow the strengthening of interventions to reduce the determinants of NCDs and to improve access and quality in health care.
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Laranjeira FO, da Silva EN, Pereira MG. Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil. PLoS One 2016; 11:e0167039. [PMID: 27907034 PMCID: PMC5132224 DOI: 10.1371/journal.pone.0167039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/08/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Long-acting insulin analogues for type 1 diabetes (T1D) treatment have been available on the Brazilian market since 2002. However, the population cannot access the analogues through the public health system. OBJECTIVE To estimate the incremental budget impact of long-acting insulin analogues coverage for T1D patients in the Brazilian public health system compared to NPH insulin. METHODS We performed a budget impact analysis of a five-year period. The eligible population was projected using epidemiological data from the International Diabetes Federation estimates for patients between 0-14 and 20-79 years old. The prevalence of T1D was estimated in children, and the same proportion was applied to the 15-19-year-old group due to a gap in epidemiological information. We considered 4,944 new cases per year and a 34.61/100,000 inhabitants mortality rate. Market share for long-acting insulin analogues was assumed as 20% in the first year, reaching 40% in the fifth year. The mean daily dose was taken from clinical trials. We calculated the bargaining power of the Ministry of Health by dividing the price paid for human insulin in the last purchase by the average regulated price. We performed univariate and multivariate sensitivity analyses. RESULTS The incremental budget impact of long-acting insulin analogues was US$ 28.6 million in the first year, and reached US$ 58.7 million in the fifth year. The total incremental budget impact was US$ 217.9 million over the five-year period. The sensitivity analysis showed that the percentage of T1D among diabetic adults and the insulin analogue price were the main factors that affected the budget impact. CONCLUSIONS The cost of the first year of long-acting insulin analogue coverage would correspond to 0.03% of total public health expenditure. The main advantage of this study is that it identifies potential bargaining power because it features more realistic profiles of resource usage, once centralized purchasing is established as an economically sustainable strategy. Clinical guidelines restricting the use of insulin analogues would make the decision towards insulin analogue coverage more affordable.
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Araújo LDO, Silva ESE, Mariano JDO, Moreira RC, Prezotto KH, Fernandes CAM, Marcon SS. Risk of developing diabetes mellitus in primary care health users: a cross-sectional study. Rev Gaucha Enferm 2015; 36:77-83. [DOI: 10.1590/1983-1447.2015.04.50195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 08/31/2015] [Indexed: 11/21/2022] Open
Abstract
Objective: to identify the risk of developing diabetes mellitus among primary care users in a municipality of the Southern Brazil. Method: data were collected from October 2013 to April 2014 by applying the Finnish Diabetes Risk Score questionnaire on 189 users. Results: the majority of the interviewees presented a slight moderate to moderate risk of developing diabetes mellitus (63.5%). There was a greater prevalence of high risk among the men. The variables with a significant prevalence ratio for high risk were age, obesity, abdominal circumference, sedentarism and family history of diabetes mellitus. Conclusion: the identified risk factors for diabetes reveal the importance of the health team and how it can intervene to prevent disease.
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Schmidt MI, Duncan BB, Ishitani L, da Conceição Franco G, de Abreu DMX, Lana GC, França E. Trends in mortality due to diabetes in Brazil, 1996-2011. Diabetol Metab Syndr 2015; 7:109. [PMID: 26617678 PMCID: PMC4661935 DOI: 10.1186/s13098-015-0105-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/11/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Over recent decades, Brazilian mortality registration has undergone increasing improvement in terms of completeness and quality in cause of death reporting. These improvements, however, complicate the description of mortality trends over this period. We aim to characterize the trend in diabetes mortality in Brazil and its five regions in adults (30-69 years), from 1996 to 2011 after corrections for underreporting of deaths and redistribution of ill-defined causes and "garbage codes". METHODS Starting with official data from the Brazilian Mortality Information System (SIM) for adults aged 30-69 in the period 1996 to 2011 for diabetes (ICD-10 codes E10-14), we redistributed garbage codes using methods based on the Global Burden of Disease Study (2010), redistributed ill-defined causes based on recent Brazilian investigations of similar cases and corrected for underreporting using official estimates of deaths. RESULTS With these corrections, age-standardized mortality fell approximately 1.1 %/year for men and 2.2 %/year for women from 1996 to 2011. The rate of decline first accelerated and then decelerated, reaching stable rates in men and minimal declines in women from 2005 onward. Regional inequalities decreased during the period in both relative and absolute terms. CONCLUSION Mortality due to diabetes declined in Brazil from 1996 to 2011, minimally in men and considerably in women. The lesser declines in recent years may reflect the increasing prevalence of diabetes, and suggest that current efforts to prevent diabetes and minimize the impact of its complications need to be reinforced to ensure that declines will continue.
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Affiliation(s)
- Maria Inês Schmidt
- />Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600/414, Porto Alegre, RS 90035-003 Brazil
| | - Bruce B. Duncan
- />Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600/414, Porto Alegre, RS 90035-003 Brazil
| | - Lenice Ishitani
- />Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, MG Brazil
| | | | - Daisy Maria Xavier de Abreu
- />Grupo de Pesquisa em Epidemiologia e Avaliação em Saúde-(GPEAS), Federal University of Minas Gerais, Belo Horizonte, MG Brazil
| | - Gustavo C. Lana
- />Statistics Department, Federal University of Minas Gerais, Belo Horizonte, MG Brazil
| | - Elisabeth França
- />Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG Brazil
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Santos VPD, Alves CAS, Fidelis C, Araújo Filho JSD. Análise das arteriografias de diabéticos e não diabéticos com isquemia crítica da perna. Rev Assoc Med Bras (1992) 2013. [DOI: 10.1590/s0104-42302013000600008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
RESUMO OBJETIVO: Comparar características angiográficas de pacientes diabéticos e não diabéticos com isquemia crítica. MÉTODOS: Foram incluídos 161 membros inferiores de pacientes com isquemia crítica infrainguinal. Avaliaram-se as características clínicas e arteriográficas (número e presença de opacificação das artérias da perna) dos dois grupos de pacientes. A análise estatística foi realizada pelo EPI-INFO RESULTADOS: A maioria dos pacientes era categoria 5da Classificação de Rutherford e apresentava doença do território fêmoro-poplíteo. Opacificação da artéria fibular foi encontrada em 72% dos não diabéticos e em 67% dos diabéticos (p = 0,25), sendo esta a artéria mais presente em ambos os grupos. Os diabéticos apresentaram menor índice de opacificação da artéria tibial posterior na análise univariada (29% vs. 47%; p = 0,008). Na regressão logística, apenas o sexo feminino se mostrou significante para a ausência da artéria tibial posterior (OR = 2,6; p = 0,01) CONCLUSÃO: A artéria fibular foi a mais encontrada nas angiografias de diabéticos e não diabéticos com isquemia crítica. Diabéticos e não diabéticos não diferiram em relação ao padrão angiográfico da perna.
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Santos VPD, Alves CAS, Fidelis C, Araújo Filho JSD. Arteriographic findings in diabetic and non-diabetic with critical limb ischemia. Rev Assoc Med Bras (1992) 2013; 59:557-62. [PMID: 24211015 DOI: 10.1016/j.ramb.2013.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 06/06/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To compare angiographic findings of diabetic and non-diabetic patients with critical limb ischemia. METHODS We included 161 patients with infrainguinal critical limb ischemia (CLI). We evaluated the clinical and arteriographic (number and presence of opacification of leg arteries) of the two groups of patients. Statistical analysis was performed using EPI-INFO. RESULTS Most patients were category 5 of Rutherford's Classification and had femoropopliteal disease. Seventy-two percent of non-diabetic and 67% of diabetic had opacification of the fibular artery (p = 0.25), this is the most present artery in both groups. Diabetic patients had less opacification of the posterior tibial artery in the univariate analysis (29% vs. 47%, p = 0.008). But only female sex showed a significant risk for the absence of the posterior tibial artery in logistic regression (OR = 2.6; p = 0.01). CONCLUSION The peroneal artery was the most frequently artery in angiograms of diabetic and non-diabetic patients with CLI. Diabetic and non-diabetic patients did not differ in angiographic findings of the leg.
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Affiliation(s)
- Vanessa Prado dos Santos
- Instituto de Humanidades Artes e Ciências Professor Milton Santos, Universidade Federal da Bahia, Salvador, BA, Brasil.
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