Factors associated with self-reported diabetes according to the 2013 National Health Survey

Malta, Deborah Carvalho; Bernal, Regina Tomie Ivata; Iser, Betine Pinto Moehlecke; Szwarcwald, Célia Landmann; Duncan, Bruce Bartholow; Schmidt, Maria Inês

doi:10.1590/S1518-8787.2017051000011

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Original Articles • Rev. Saúde Pública 51 (suppl 1) • 2017 • https://doi.org/10.1590/S1518-8787.2017051000011 copy

Factors associated with self-reported diabetes according to the 2013 National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVES

To analyze the factors associated with self-reported diabetes among adult participants of the National Health Survey (PNS).

METHODS

Cross-sectional study using data of the PNS carried out in 2013, from interviews with adults (≥ 18 years) of 64,348 Brazilian households. The prevalence of self-reported diabetes, assessed by the question “Has a doctor ever told you that you have diabetes?,” was related to sociodemographic characteristics, lifestyle, self-reported chronic disease, and self-evaluation of the health condition. Prevalence ratios were adjusted according to age, sex, and schooling by Poisson regression with robust variance.

RESULTS

The diagnosis of diabetes was reported by 6.2% of respondents. Its crude prevalence was higher in women (7.0% vs. 5.4%), and among older adults, reaching 19.8% in the elderly. Black adults who received less schooling showed higher prevalence. Among those classified as obese, 11.8% reported having diabetes. Ex-smokers, those insufficiently active and those who consume alcohol abusively reported diabetes more often. Differences were not verified in eating habits among adults who reported, or did not, diabetes. A relation between diabetes and hypertension was found.

CONCLUSIONS

After adjustment according to age, schooling and sex, diabetes was shown to be associated with higher age, lower schooling, past smoking, overweight and obesity, and hypertension, as well as with a self-declared poor state of health, indicating a pattern of risk factors common to many chronic non-communicable diseases and the association of the disease with morbidity.

Adult; Diabetes Mellitus, epidemiology; Diagnostic Self Evaluation; Risk Factors; Socioeconomic Factors; Health Surveys

Variable	Total		Male		Female

	%	95%CI	%	95%CI	%	95%CI
Total	6.2	5.9–6.6	5.4	4.8–5.9	7	6.5–7.5
Age (years)
18–24	0.5	0.3–0.8	0.4	0.1–0.7	0.6	0.2–1.1
25–34	0.8	0.6–1.1	0.8	0.4–1.2	0.9	0.6-1.2
35–44	3	2.4–3.5	2.5	1.7–3.3	3.3	2.6–4.1
45–54	6.5	5.8–7.3	5.7	4.6–6.8	7.3	6.2–8.4
55–64	13.5	12–15	12.1	9.7–14.4	14.8	12.9–16.7
≥ 65	19.8	18.2–21.4	18	15.2–20.7	21.2	19.1–23.4
Schooling (years)
Illiterate/some elementary or middle school	9.6	8.9–10.3	6.7	5.8–7.6	12.3	11.3–13.4
Elementary or middle school/some high school	5.4	4.4–6.3	5.4	3.8–6.9	5.4	4.3–6.4
High school/some college	3.4	3–3.9	3.6	2.8–4.3	3.3	2.7–3.9
College degree	4.2	3.3–5	5.7	4–7.4	3.1	2.2–3.9
Race/color^a
White	6.7	6.1–7.2	6	5.2–6.8	7.3	6.5–8
Black	7.2	5.8–8.5	5.4	3.2–7.6	8.7	7.1–10.4
Pardo	5.5	5.1–6	4.6	3.9–5.2	6.4	5.8–7
Categories of BMI^b
Underweight/normal (< 25 kg/m²)	3.3	2.8–3.8	3.4	2.7–4.2	3.2	2.5–3.8
Overweight (between 25 and 29.9 kg/m²)	6.9	6.1–7.7	6.5	5.3–7.6	7.5	6.4–8.6
Obesity (≥ 30 kg/m²)	11.8	10.4–13.1	10.3	8.5–12.1	13	11.2–14.8
Insufficiently active in the 4 domains^c
No	4.9	4.5–5.3	4	3.5–4.5	5.9	5.2–6.6
Yes	7.8	7.3–8.4	7.4	6.4–8.5	8.1	7.4–8.7
Smoking
Non-smoker	5.4	5–5.8	4.1	3.6–4.7	6.2	5.7–6.8
Ex-smoker	10.8	9.8–11.9	9.8	8.3–11.3	12.2	10.7–13.8
Smoker	4.8	3.9–5.7	4.2	2.9–5.5	5.7	4.5–6.8
Recommended consumption of fruits and vegetables (5 or more servings per day)
Yes	8	7–8.9	7.8	6.4–9.2	8.1	6.8–9.3
No	5.9	5.5–6.3	5	4.4–5.6	6.8	6.3–7.3
Consumption of red meat with fat
Yes	5.4	4.8–6	4.4	3.6–5.2	6.7	5.8–7.6
No	6.7	6.2–7.1	6	5.3–6.7	7.1	6.6–7.7
High salt intake
No	6.6	6.2–7	5.7	5.1–6.3	7.3	6.8–7.8
Yes	4.2	3.4–5	3.5	2.4–4.5	5.1	3.8–6.3
Abusive consumption of alcohol
No	2.6	1.8–3.3	2.4	1.6–3.3	3	1.2–4.7
Yes	6.5	6.1–6.8	5.7	5.1–6.3	7.1	6.6–7.6
Systemic hypertension
No	3	2.7–3.2	2.8	2.4–3.2	3.1	2.8–3.5
Yes	18.3	17–19.5	16.9	14.7–19	19.2	17.6–20.8
High cholesterol
No	4.5	4.1–4.8	4.1	3.6–4.7	4.8	4.4–5.2
Yes	18.5	16.9–20.1	16.7	13.9–19.4	19.6	17.6–21.5
Assessment of the state of health
Good	2.6	2.3–2.8	2.4	2–2.8	2.7	2.4–3.1
Regular	12.2	11.3–13.2	12	10.4–13.6	12.4	11.2–13.5
Poor/very poor	19.1	16.9–21.2	14.2	11–17.4	22.1	19.3–25

Variable	Total		Male		Female

	PR_crude	95%CI	PR_crude	95%CI	PR_crude	95%CI
Age (years)
18–24	1		1		1
25–34	1.6	0.9–2.8	1.9	0.8–4.6	1.4	0.7–2.7
35–44	5.6	3.3–9.4	6.2	2.9–13.5	5.2	2.6–10.3
45–54	12.4	7.7–20.1	14	6.8–29	11.3	5.9–21.9
55–64	25.7	15.7–42	29.7	14.4–61.3	22.9	11.8–44.4
≥ 65	37.6	23.1–61.2	44.3	21.7–90.6	32.9	17–63.6
Schooling (years)
Illiterate/some elementary or middle school	1		1		1
Elementary or middle school/some high school	0.6	0.5–0.7	0.8	0.6–1.1	0.4	0.4–0.5
High school/some college	0.4	0.3–0.4	0.5	0.4–0.7	0.3	0.2–0.3
College degree	0.4	0.3–0.5	0.8	0.6–1.2	0.3	0.2–0.3
Race/color^a
White	1		1		1
Black	1.1	0.9–1.3	0.9	0.6–1.4	1.2	1–1.5
Pardo	0.8	0.7–0.9	0.8	0.6–0.9	0.9	0.8–1
Categories of BMI^b
Underweight/normal (< 25 kg/m²)	1		1		1
Overweight (between 25 and 29.9 kg/m²)	2.1	1.8–2.5	1.9	1.5–2.4	2.4	1.9–3
Obesity (≥ 30 kg/m²)	3.6	3–4.3	3	2.3–3.9	4.1	3.3–5.2
Insufficiently active in the 4 domains^c
No	1		1		1
Yes	1.6	1.4–1.8	1.9	1.5–2.2	1.4	1.2–1.6
Smoking
Non-smoker	1		1		1
Ex-smoker	2	1.8–2.3	2.4	1.9–2,9	2	1.7–2.3
Smoker	0.9	0.7–1.1	1	0.7–1.4	0.9	0.7–1.1
Recommended consumption of fruits and vegetables (5 or more servings per day)
Yes	1		1		1
No	0.7	0.6–0.9	0.6	0.5–0.8	0.8	0.7–1
Consumption of red meat with fat
Yes	1		1		1
No	1.2	1.1–1.4	1.4	1.1–1.7	1.1	0.9–1.2
High salt intake
No	1		1		1
Yes	0.6	0.5–0.8	0.6	0.4–0.8	0.7	0.5–0.9
Abusive consumption of alcohol
No	1		1		1
Yes	2.5	1.9–3.4	2.3	1.6–3.3	2.4	1.4–4.3
Hypertension
No	1		1		1
Yes	6.2	5.5–6.9	6.1	5–7.4	6.1	5.3–7.1
High cholesterol
No	1		1		1
Yes	4.1	3.7–4.6	4	3.3–4.9	4.1	3.6–4.7
Assessment of the state of health
Good	1		1		1
Regular	4.8	4.2–5.4	5	4.1–6.1	4.5	3.9–5.3
Poor/very poor	7.4	6.4–8.7	5.9	4.5–7.8	8.1	6.7–9.7

Variable	Total		Male		Female

	adjPR^d	95%CI	adjPR^e	95%CI	adjPR^e	95%CI
Age (years)
18–24	1			1	1
25–34	1.7	1–2.9	2	0.9–4.8	1.4	0.7–2.8
35–44	5.8	3.4–9.7	6.9	3.2–14.9	5	2.5–10.1
45–54	12.6	7.8–20.4	15.9	7.7–33.2	10.3	5.3–20
55–64	25.8	15.7–42.5	35.1	16.8–73.3	20.1	10.3–39.3
≥ 65	37	22.6–60.6	56.4	27.2–116.9	26.4	13.5–51.7
Schooling (years)
Illiterate/some elementary or middle school	1				1
Elementary or middle school/some high school	1.2	1–1.4	1.7	1.3–2.4	0.9	0.7–1.1
High school/some college	0.9	0.7–1	1.4	1.1–1.8	0.6	0.5–0.8
College degree	0.7	0.6–0.9	1.3	0.9–1.8	0.4	0.3–0.6
Race/color^a
White	1				1
Black	1.1	0.9–1.4	1.1	0.7–1.6	1.1	0.9–1.4
Pardo	1	0.3–1.1	0.9	0.8–1.1	1	0.8–1.1
Categories of BMI^b
Underweight/normal (< 25 kg/m²)	1				1
Overweight (between 25 and 29.9 kg/m²)	1.8	1.5–2.2	1.7	1.3–2.2	1.9	1.5–2.3
Obesity (≥ 30 kg/m²)	2.9	2.4–3.5	2.7	2.1–3.6	2.9	2.4–3.7
Insufficiently active in 4 households^c
No	1				1
Yes	1	0.9–1.1	1.1	0.9–1.4	0.9	0.8–1
Smoking
Non-smoker	1				1
Ex-smoker	1.3	1.2–1.5	1.3	1–1.6	1.4	1.2–1.6
Smoker	0.9	0.7–1.1	0.9	0.7–1.3	0.8	0.7–1
Recommended consumption of fruits and vegetables (5 or more servings per day)
Yes	1				1
No	0.9	0.8–1	0.9	0.7–1.1	0.9	0.7–1
Consumption of red meat with fat
Yes	1				1
No	1.1	1–1.3	1.2	1–1.5	1	0.9–1.2
High salt intake
No	1				1
Yes	0.9	0.8–1.1	0.8	0.6–1.1	1	0.8–1.3
Abusive consumption of alcohol
No	1				1
Yes	1.5	1.1–2	1.5	1.1–2.2	1.3	0.7–2.2
Hypertension
No	1				1
Yes	3.1	2.8–3.6	3.1	2.5–3.8	3.1	2.6–3.6
High cholesterol
No	1				1
Yes	2.6	2.3–2.9	2.7	2.2–3.3	2.4	2.1–2.8
Assessment of the state of health
Good	1				1
Regular	3.2	2.7–3.6	3.5	2.8–4.4	2.9	2.5–3.4
Bad/very bad	4	3.4–4.9	3.6	2.6–5.1	4.2	3.3–5.2

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[1] Correspondence: Deborah Carvalho Malta. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem – UFMG. Av. Alfredo Balena, 190, Santa Efigênia. 30130-100 Belo Horizonte, MG, Brasil. E-mail: dcmalta@uol.com.br