Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country

作者：Cunningham Myrie Colette; Younger Coleman Novie; Tulloch Reid Marshall; McFarlane Shelly; Francis Damian; Ferguson Trevor; Gordon Strachan Georgiana; Wilks Rainford^*

来源：Tropical Medicine and International Health, 2013, 18(11): 1365-1378.

DOI：10.1111/tmi.12190

• diabetes mellitus
• obesity
• prevalence
• population-attributable fraction
• sex
• socio-economic status

ObjectiveThe objective of this study was to provide valid estimates of the burden of and risk factors for diabetes mellitus by sex in Jamaica, a predominantly Black, middle-income and developing country.
MethodsThe Jamaica Health and Lifestyle Survey 2008 examined a nationally representative sample of 2848 Jamaicans aged 15-74. Parameter estimates and 95% confidence intervals [CI] were weighted for non-response as well as age and sex of the source population. Sex differences in risk factors and diabetes prevalence, awareness, treatment and control were estimated in multivariable models. Population-attributable fractions (PAFs) of obesity on diabetes mellitus were estimated in both sexes.
ResultsThe prevalence of diabetes mellitus was 7.9% (95% CI: 6.7-9.1%), significantly higher in women than men 9.3% vs. 6.4% (P=0.02) and increasing with age. Seventy-six percentage of persons with diabetes mellitus were aware of their status; urban women and rural men were less likely to be aware. Diabetes control (43% overall) was less common in higher-income men, but more common in higher-income women. Persons without health insurance were less likely to control their diabetes. The prevalence of diabetes risk factors was higher in women than men. Increased waist circumference (94cm [men]/80cm [women]), overweight/obesity (body mass index25kg/m(2)) and low physical activity/inactivity were associated with PAFs for diabetes mellitus of 27%, 37% and 15%, respectively, in men and 77%, 54% and 24%, respectively, in women.
ConclusionsPrevalence of diabetes mellitus and its risk factors is high in Jamaica, especially among women, and national programmes to stem the diabetes mellitus epidemic should take these sex differences into consideration.

• 出版日期2013-11