High prevalence of diabetes and impaired fasting glucose in urban Latin America: the CARMELA Study

AIMS: Cardiovascular risk is increased with glucose metabolism abnormalities. Prevalence data can support public health initiatives required to address this risk. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study was designed to estimate the prevalence of Type 2 diabetes, impaired fasting glucose and related risk factors in seven urban Latin American populations. METHODS: CARMELA was a cross-sectional, population-based study of 11 550 adults 25-64 years of age. With a multi-stage sample design of a probabilistic nature, approximately 1600 subjects were randomly selected in each city. RESULTS: Overall, the prevalence of diabetes was 7.0% (95% confidence intervals 6.5-7.6%). The prevalence of individuals with diabetes or impaired fasting glucose increased with increasing age. In the oldest age category, 55-64 years of age, prevalence of diabetes ranged from 9 to 22% and prevalence of impaired fasting glucose ranged from 3 to 6%. Only 16.3% of people with prior diagnosis of diabetes and who were receiving pharmacologic treatment, were in good glycaemic control (fasting glucose < 6.1 mmol/l). The prevalence of diabetes in individuals with abdominal obesity was approximately twofold higher. Participants with hypertension, elevated serum triglycerides and increased common carotid artery intima-media thickness were also more likely to have diabetes. CONCLUSIONS: The prevalence of diabetes and impaired fasting glucose is high in seven major Latin American cities; intervention is needed to avoid substantial medical and socio-economic consequences. CARMELA supports the associations of abdominal obesity, hypertension, elevated serum triglycerides and carotid intima-media thickness with diabetes.