DIABETES PREVALENCE IN BRAZIL: A SYSTEMATIC REVIEW AND META-ANALYSIS

OBJECTIVES: Worldwide diabetes prevalence is around 9%, affecting approximately 415 million people. In Brazil, although there are several epidemiological studies on this subject, the prevalence of diabetes is still matter of debate. Our objective is to investigate the prevalence of diabetes in Brazil METHODS: We performed a systematic review on the prevalence of diabetes in Brazil. Potentially relevant studies were identified through an exhaustive search in MEDLINE, SciELO, LILACS, Ministry of Health and hand-search. Inclusion criteria were cross-sectional population-based, censuses, surveys or cohorts studies where diabetes diagnosis, regardless if type 1 or type 2, was self-reported (SR) or confirmed by blood glucose testes (BGT), in the Brazilian population. We conducted a meta-analysis to provide the current best prevalence estimate, using a random effects model. Descriptive analysis of studies and a comparison between self-reported and BGT studies were performed. RESULTS: Among the 968 located references, we included 28 studies. Thirteen were population-based studies with national representation and 15 were studies with local/regional representation. Fifteen studies were SR and 13 relied on BGT to confirm diagnosis. On SR studies, the mean prevalence was 6.25% (95% CI 5.75% - 6.74%; 12 50%) and on studies confirmed by BGT, the mean prevalence was 10.05% (95% CI 6.41% - 13.68%; 1264%). From 24.0% to 50.4% of interviewed people were unaware of their diabetes diagnosis. CONCLUSIONS: Diabetes is a global health challenge. Our findings suggest that there is a difference between the prevalence reported by SR studies and those where diagnosis is confirmed by BGT. A significant number of people are unaware of their condition therefore increasing the awareness about diabetes, screening, diagnosis and care is critical. Our estimates constitute a valuable tool for policy and decision-making process, mainly in developing countries.