title: The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.
abstract: BACKGROUND
  Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria.
  
  
  METHODS
  Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L).
  
  
  RESULTS
  Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes.
  
  
  CONCLUSIONS
  Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.
authors.affiliation: Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Aquiles
authors.initials: A
authors.lastname: Salas
authors.affiliation: Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic.
authors.forename: Daisy
authors.initials: D
authors.lastname: Acosta
authors.affiliation: Universidade Fedral de São Paulo, Department of Psychobiology, Sao Paulo, Brasil.
authors.forename: Cleusa P
authors.initials: CP
authors.lastname: Ferri
authors.affiliation: Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi", Lima, Peru.
authors.forename: Mariella
authors.initials: M
authors.lastname: Guerra
authors.affiliation: Peking University, Institute of Mental Health, Beijing, China.
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Christian Medical College, Vellore, India.
authors.forename: K S
authors.initials: KS
authors.lastname: Jacob
authors.affiliation: Internal Medicine Dept., Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Ivonne Z
authors.initials: IZ
authors.lastname: Jimenez-Velazquez
authors.affiliation: Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Llibre Rodriguez
authors.affiliation: National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico.
authors.forename: Ana L
authors.initials: AL
authors.lastname: Sosa
authors.affiliation: Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Richard
authors.initials: R
authors.lastname: Uwakwe
authors.affiliation: Department of Community Health, Voluntary Health Services, Chennai, India.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Williams
authors.affiliation: Public Health Foundation of India, New Delhi, India.
authors.forename: A T
authors.initials: AT
authors.lastname: Jotheeswaran
authors.affiliation: Peking University, Institute of Mental Health, Beijing, China.
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Policlinico 19 de abril, Plaza, La Habana, Cuba.
authors.forename: A M
authors.initials: AM
authors.lastname: Lopez Medina
authors.affiliation: National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Salinas-Contreras
authors.affiliation: King's College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Prince
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia; D003906:Developing Countries / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D015233:Models, Statistical; D015995:Prevalence; D011795:Surveys and Questionnaires