title: Diabetes mellitus and obesity in the French Caribbean: A special vulnerability for women?
abstract: The objective of this study was to analyze the prevalence, awareness, treatment, and control of diabetes and its risk factors among French Caribbean adults. This cross-sectional study included 18-74-year olds (N = 2252; 56.5 percent women) who underwent a heath examination in Guadeloupe during July-December 2014. Diabetes was defined as using antidiabetic treatment, or fasting glucose ≥7 mmol/l, and glycated hemoglobin (HbA1c) ≥6.5 percent; diabetes control was defined as HbA1c < 7 percent. Multilevel logistic regression was used. Diabetes prevalence was 8.2 percent for women and 5 percent for men (age-adjusted odds ratio [aOR] for women = 2.0; 95 percent confidence interval [CI]: 1.4-2.9). The proportion of women with diabetes who were aware of it was 84.5 versus 67.3 percent in men (aOR = 2.7; 95 percent CI: 1.2-6.2). Nearly, all diagnosed participants were being treated. In less than a third of diabetics in both sexes was diabetes control obtained. Most women (55.3 percent) had a waist circumference at or above the National Cholesterol Education Program thresholds versus 14 percent of men (aOR = 9.3; 95 percent CI: 7.5-11.7), which wholly accounted for excess diabetes in women. In women, obesity and diabetes were associated with low education and income. In this French Caribbean sample, abdominal obesity and diabetes affected more women. Diabetes was rarely controlled. A comprehensive women's health policy for the prevention of abdominal obesity and diabetes is needed.
authors.affiliation: a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.|b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.|c Guadeloupean Association for the Management and Conduct of Health Examinations and the Promotion of Health (AGREXAM) , Pointe-à-Pitre , Guadeloupe , France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Carrère
authors.affiliation: d Endocrinology-Diabetology-Nutrition Unit , University Hospital, Fort-de-France , Martinique , France.|e Clinical Epidemiology and Medicine Research Team , EA4540 LAMIA, University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Fagour
authors.affiliation: a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.|b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.
authors.forename: Dan
authors.initials: D
authors.lastname: Sportouch
authors.affiliation: a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.
authors.forename: Franciane
authors.initials: F
authors.lastname: Gane-Troplent
authors.affiliation: a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Hélène-Pelage
authors.affiliation: b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lang
authors.affiliation: b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.|f Department of Cardiology , University of the French West Indies and Guiana , Fort-de-France , Martinique , France.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Inamo
mesh_terms: D000328:Adult; D000368:Aged; D017691:Caribbean Region / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Caribbean; France; diabetes mellitus; obesity; socioeconomic factors; women’s health