Este es un buen artículo que proviene de la investigación en Guatemala publicado en
PLOS ONE | https://doi.org/10.1371/journal.pone.0200434 August 9, 2018
RESEARCH ARTICLE Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized crosssectional analysis of risk
Kent D. W. Bream1,2,3,4,5*, Amelia Breyre2,6, Kristian Garcia4,7, Erwin Calgua4,5, Juan M. Chuc8, Lynne Taylor9
1 Department of Family Medicine and Community Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 2 Center for Global Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 3 Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 4 Harnwell College House, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 5 Facultad de Ciencias Medicas, Universidad de San Carlos de Guatemala, Ciudad Guatemala, Guatemala, 6 Department of Emergency Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 7 Health and Societies Program, Department of History and Sociology of Science, School of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 8 Hospitalito Atitla ´n, Canton Ch’utch’aj, Santiago Atitla ´n, Solola ´, Guatemala, 9 Center of Excellence for Diversity in Health Education and Research, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
*bream@mail.med.upenn.edu
Abstract
Background
Developing countries and Indigenous populations are disproportionately affected by global trends in diabetes (T2DM), but inconsistent data are available to corroborate this pattern in Guatemala and indigenous communities in Central America. Historic estimates of T2DM, using a variety of sampling techniques and diagnostic methods, in Guatemala include a T2DM prevalence of: 4 2% (1970) and 8 4% (2003). Objectives of this geographically randomized, cross-sectional analysis of risk include: (1) use HbA1c to determine prevalence of T2DM and prediabetes in rural Indigenous community of Atitla ´n (2) identify risk factors for T2DM including age, BMI and gender.
Methods
A spatially random sampling method was used to identify 400 subjects. Prevalence was compared using the confidence interval method, and logistic regression and linear regression were used to assess association between diabetes and risk factors.
Findings The overall prevalence of T2DM using HbA1c was 13 81% and prediabetes was also 13 81% in Atitla ´n, representing a tripling in diabetes from historic estimates and a large population with pre-diabetes. The probability of diabetes increased dramatically w
PLOS ONE | https://doi.org/10.1371/journal.pone.0200434 August 9, 2018
RESEARCH ARTICLE Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized crosssectional analysis of risk
Kent D. W. Bream1,2,3,4,5*, Amelia Breyre2,6, Kristian Garcia4,7, Erwin Calgua4,5, Juan M. Chuc8, Lynne Taylor9
1 Department of Family Medicine and Community Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 2 Center for Global Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 3 Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 4 Harnwell College House, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 5 Facultad de Ciencias Medicas, Universidad de San Carlos de Guatemala, Ciudad Guatemala, Guatemala, 6 Department of Emergency Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 7 Health and Societies Program, Department of History and Sociology of Science, School of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 8 Hospitalito Atitla ´n, Canton Ch’utch’aj, Santiago Atitla ´n, Solola ´, Guatemala, 9 Center of Excellence for Diversity in Health Education and Research, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
*bream@mail.med.upenn.edu
Abstract
Background
Developing countries and Indigenous populations are disproportionately affected by global trends in diabetes (T2DM), but inconsistent data are available to corroborate this pattern in Guatemala and indigenous communities in Central America. Historic estimates of T2DM, using a variety of sampling techniques and diagnostic methods, in Guatemala include a T2DM prevalence of: 4 2% (1970) and 8 4% (2003). Objectives of this geographically randomized, cross-sectional analysis of risk include: (1) use HbA1c to determine prevalence of T2DM and prediabetes in rural Indigenous community of Atitla ´n (2) identify risk factors for T2DM including age, BMI and gender.
Methods
A spatially random sampling method was used to identify 400 subjects. Prevalence was compared using the confidence interval method, and logistic regression and linear regression were used to assess association between diabetes and risk factors.
Findings The overall prevalence of T2DM using HbA1c was 13 81% and prediabetes was also 13 81% in Atitla ´n, representing a tripling in diabetes from historic estimates and a large population with pre-diabetes. The probability of diabetes increased dramatically w
