Prevalência e fatores associados ao diabetes mellitus: estudo de base populacional com mulheres residentes em aldeias indígenas de Alagoas

Abstract

Introduction: Indigenous populations face multifaceted social vulnerability, encompassing economic, educational, health, and territorial issues, which contribute to higher morbidity and mortality rates. Diabetes mellitus (DM) is a condition characterized by the body's inability to produce enough insulin or to use it effectively, leading to a state of hyperglycemia that is harmful to various body systems. The development of DM is influenced by a combination of risk factors, some modifiable, such as lifestyle and dietary habits, and others non-modifiable, such as genetic predisposition and family history. This study aimed to investigate the prevalence and factors associated with diabetes mellitus in women living in Indigenous villages in Alagoas. Methods: This is a population-based, cross-sectional study with a probabilistic sample (n=676) representative of women living in 12 randomly selected villages from the total number of communities (n=29), with one village chosen for each of the 11 existing ethnic groups in the state. During household visits, anthropometric measurements, blood pressure, glycated hemoglobin, as well as socioeconomic, demographic, behavioral, reproductive, and health variables were collected. The dependent variable was diabetes mellitus, defined by glycated hemoglobin higher than 6.5%. The measure of association was the prevalence ratio (PR) and its 95% confidence interval (95%CI), using Poisson regression with robust variance in a theoretical, multiple, and hierarchical model. Results and discussion: The prevalence of DM was 7.4%. After adjusted analysis, the independent variables associated with the prevalence of DM were: age ≥35 years (PR=4.38; 95%CI=2.09-9.15); parity ≥ three children (PR=4.79; 95%CI=2.12-10.7); use of public health services (PR=2.22; 95% CI=6.31-7.81); use of other health services (PR=1.05; 95%CI=1.91-5.82); abdominal obesity (PR=13.3; 95%CI=1.77- 100.1); systemic arterial hypertension (PR:1.88; 95% CI=1.03-3.40); and illness in the last 15 days (RP=1.69; 95% CI=1.00-2.87)Conclusion: The results highlight the need for special attention to the characteristics of women living in Indigenous villages, which should be considered in preventive interventions and in the control of risk factors, making them more effective and specific for this population.