Résumé :
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[BDSP. Notice produite par INIST-CNRS aiWR0xWr. Diffusion soumise à autorisation]. Objective To examine the distribution and impact of diabetes, glycaemic status, and related factors, in a predominantly black adult Caribbean population. Methods The study included 4709 people, or 84% of a simple random sample of Barbadian-born citizens aged 40-84 years, examined between 1988 and 1992 and re-assessed 4 years later. Diabetes was evaluated according to physician-diagnosis and glycosylated haemoglobin (GHb). Associations were assessed by logistic regression analyses, cumulative mortality by product-limit methods and death-rate ratios by Cox proportional hazards regression. Results Among the 4314 black participants, the prevalence of known diabetes, predominantly type 2, was 9.1% at 40-49 years of age and increased to 24.0% at 70-79 years. The overall prevalence was 17.5%, while it was 12.5% in mixed (black/white ; n=184) and 6.0% in white/other participants (n=133), only 0.3% had younger-onset. Additionally, 2% had GHb>10% (>2 SD over the mean) without diabetes history. Sulphonylureas were the most frequent treatment, while insulin use was infrequent. In black participants, diabetes was positively associated with age (OR=1.03 per year ; 95% CI : 1.02-1.04), diabetes family history (OR=2.85,95% CI : 2.39-3.40), hypertension (OR=1.71,95% CI : 1.42-2.05), obesity (BMI>=25 kg/m2 ; OR=1.74,95% CI : 1.44-2.10), and high waist-hip ratio (WHR>=0.92 ; OR=1.29,95% CI : 1.09-1.53). Ocular co-morbidities were increased among people with diabetes, as was 4-year-mortality (death rate ratio=1.42,95% CI : 1.10-1.83). There was a 9% increase in mortality for each 1% increase in GHb (death rate ratio=1.09,95% CI : 1.04-1.15). Conclusions A markedly high prevalence of diabetes existed in the adult black population, affecting almost one in five people and increasing morbidity and mortality. (...)
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