Cardiovascular risk management in adults with diagnosed diabetes in Mexico from 2016-2023: A retrospective analysis of nationally representative surveys.

Journal: MedRxiv : The Preprint Server For Health Sciences
Published:
Abstract

Background: Effective cardiovascular disease (CVD) risk management is a cornerstone of optimal diabetes care. Here, we estimated the prevalence and determinants of CVD risk factor control amongst individuals with diagnosed diabetes in Mexico.

Methods: We analyzed data from individuals with diagnosed diabetes ≥20 years from the 2016-2023 Mexican National Health and Nutrition Surveys. We estimated the prevalence of glycemic, blood pressure (BP), non-current smoking, and combined CVD risk factor control. LDL-C control was assessed using SCORE2-Diabetes risk categories. We estimated the prevalence of BP-lowering, cholesterol-lowering, and glucose-lowering medication use, and explored determinants of control achievement using logistic regression.

Results: We analyzed data representing 43.2 million adults with diagnosed diabetes during 2016-2023. In 2023, glycemic control was 29% (95%CI 21%-38%), BP control 22.9% (95%CI 14%-31%), and non-current smoking 89% (95%CI 81%-96%). The proportion of people classified as high or very-high CVD risk increased from 59.8% (95%CI 52.1%-67.0%) in 2016 to 68.4% (95%CI 55.6%-78.9%) in 2023, representing ∼5.1 million adults. LDL-C control prevalence increased from 2.8% (95%CI 1.2%-4.4%) in 2016 to 6.6% (95%CI 1.9%-11.2%) in 2023. Combined risk factor control achievement was low primarily due to suboptimal LDL-C control, despite high medication use; this was more likely achieved in females, younger individuals, and those with college education or living in states with higher socioeconomic position.

Conclusions: Despite increasing CVD risk during this period, comprehensive glycemic and CVD risk factor management for adults with diabetes in Mexico remains suboptimal. Our findings highlight the need for strategies to address gaps in CVD risk management to reduce premature mortality in this population. This study examined how well adults with diabetes in Mexico are controlling key risk factors for cardiovascular disease, such as blood glucose levels, blood pressure, smoking, and cholesterol levels. Authors used nationally representative surveys from 2016-2023 analyzing data which represents over 43.2 million adults living with diagnosed diabetes.In 2023, fewer than one-third of individuals with diabetes had adequate blood glucose control, and fewer than one in ten met recommended cholesterol targets, despite high rates of medication use. Cardiovascular risk increased for those at the highest risk by nearly 9% between 2016 and 2023.Better control of these risk factors was more common among women, younger individuals, those with higher education, and those living in more socioeconomically advantaged areas. null

Authors
Daniel Ramírez García, Jerónimo Perezalonso Espinosa, Padme Méndez Labra, Carlos Fermín Martínez, Juan Díaz Sánchez, César Paz Cabrera, Arsenio Vargas Vázquez, Miriam López Teros, David Flood, Jennifer Manne Goehler, Neftali Antonio Villa, Goodarz Danaei, Jacqueline Seiglie, Omar Bello Chavolla