Diabetes in Bolivia.

OBJECTIVE To measure the prevalence of diabetes mellitus (DM), hypertension, obesity, and related risk factors in major cities in Bolivia. METHODS A population-based survey was conducted in four Bolivian cities: La Paz, El Alto, Santa Cruz, and Cochabamba. The total sample size was chosen to be 2,948 persons. The overall response rate was 86%, with the rate varying somewhat among the four cities. DM was diagnosed through an oral glucose tolerance test (OGTT) 2 hours after an overload of 75 grams of glucose, using World Health Organization criteria. RESULTS The overall prevalence of DM in the four urban areas combined was 7.2% (95% confidence interval (CI): 6.2%-8.3%) and of impaired glucose tolerance (IGT) was 7.8%. A total of 73.1% (95% CI: 65.0%-81.0%) of those previously diagnosed with DM and 73.7% (95% CI: 61.0%-86.4%) of newly diagnosed cases were overweight, according to measurements of body mass index. Hypertension was found in 36.5% (95% CI: 27.6%-45.5%) of known diabetics and in 36.6% (95% CI: 23.0%-50.1%) of newly diagnosed cases, compared to only 15.9% (95% CI: 14.3%-17.5%) among people without DM. The disease was most common among older persons and those with little education. CONCLUSIONS Diabetes is a genuine public health problem in Bolivia. Further, the high prevalence of IGT that was found suggests that diabetes prevalence will increase in the near future in the country unless prevention strategies are implemented.