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      The Burden of Diabetes in Argentina

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          Abstract

          Objective:

          To measure the economic burden of diabetes in Argentina by age, gender and region for the year 2005, in disability-adjusted life years (DALYs).

          Methods:

          DALYs were estimated by the sum of years of life lost due to premature death (YLL) and years of life lived with disability (YLD).

          Results:

          In the population studied (20 to 85 years), the burden of diabetes without complications was 1.3 million DALYs, 85% of which were caused by disabilities. Whereas mortality rates (YLL) increased as a function of age, YLD showed the opposite relationship. Women had higher burden of disease values, represented by 51 and 61% of YLL and YLD, respectively, independently of age.

          Conclusions:

          Our results demonstrate that disabilities are a key component of diabetes burden; its regular and systematic estimation would allow to design effective prevention strategies, to assess the impact of their implementation and to optimize resource allocation based on objective evidence.

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          Most cited references43

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          The global burden for disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020

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            Quantifying the burden of disease: the technical basis for disability-adjusted life years.

            C. Murray (1994)
            Detailed assumptions used in constructing a new indicator of the burden of disease, the disability-adjusted life year (DALY), are presented. Four key social choices in any indicator of the burden of disease are carefully reviewed. First, the advantages and disadvantages of various methods of calculating the duration of life lost due to a death at each age are discussed. DALYs use a standard expected-life lost based on model life-table West Level 26. Second, the value of time lived at different ages is captured in DALYs using an exponential function which reflects the dependence of the young and the elderly on adults. Third, the time lived with a disability is made comparable with the time lost due to premature mortality by defining six classes of disability severity. Assigned to each class is a severity weight between 0 and 1. Finally, a three percent discount rate is used in the calculation of DALYs. The formula for calculating DALYs based on these assumptions is provided.
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              Risk factors for acute myocardial infarction in Latin America: the INTERHEART Latin American study.

              Current knowledge of the impact of cardiovascular risk factors in Latin America is limited. As part of the INTERHEART study, 1237 cases of first acute myocardial infarction and 1888 age-, sex-, and center-matched controls were enrolled from Argentina, Brazil, Colombia, Chile, Guatemala, and Mexico. History of smoking, hypertension, diabetes mellitus, diet, physical activity, alcohol consumption, psychosocial factors, anthropometry, and blood pressure were recorded. Nonfasting blood samples were analyzed for apolipoproteins A-1 and B-100. Logistic regression was used to estimate multivariate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs). Persistent psychosocial stress (OR, 2.81; 95% CI, 2.07 to 3.82), history of hypertension (OR, 2.81; 95% CI, 2.39 to 3.31), diabetes mellitus (OR, 2.59; 95% CI, 2.09 to 3.22), current smoking (OR, 2.31; 95% CI, 1.97 to 2.71), increased waist-to-hip ratio (OR for first versus third tertile, 2.49; 95% CI, 1.97 to 3.14), and increased ratio of apolipoprotein B to A-1 (OR for first versus third tertile, 2.31; 95% CI, 1.83 to 2.94) were associated with higher risk of acute myocardial infarction. Daily consumption of fruits or vegetables (OR, 0.63; 95% CI, 0.51 to 0.78) and regular exercise (OR, 0.67; 95% CI, 0.55 to 0.82) reduced the risk of acute myocardial infarction. Abdominal obesity, abnormal lipids, and smoking were associated with high population-attributable risks of 48.5%, 40.8%, and 38.4%, respectively. Collectively, these risk factors accounted for 88% of the population-attributable risk. Interventions aimed at decreasing behavioral risk factors, lowering blood pressure, and modifying lipids could have a large impact on the risk of acute myocardial infarction among Latin Americans.
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                Author and article information

                Journal
                Glob J Health Sci
                Glob J Health Sci
                Global Journal of Health Science
                Canadian Center of Science and Education (Canada )
                1916-9736
                1916-9744
                May 2015
                17 November 2014
                : 7
                : 3
                : 124-133
                Affiliations
                [1 ]CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP–CONICET), Centro Colaborador de OPS/OMS para Diabetes, Facultad de Ciencias Médicas (UNLP), La Plata, Argentina
                Author notes
                Correspondence: Juan J. Gagliardino, CENEXA, Centro de Endocrinología Experimental y Aplicada (UNLP – CONICET), Centro Colaborador de OPS/OMS para Diabetes, Facultad de Ciencias Médicas UNLP, 60 y 120 4to piso, 1900 La Plata, Argentina. Tel: 54-221-423-6712. E-mail: direccion@ 123456cenexa.org
                Article
                GJHS-7-124
                10.5539/gjhs.v7n3p124
                4802096
                25948443
                5a9d79a5-489b-4d33-9d87-3c3a31eb90bf
                Copyright: © Canadian Center of Science and Education

                This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 10 September 2014
                : 27 October 2014
                Categories
                Articles

                diabetes,daly,yld,yll,disability,mortality,argentina
                diabetes, daly, yld, yll, disability, mortality, argentina

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