Diabetes mellitus with inadequate blood sugar control increases mortality in Brazilian older adults: evidence from ELSI-Brazil

Abstract

This study evaluated the association between blood sugar control of diabetes mellitus and all-cause mortality, considering the categories “no diabetes mellitus”, “diabetes mellitus with adequate blood sugar control”, and “diabetes mellitus with inadequate blood sugar control”. Data from the ELSI-Brazil baseline survey (2015/2016) were used, with a representative national sample of the population aged 50 years or older, linked to the Brazilian Mortality Information System (SIM, acronym in Portuguese) in the 2015-2021 period. Diabetes mellitus was identified by self-report, and blood sugar control was assessed by glycated hemoglobin levels, and values ≥ 7% were considered inadequate. Mortality was verified by death certificates and probabilistic linkage with SIM. The statistical analysis considered the sample parameters and was based on Cox regression models. Among 2,338 participants, 16% had diabetes mellitus; of these, 49.1% had inadequate control. In five years of follow-up, 194 deaths were recorded. The adjusted mortality risk was higher only in the group with diabetes mellitus and inadequate control (HR = 2.68; 95%CI: 1.08-6.65) in relation to those without diabetes mellitus. The findings reinforce the importance of blood sugar control and its continuous monitoring in primary health care.

Keywords:
Diabetes Mellitus; Aged; Glycemic Control; Mortality