Diabetes

The main non-communicable diseases in Mexico are diabetes, hypertension, and obesity. The prevalence of diabetes reached very high levels at the beginning of this century and has been steadily increasing. In 2000, 6.5% of the population aged 20 or over was diagnosed as diabetic, rising to 7.5% in 2006 and to 9.4% in 2016 (Rojas-Martínez et al., 2017).

In an actualisation of the GBD reported in 2016, in Mexico diabetes was the first cause of YLDs, similar to other countries in Latin America like Barbados, Jamaica, Puerto Rico, Saint Vincent and the Grenadines, Trinidad and Tobago, and the Virgin Islands (Vos et al., 2016). This emphasises the necessity of intensive long-term management to prevent fatal and disabling complications in those countries.

The National Health and Nutrition Survey (ENSANUT), a national probabilistic survey, reported in 2016 that 9.4% of the adults interviewed (10.3% of women and 8.4% of men), reported a diagnosis of diabetes by a physician or other health professionals (Table 4), a slight increase from ENSANUT 2012’s reported prevalence of 9.2%, and 7.25% in ENSANUT 2006. The majority (87.8%) reported receiving medical treatment to control their illness. Most people with a previous medical diagnosis of diabetes were between 60 and 70 years of age (INSP & Secretaría de Salud, 2016).

Table 4. Percentage of adults who reported having received a prior medical diagnosis of diabetes

	Men		Women		Total
Age group	Number (Thousands)	%	Number (Thousands)	%	Number (Thousands)	%
20-29	23.2	0.3	153.1	1.6	176.3	1.0
30-39	70.0	0.9	275.6	3.1	345.6	2.1
40-49	543.6	9.4	582.6	8.2	1126.2	8.7
50-59	743.9	17.7	872.1	17.2	1616	17.4
60-69	951.8	27.7	1,228.4	32.7	2,180.2	30.3
70-79	280.1	19.3	500.5	29.8	780.5	24.9
80 and more	80.6	12.5	159.3	21.8	239.9	17.5
Total	2,693.2	8.4	3,771.6	10.3	6,464.8	9.4

(Source: ENSANUT MC, 2016)

The report of diabetes by previous medical diagnosis was higher among women than among men, both nationally (10.3% vs 8.4%), in urban (10.5% vs 8.2%) or rural (9.5% vs 8.9%) localities (INSP & Secretaría de Salud, 2016).

Hypertension

According to ENSANUT 2016 (Campos-nonato et al., 2018), current prevalence of hypertension[1] is 25.5%, although 40.0% of these did not know they had hypertension before the survey. Of the total adults 20 years and older with a previous diagnosis of hypertension who were receiving treatment, only 45.6% had controlled or normal hypertension (SBP≤140mmHg; DBP≤90mmHg) when measured at the time of the survey. By sex, 26.1% of men and 24.9% of women reported having hypertension. The prevalence was highest among people aged 70 to 79 years. In ENSANUT 2016, no statistically significant differences were observed in the prevalence of arterial hypertension between geographic regions, nor between rural and urban localities (INSP & Secretaría de Salud, 2016).

Table 5. Prevalence of hypertension, by sex and age group. Mexico 2015

	Hypertension			Detected at survey			Previous diagnosis
	%	(CI 95%)	n	%	(CI 95%)	n	%	(CI 95%)	n
Total	25.5	23.3-27.8	2204	10.2	8.9-11.7	839	15.3	13.4-17.5	1365
Women	26.1	23.5-28.9	1426	7.7	6.5-9.1	447	18.4	16.0-21.2	979
Men	24.9	21.6-28.5	778	12.8	10.9-15.0	392	12.1	9.4-15.5	386
Age Group
20-29	8.3	6.1-11.2	96	5.4	3.6-8.0	54	2.9	1.8-4.7	42
30-39	13.1	8.8-19.2	198	5.6	3.8-8.1	104	7.6	3.8-14.6	94
40-49	24.2	20.9-27.9	388	10.6	8.3-13.6	164	13.6	11.3-16.2	224
50-59	39.8	35.3-44.5	489	13.3	10.4-16.9	157	26.5	22.1-31.4	332
60-69	56.0	50.6-61.2	529	19.6	14.4-26.2	178	36.3	30.2-43.0	351
70-79	66.3	60.0-72.1	367	23.9	17.9-31.2	129	42.4	36.0-49.1	238
≥80	59.4	49.1-69.0	137	22.1	14.7-31.9	53	37.3	27.5-48.3	84

Source: (Campos-nonato et al., 2018)

Obesity

In Mexico it is considered that there is an epidemic of being overweight and obesity, which began in the 90’s and has presented a growing trend, especially in children under 20 (Secretaría de Salud, 2015b). By sex, the prevalence of obesity (BMI ≥30 kg/m2) is higher in females (38.6%, 95% CI 36.1, 41.2) than males (27.7%, 95% CI 23.7, 32.1) (Secretaría de Salud, 2015b).

The prevalence of abdominal obesity (defined as having a waist circumference in men ≥90 cm and in women ≥80 cm) in adults 20 years of age or older is 76.6%. Prevalence is higher for women than for men and increases with age, except for the very old (INSP & Secretaría de Salud, 2016).

Table 6. Prevalence of abdominal obesity* in adults 20 years of age or older, categorised by sex and age groups

Age Group	Waist Perimeter		Abdominal obesity
	Men	Women	Men	Women
20-29	49.0	24.7	51.0	75.3
30-39	32.2	10.2	67.8	89.8
40-49	29.8	8.4	70.2	91.6
50-59	27.8	5.3	72.2	94.7
60-69	25.9	6.1	74.1	93.9
70-79	20.0	13.7	80.0	86.3
≥80	33.2	14.7	66.8	85.3
Total	34.6	12.3	65.4	87.7

Source: (Secretaría de Salud, 2015b)

According to national data, the combined prevalence of being overweight and obese in the school-age population in 2016 was 33.2%. The prevalence of being overweight was 17.9% and obesity 15.3%. In contrast with the adult population, a higher prevalence of obesity was observed in boys 18.3%, compared to girls 12.2% (INSP & Secretaría de Salud, 2016).

[1] Hypertension is classified as those who reported have been previously given a diagnosis of hypertension by a health professional or that presented, when interviewed, measures of systolic blood pressure (SBP) ≥140mmHg and diastolic blood pressure ≥90mmHg.

References:

Campos-nonato, I., Hernández-Barrera, L., Pedroza-Tobías, A., Medina, C., & Barquera, S. (2018). Hipertensión arterial en adultos mexicanos: prevalencia, diagnóstico y tipo de tratamiento. Ensanut MC 2016. Salud Publica de Mexico, 60(3), 233–243. https://doi.org/10.21149/8813

INSP, & Secretaría de Salud. (2016). Encuesta Nacional de Salud y Nutrición de Medio Camino, 2016 (Vol. 2016). https://doi.org/10.1111/acem.12546

Rojas-Martínez, R., Basto-Abreu, A., Aguilar-Salinas, C. A., Zárate-Rojas, E., Villalpando, S., & Barrientos-Gutiérrez, T. (2017). Prevalencia de diabetes por diagnóstico médico previo en México. Salud Pública de México, 60(3). https://doi.org/10.21149/8566

Secretaría de Salud. (2015b). Prontuario de la Salud. Informe sobre la salud de los Mexicanos 2015.

Vos, T., Allen, C., Arora, M., Barber, R. M., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coggeshall, M., Cornaby, L., Dandona, L., Dicker, D. J., Dilegge, T., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Fleming, T., Forouzanfar, M. H., … Zuhlke, L. J. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1545–1602. https://doi.org/10.1016/S0140-6736(16)31678-6