Diabetes mellitus and obesity in the French Caribbean: A special vulnerability for women?

ABSTRACT

The objective of this study was to analyze the prevalence, awareness, treatment, and control of diabetes and its risk factors among French Caribbean adults. This cross-sectional study included 18–74-year olds (N = 2252; 56.5 percent women) who underwent a heath examination in Guadeloupe during July–December 2014. Diabetes was defined as using antidiabetic treatment, or fasting glucose ≥7 mmol/l, and glycated hemoglobin (HbA1c) ≥6.5 percent; diabetes control was defined as HbA1c < 7 percent. Multilevel logistic regression was used. Diabetes prevalence was 8.2 percent for women and 5 percent for men (age-adjusted odds ratio [aOR] for women = 2.0; 95 percent confidence interval [CI]: 1.4–2.9). The proportion of women with diabetes who were aware of it was 84.5 versus 67.3 percent in men (aOR = 2.7; 95 percent CI: 1.2–6.2). Nearly, all diagnosed participants were being treated. In less than a third of diabetics in both sexes was diabetes control obtained. Most women (55.3 percent) had a waist circumference at or above the National Cholesterol Education Program thresholds versus 14 percent of men (aOR = 9.3; 95 percent CI: 7.5–11.7), which wholly accounted for excess diabetes in women. In women, obesity and diabetes were associated with low education and income. In this French Caribbean sample, abdominal obesity and diabetes affected more women. Diabetes was rarely controlled. A comprehensive women’s health policy for the prevention of abdominal obesity and diabetes is needed.

KEYWORDS:

• Caribbean
• diabetes mellitus
• France
• obesity
• socioeconomic factors
• women’s health

Acknowledgments

We would like to thank the personnel of the Guadeloupean Association for the Management and Realization of Health Examinations and the Promotion of Health, and their director, Mr. Maurice Meissonier; the medical analysis laboratory Synergie Bio, in particular Ms. Marie-Lyne Péan-Dulorme; the general social security fund of Guadeloupe; Mr. Gauthier Chassang, legal counsel; the HTA-Gwad network and its founder, Mr. André Atallah; the Regional Union of Health Professionals and Private Practitioners of Guadeloupe, General practice section.