Original Article Prevalence of prediabetes and diabetes among older adults in Ecuador: Analysis of the SABE survey Carlos H. Orces a, *, Carlos Lorenzo b a Laredo Medical Center, Department of Medicine, 1700 East Saunders, Laredo, TX 78041, United States b University of Texas Health Science Center, Division of Clinical Epidemiology, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States A R T I C L E I N F O Article history: Available online xxx Keywords: Diabetes Prediabetes Older adults Ecuador A B S T R A C T Aims: To examine the prevalence of prediabetes and diabetes among subjects aged 60 years and older in Ecuador. Materials and methods: The present study used data from the National Survey of Health, Wellbeing, and Aging to describe the prevalence of prediabetes and diabetes among older adults. Logistic regression models were assembled to examine the association between certain demographic and health characteristics of participants and prediabetes and diabetes prevalence rates. Results: Of 2298 participants, the prevalence of prediabetes and diabetes was 36.9% (95% CI: 34.2%–39.6%) and 16.7% (95% CI: 14.9%–18.7%) among older adults in Ecuador, respectively. Notably, higher diabetes prevalence rates were seen among women, black subjects, residents in the urban coastal region, and obese participants than those without. In general, the prevalence of diabetes widely varied across provinces of the country, with higher rates seen in provinces along the coastal region of the country. After adjustment for age, gender, and BMI, residents in the urban coast, subjects with greater number of comorbidities, and those classified as having hypertension, and hypertriglyceridemia had significantly higher odds of having diabetes than those without. Conclusions: Prediabetes and diabetes are prevalent among older adults in Ecuador. The increased prevalence of these metabolic disorders was particularly associated with obesity. Thus, the present findings may assist health care authorities to implement healthy lifestyle interventions among older Ecuadorians at risk for diabetes. © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved. 1. Introduction Diabetes is a worldwide public health burden associated with increased morbidity related to its complications, excess disability, health care costs, and premature mortality [1–3]. According to the World Health Organization global report on diabetes, the number of people with diabetes has steadily risen over the past few decades, due to population growth, the increase in the average age of the population, and increasing rates of overweight and obesity. Moreover, diabetes prevalence rates have increased faster in low- and middle-income countries than in high-income countries [4]. The incidence of diabetes increases with age until about age 65 years, after which both incidence and prevalence seem to level off. As a result, older adults with diabetes may either have incident disease or long-standing diabetes with onset in middle-age or earlier [5]. For instance, the median prevalence of self-reported diabetes among U.S. adults aged 65–74 and 75 years and older was 22.5% and 21.2% in 2015, respectively [6]. In Latin America, a previous analysis of the SABE survey described that the prevalence of self-reported diabetes ranged from 12.2% in Buenos Aires to 21.3% in Mexico City [7]. Likewise, the prevalence of diabetes among older participants in the 10/66 dementia research group differed widely in Latin America sites from 8.7% in urban Peru to 32.1% in Puerto Rico [8]. In Ecuador, a previous study conducted to examine the association between sociodemographic and lifestyle factors and self-reported chronic medical conditions reported that diabetes was prevalent in 13.1% of adults aged 60 years and older [9]. Notably, a high prevalence of the metabolic syndrome, a cluster of cardio metabolic risk factors associated with increased risk of diabetes, was also described among older Ecuadorians [10]. Likewise, older women defined as having abdominal obesity had 2-fold higher odds of having diabetes than those who did not [11]. Despite these facts, there is scarce epidemiological data regarding the prevalence of diabetes, particularly among older adults in * Corresponding author. E-mail addresses: corces07@yahoo.com (C.H. Orces), LORENZO@uthscsa.edu (C. Lorenzo). https://doi.org/10.1016/j.dsx.2017.12.002 1871-4021/© 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved. Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2017) xxx–xxx G Model DSX 885 No. of Pages 9 Please cite this article in press as: C.H. Orces, C. Lorenzo, Prevalence of prediabetes and diabetes among older adults in Ecuador: Analysis of the SABE survey, Diab Met Syndr: Clin Res Rev (2017), https://doi.org/10.1016/j.dsx.2017.12.002 Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepa ge: www.elsev ier.com/locate/dsx