Prevalence, awareness, treatment and control of diabetes in Guatemala: a nationally representative survey among reproductive-age women.

Introduction: There has been no nationally representative diabetes survey in Guatemala. The objectives of this study are (1) To provide national estimates for the prevalence of diabetes among women of reproductive age in Guatemala and (2) To assess indicators of diabetes care, including diagnosis, treatment and control in this setting. Methods: We analysed cross-sectional household survey data from the Epidemiological Health and Nutrition Surveillance System in Guatemala, collected between August 2018 and April 2019. The sample included non-pregnant women aged 15-49 with available HbA1c data. We estimated diabetes prevalence and the care cascade. Diabetes was defined as HbA1c ≥6.5% or use of glucose-lowering medication. Treatment was defined as use of medication or receiving dietary management. Control was defined as HbA1c <7%. Results: The sample consisted of 1504 women. The overall weighted prevalence of diabetes was 5.0% (95% CI 3.8% to 6.5%). Prevalence rose sharply with age, and women aged 40-49 years had a prevalence of 13.3% (95% CI 9.4% to 18.4%). Of all women with diabetes, 45.6% (95% CI 33.6% to 58.1%) had received a diagnosis, 33.6% (95% CI 25.8% to 49.0%) were treated, and 8.0% (95% CI 3.2% to 18.9%) were controlled. Conclusions: Diabetes among reproductive-age women in Guatemala poses a major public health challenge. There is a need for multisectoral efforts to strengthen the provision of diabetes prevention, diagnosis and treatment in Guatemala.