Alcohol abuse in older adults with type 2 diabetes mellitus in primary health care: a cross-sectional study

Oliveira, Rinaldo Eduardo Machado de; Consoli, Lívia Maria Ferrante Vizzotto; Godoy, Anelize Roveri Arcanjo; Franco, Laercio Joel

doi:10.1590/1413-81232023288.06492023EN

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ARTICLE • Ciênc. saúde coletiva 28 (8) • Aug 2023 • https://doi.org/10.1590/1413-81232023288.06492023EN copy

Alcohol abuse in older adults with type 2 diabetes mellitus in primary health care: a cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This cross-sectional study aimed to analyze alcohol abuse in older adults with type 2 diabetes mellitus in primary health care. Household data were collected from March to October 2018 in the Family Health Strategy in Ribeirão Preto, São Paulo through face-to-face interviews with a form application. The pattern of alcohol consumption was estimated with the Alcohol Use Disorders Identification Test-C. A total of 338 older adults with type 2 diabetes mellitus participated, and 19.2% (95%CI 15.0-23.4) engaged in alcohol abuse. Among them, we observed a higher frequency of males (63.1%), aged 60 to 64 years (35.4%), economic class C (49.2%), 1-4 schooling years (53.8%), and multimorbidity (92.3%). There was a negative association between alcohol abuse and drug therapy adherence (PR = 0.55; 95%CI 0.36-0.86). The frequency of alcohol abuse and non-adherence to drug treatment among those with a high consumption pattern is troubling since it can lead to diabetes complications. Therefore, we underscore the importance of multidimensional elderly care and health education in primary care.

Key words:
Binge drinking; Health of the elderly; Diabetes mellitus; Delivery of health care; Public health surveillance

Variable	Alcohol abuse				P-value^a
	No (n = 273)		Yes (n = 65)
	n	%	n	%
Gender
Male	73	26.7	41	63.1	< 0.001
Female	200	73.3	24	36.9
Age group (years)
60-64	63	23.1	23	35.4	0.019
65-69	67	24.5	21	32.3
70-74	53	19.4	5	7.7
75-79	37	13.6	10	15.4
≥ 80	53	19.4	6	9.2
Economic class ^b
A	5	1.8	2	3.1	0.432
B	39	14.3	14	21.5
C	143	52.4	32	49.2
D/E	86	31.5	17	26.2
Schooling (years)
0	49	17.9	4	6.2	0.029
1-4	147	53.8	35	53.8
≥ 5	77	28.2	26	40.0
Tobacco use
No	248	90.8	52	80	0.023
Yes	25	9.2	13	20
Multimorbidity15
No	16	5.9	5	7.7	0.792
Yes	257	94.1	60	92.3
Cardiovascular disease
No	42	15.4	12	18.5	0.674
Yes	231	84.6	53	81.5
Dyslipidemia
No	110	40.3	33	50.8	0.162
Yes	163	59.7	32	49.2
Overweight/obesity
No	207	75.8	48	73.8	0.863
Yes	66	24.2	17	26.2
Emotional distress in living with T2DM¹⁶
No	223	81.7	51	78.5	0.674
Yes	50	18.3	14	21.5
Complications arising from T2DM
No	133	48.7	35	53.8	0.545
Yes	140	51.3	30	46.2
Drug therapy adherence¹⁷
No	120	44	41	63.1	0.008
Yes	153	56	24	36.9
Medications used for T2DM
Only oral antidiabetic	195	71.4	54	83.1	0.066
Only insulin	18	6.6	5	7.7
Oral antidiabetic and insulin	60	22	6	9.2
Blood glucose control c (n = 243)
No	54	26.9	9	21.4	0.591
Yes	147	73.1	33	78.6

Variável	Crude analysis		Adjusted analysis
Variável	PR a (95%CI) ^b	p ^c	PR (95%CI)	p
Gender
Male	-	-	-	-
Female	0.29 (0.18-0.46)	< 0.01	-	-
Age group (years)
60-64	-	-	-	-
65-69	0.89 (0.53-1.48)	0.66	-	-
70-74	0.32 (0.13-0.79)	0.01	-	-
75-79	0.79 (0.41-1.52)	0.49	-	-
≥ 80	0.38 (0.16-0.87)	0.02	-	-
Economic class ^d
A	-	-	-	-
B	0.92 (0.26-3.24)	0.90	0.93 (0.26-3.33)	0.92
C	0.64 (0.19-2.15)	0.47	0.62 (0.18-2.10)	0.44
D/E	0.57 (0.16-2.01)	0.38	0.64 (0.18-2.26)	0.49
Schooling (years)
0	-	-	-	-
1-4	2.54 (0.94-6.84)	0.06	1.95 (0.73-5.16)	0.17
≥ 5	3.34 (1.23-9.08)	0.01	2.50 (0.90-6.93)	0.07
Tobacco use
No	-	-	-	-
Yes	1.97 (1.19-3.27)	< 0.01	1.46 (0.87-2.46)	0.15
Multimorbidity¹⁵
No	-	-	-	-
Yes	0.79 (0.35-1.76)	0.57	1.01 (0.43-2.36)	0.96
Cardiovascular disease
No	-	-	-	-
Yes	0.83 (0.48-1.46)	0.53	0.99 (0.56-1.76)	0.99
Dyslipidemia
No	-	-	-	-
Yes	0.71 (0.45-1.09)	0.12	0.89 (0.58-1.36)	0.61
Overweight/obesity
No	-	-	-	-
Yes	1.08 (0.66-1.78)	0.73	1.41 (0.88-2.25)	0.15
Emotional distress in living with T2DM¹⁶
No	-	-	-	-
Yes	1.17 (0.69-1.98)	0.54	1.24 (0.77-2.02)	0.36
Complications arising from T2DM
No	-	-	-	-
Yes	0.84 (0.54-1.31)	0.45	0.86 (0.57-1.29)	0.47
Drug therapy adherence¹⁷
No	-	-	-	-
Yes	0.53 (0.33-0.84)	<0.01	0.55 (0.36-0.86)	<0.01
Medications used for T2DM
Only oral antidiabetic	-	-	-	-
Only insulin	1.00 (0.44-2.25)	0.99	1.09 (0.44-2.69)	0.85
Oral antidiabetic and insulin	0.41 (0.18-0.93)	0.03	0.45 (0.21-0.96)	0.03
Blood glucose control e (n = 243)
No	-	-	-	-
Yes	1.28 (0.65-2.53)	0.47	1.28 (0.67-2.47)	0.44

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[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva