Importance of women's health in Latin America (Chile)

Abstract

Type 2 diabetes mellitus (T2DM) constitutes a significant public health problem worldwide. Chile is no exception, with a prevalence reaching 12.3% of the adult population and exceeding 30% in people over 65 years old, the highest rate in South America¹. This prevalence is slightly lower in women than in men at middle ages but higher in older ages, primarily due to higher life expectancy. According to the latest National Health Survey in Chile², 14% of women versus 10.6% of men have diabetes.

A very concerning aspect is that this increase in prevalence affects women of childbearing age, where it has risen 47 times over the last two decades. This could lead to an increase in congenital malformations and an even greater rise in the incidence of diabetes in the coming decades³. On the other hand, mortality due to diabetes has seen a slight decrease between 1990 and 2020 at the expense of women, as it has increased in men. For women, the leading cause of death is tumors, followed by stroke and acute myocardial infarction, with diabetes in sixth place⁴.

The costs associated with diabetic complications due to non-compliance with blood glucose control goals and other cardiovascular risk factors increase exponentially. Women with diabetes have a higher number of some comorbidities such as obesity and chronic kidney disease, while men have more cardiovascular disease and amputations^5,6.

For years, Chile has had a National Strategy to improve the control of Diabetes and Cardiovascular Risk Factors (CVRF), implemented through the Cardiovascular Health Program. Along with the Explicit Health Guarantees system (GES), this program ensures diagnosis and treatment throughout the country for people with hypertension and diabetes, regulated by national clinical guidelines and corresponding laws. Fortunately, between 2010 and 2020, there was an increase in patients achieving metabolic compensation goals (from 39% to 45%), but post-pandemic, these rates dropped to 28% and 35% in 2019 and 2020⁷.

Current challenges include regaining control targets and hopefully achieving gender-specific strategies to address persistent issues more effectively.