Factors Associated with Healthcare Services Utilization and Pharmacological Treatment in Individuals with Diabetes Diagnosis: Lessons from a Nationwide Program for Diabetes Mellitus Detection in Brazil

The Brazilian Nationwide Population Screening Program for Diabetes, conducted in 2001, diagnosed 346,168 new cases. Although unexpected, approximately 65,000 previously diabetic individuals participated. We describe their characteristics compared to new cases, based on data obtained by a follow-up study of a subsample of 4991 positively screened from a representative sample of 90,106 individuals. Two groups were analyzed regarding factors associated with adherence to treatment, healthcare services utilization, and compliance to pharmacological treatment: 497 with newly diagnosed diabetes and 257 individuals with previous diabetes diagnosis who were not under treatment at the screening program. For this group, healthcare service utilization was lower when compared with the new cases (OR = 0.06; 95% CI: 0.03–0.12). Diabetes status (OR = 0.23; 95% CI: 0.14–0.37), a healthy behavior score (OR = 0.53, 95% CI: 0.34–0.83), and glucose levels at screening (altered, OR = 5.01; 95% CI: 2.38–10.6 and likely and very likely DM OR = 11.2; 95% CI: 6.85–18.4) were independently associated with pharmacological treatment.