16 Previous studies conducted with occupational cohorts have sugg

16 Previous studies conducted with occupational cohorts have suggested that self-rated health principally indicates physical and mental health problems and, to a lesser extent, age, early life factors, family history, sociodemographic variables, psychosocial factors and health-related behaviour.17 18 As it was a cross-sectional study, one can only say directly that there was an association of onset of diabetes with self-rated health. So it was not possible to demonstrate that poor self-rated health was a causative factor or the effect of the onset of diabetes, due to the design of this study. Sharing a home with more than one person was associated with the presence of diabetes.

Reports in the literature on the number of individuals sharing a home and the presence of diabetes are conflicting. In a population cohort that included both men and women, an association was found between living alone and type 2 diabetes in men; however, there was no increased risk for women living alone.19 Nevertheless, a Swedish study investigating the role of household conditions in the progression from impaired glucose tolerance to diabetes in 461 women aged 50–64 years

found that women living alone had a 2.7-fold increased risk of type 2 diabetes even after adjustment for biological risk factors.20 In other countries, living alone is believed to be related to poor perceived social support, lack of a close confidant and poor emotional support, and may be a proxy for poor social support and consequently social isolation.21 We may hypothesise that the difference between the findings of this study and those of Lidfeldt et al20 may be explained by the fact that in Brazil the women most likely to have type 2 diabetes are older and share a home with other people because they require care. In addition, one may also hypothesise that these women may have lower incomes and poorer health conditions. A large body of evidence

suggests that socioeconomically disadvantaged groups are at increased risk of type 2 diabetes.22 23 A BMI increase at 20–30 years of age was another factor associated with the onset of diabetes. Studies Dacomitinib showed that being obese or overweight at a younger age may increase the risk of developing diabetes.24 25 In a longitudinal study enrolling adults aged above 35 years with no cardiovascular disease or diabetes, which was conducted during a 7-year follow-up period, the BMI cut-off of 30 kg/m2 was associated with a 1.94-fold (1.42–2.66) increased risk of type 2 diabetes.24 Jeffreys et al25 Have also demonstrated that overweight at any point in a person’s life is associated with an increased risk of developing diabetes and that the risk associated with being overweight is cumulative across the life course. No association was found between menopausal status and the onset of diabetes in this study.

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