Diabetes and other disorders of glycemia in a rural South African community: prevalence and associated risk factors

Ayesha A Motala, Tonya Esterhuizen, Eleanor Gouws, Fraser J Pirie, Mahomed A K Omar, Ayesha A Motala, Tonya Esterhuizen, Eleanor Gouws, Fraser J Pirie, Mahomed A K Omar

Abstract

Objective: The purpose of this study was to determine the prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), and associated risk factors in a rural South African black community.

Research design and methods: This was a cross-sectional survey conducted by random cluster sampling of adults aged >15 years. Participants had a 75-g oral glucose tolerance test using the 1998 World Health Organization criteria for disorders of glycemia.

Results: Of 1,300 subjects selected, 1,025 subjects (815 women) participated (response rate 78.9%). The overall age-adjusted prevalence of diabetes was 3.9%, IGT 4.8%, and IFG 1.5%. The prevalence was similar in men and women for diabetes (men 3.5%; women 3.9%) and IGT (men 4.6%; women 4.7%) but higher in men for IFG (men 4.0%; women 0.8%). The prevalence of diabetes and IGT increased with age both in men and women, with peak prevalence in the 55- to 64-year age-group for diabetes and in the >or=65-year age-group for IGT. Of the cases of diabetes, 84.8% were discovered during the survey. In multivariate analysis, the significant independent risk factors associated with diabetes included family history (odds ratio 3.5), alcohol ingestion (2.8), waist circumference (1.1), systolic blood pressure (1.0), serum triglycerides (2.3), and total cholesterol (1.8); hip circumference was protective (0.9).

Conclusions: There is a moderate prevalence of diabetes and a high prevalence of total disorders of glycemia, which suggests that this community, unlike other rural communities in Africa, is well into an epidemic of glucose intolerance. There is a low proportion of known diabetes and a significant association with potentially modifiable risk factors.

References

    1. McLarty DG, Pollitt C, and Swai ABM: Diabetes in Africa. Diabet Med 7:670-684,1990
    1. Motala AA, Omar MA, Pirie FJ: Diabetes in Africa: epidemiology of type 1 and type 2 diabetes in Africa. J Cardiovasc Risk 10:77–83, 2003
    1. International Diabetes Federation: Diabetes Atlas. 3rd ed. Brussels, International Diabetes Federation, 2006
    1. World Health Organization: Diabetes Mellitus: Report of a WHO Study Group. Geneva, World Health Org., 1985 (Tech. Rep. Ser., no. 727)
    1. Levitt NS, Unwin NC, Bradshaw D, Kitange HM, Mbanya J-CN, Mollentze WF, Omar MAK, Motala AA, Joubert G, Masuki G, Machibya H: Application of the new ADA criteria for the diagnosis of diabetes to population studies in sub-Saharan Africa. Diabet Med 17: 381–385, 2000
    1. Omar MAK, Seedat MA, Motala AA, Dyer RB, Becker P: The prevalence of diabetes mellitus and impaired glucose tolerance in a group of urban South African blacks. S Afr Med J 83:641–643, 1993
    1. Levitt NS, Katzenellenbogen JM, Bradshaw D, Hoffman MN, Bonnici F: The prevalence and identification of risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care 16:601–607, 1993
    1. Mollentze WF, Moore AJ, Steyn AF, Joubert G, Steyn K, Oosthuizen GM, Weich DJV: Coronary heart disease risk factors in a rural and urban Orange Free State black population. S Afr Med J 85:90–96, 1995
    1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 20:1183–1197, 1997
    1. Alberti KGMM, Zimmet PZ, WHO Consultation: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med 15: 539–553, 1998
    1. Aspray TJ, Mugusi F, Rashid S, Whiting D, Edwards R, Alberti KG, Unwin NC, Essential Non-Communicable Disease Health Intervention Project: Rural and urban differences in diabetes prevalence in Tanzania: the role of obesity, physical inactivity and urban living. Trans R Soc Trop Med Hyg 94:637–644, 2000
    1. Amoah AG, Owusu SK, Adjei S: Diabetes in Ghana: a community based prevalence study in Greater Accra. Diabetes Res Clin Pract 56:197–205, 2002
    1. World Health Organization: Diabetes and Non-Communicable Disease Risk Factor Surveys: A Field Guide. Geneva World Health Org., 1999. (WHO/NCD/NCS/99--1)
    1. World Health Organization: Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. Geneva, World Health Org., 2000. (Tech. Rep. Ser., no. 894)
    1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Follow up report on the diagnosis of diabetes mellitus. Diabetes Care 26:3160-3167, 2003
    1. Waterhouse I, Correa P, Muir C, Powell J: Cancer Incidence in Five Continents. Vol. III, Lyon, France IARC, 1976, p. 456
    1. Teuscher T, Rosman JB, Baillod P, Teuscher A: Absence of diabetes in a rural West African population with a high carbohydrate/cassava diet. Lancet 1:765-768, 1987
    1. Mbanya JC Ngogang J, Salah JN, Minkoulou E, Balkau B: Prevalence of NIDDM and impaired glucose tolerance in a rural and urban population in Cameroon. Diabetologia 40:824–829, 1997
    1. McLarty DG, Swai ABM, Kitange HM, Masuki G, Mtinangi BL, Kilima PM, Makene WJ, Chuwa LM, Alberti KGMM: Prevalence of diabetes and impaired glucosetolerance in rural Tanzania. Lancet 1:871–875, 1989
    1. Boronat M, Varillas VF, Saavedra P, Suarez V, Bosch E, Carrillo A, Novoa FJ: Diabetes mellitus and impaired glucose regulation in the Canary Islands (Spain): prevalence and associated factors in the adult population of Telde, Gran Canaria. Diabet Med 23:148–155, 2006
    1. Snijder MB, Zimmet PZ, Visser M, Dekker JM, Seidell JC, Shaw JE: Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study. Int J Obes Relat Metab Disord 28:402–409, 2004
    1. Kim SM, Lee JS, Lee J, Na JK, Han JH, Yoon DK, Baik SH, Choi DS, Choi KM: Prevalence of diabetes and impaired fasting glucose in Korea: Korean National Health and Nutrition Survey 2001. Diabetes Care 29:226–223, 2006

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir