Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis

Carmen Pheiffer, Victoria Pillay-van Wyk, Eunice Turawa, Naomi Levitt, Andre P Kengne, Debbie Bradshaw, Carmen Pheiffer, Victoria Pillay-van Wyk, Eunice Turawa, Naomi Levitt, Andre P Kengne, Debbie Bradshaw

Abstract

Synthesis of existing prevalence data using rigorous systematic review methods is considered an effective strategy to generate representative and robust prevalence figures to inform health planning and policy. The purpose of this systematic review was to identify, collate, and synthesise all studies reporting the prevalence of total and newly diagnosed type 2 diabetes (T2DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in South Africa. Four databases, PubMed, Scopus, Web of Science, and African Index Medicus were searched for articles published between January 1997 and June 2020. A total of 1886 articles were identified, of which 11 were included in the meta-analysis. The pooled prevalence in individuals 25 years and older was 15.25% (11.07-19.95%) for T2DM, 9.59% (5.82-14.17%) for IGT, 3.55% (0.38-9.61%) for IFG, and 8.29% (4.97-12.34%) for newly diagnosed T2DM. Although our pooled estimate may be imprecise due to significant heterogeneity across studies with regard to population group, age, gender, setting, diagnostic test, and study design, we provide evidence that the burden of glucose intolerance in South Africa is high. These factors contribute to the paucity of representative T2DM prevalence data. There is a need for well-designed epidemiological studies that use best-practice and standardised methods to assess prevalence.

Keywords: South Africa; impaired fasting glucose; impaired glucose tolerance; newly diagnosed diabetes; prevalence; type 2 diabetes mellitus.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing selection of studies for inclusion in the systematic review.
Figure 2
Figure 2
Forest plot of T2DM prevalence. Data are represented as the crude prevalence and 95% CI. EC, Eastern Cape; KZN, KwaZulu Natal; WC, Western Cape. NR, Not Reported.
Figure 3
Figure 3
T2DM prevalence in females (A) and males (B).
Figure 3
Figure 3
T2DM prevalence in females (A) and males (B).
Figure 4
Figure 4
T2DM prevalence across age categories.

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