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What Drives Type 2 Diabetes in Sub-Saharan Africa?

- FHS Communications, Raylton Chikwati, Nigel Crowther, Michèle Ramsay, Lisa Micklesfield, Shane Norris, Alisha Wade

Insights from the AWI-Gen Study of Adults Aged 40-6

Poorly controlled type 2 diabetes can, over time, lead to several other health complications. Person with diabetes have double the risk of heart and kidney disease compared to the general population, and it frequently leads to eye, blood vessel and nerve damage.

Study overview

In the first- its kind  longitudinal study in sub-Saharan Africa, data from 10,702 participants showed the progression of type 2 diabetes at a much higher rate than initially predicted. In six years, the prevalence of type 2 diabetes doubled in a group of middle-aged people in South Africa, Kenya, Ghana and Burkina Faso. 

While initial estimations were that about 6 percent the population of sub-Saharan Africa will have diabetes by 2045 (about 60 million people), this study shows the prevalence is already 10.9%. 

“While all sites in the region showed a doubling in prevalence of type 2 diabetes during the study period, there are still marked differences between the countries. South Africa had the highest incidence of the disease, followed by East Africa and then West Africa,” says co-author Dr Raylton Chikwati, a postdoctoral fellow affiliated with Wits University’s Sydney Brenner Institute for Molecular Bioscience (SBIMB) and the Developmental Pathways to Health Research Unit (DPHRU). 

Key Findings

Chikwati notes that urban communities experienced higher rates of type 2 diabetes and those “at a later stage of epidemiological transition.” In epidemiological transition, chronic illnesses like heart disease, cancer, obesity and diabetes replace infectious diseases as leading causes of death. This shift often parallels economic development and rural-to-urban population migration. 

The study showed that several other baseline factors, such as body mass index, waist circumference, high triglycerides and glucose, lack of exercise, unemployment, hypertension, and a family history of type 2 diabetes significantly increase the risk of developing the disease.

As the prevalence of type 2 diabetes increases, context-specific interventions are needed to address its risk factors.

Original Article In: Lancet

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