Background: Four major non-communicable diseases (NCD), including T2DM, contributed to nearly three-quarters of all deaths worldwide in 2017. Dietary and lifestyle actors associated with NCDs are potentially modifiable. Therefore, this study was conducted to determine the dietary and lifestyle factors associated with T2DM, prediabetes, and hypertension among adult outpatients in Manzini, Swaziland. Methods: A random sample of 385 subjects aged 18 years and above was selected. The data regarding demographics, socioeconomic status, lifestyle behaviour, diet, and physical activities were collected. Additionally, participants' anthropometric measurements and vital signs were taken. A biochemical examination was done for fasting plasma glucose, and a 2-h oral glucose tolerance test, where necessary. The Statistical Package for Social Sciences (SPSS) version 26 was used for this data analysis, and the level of statistical significance was set at p < 0.05. Results: A total of 385 (197 men and 188 women) subjects aged 18 years and older participated in the study. The overall prevalence of hypertension was 48.3%, while the prevalence of hypertension stage 1 and 2 were 29.4 and 19%, respectively. Smoking, SES and consumption of sweet drinks, salty processed foods, fruits, and vegetables were significantly associated with T2DM. However, in the multivariate analysis, only consumption of vegetables (p < 0.0001), fruits (p =0.014), sweet drinks (p = 0.042), and salty processed foods (p = 0.005) remained significantly associated with T2DM. Smoking (p = 0.002) and consumption of fruits (p < 0.0001), vegetables (p < 0.0001), and sweet drinks (p = 0.043) were independently associated with pre-diabetes, while the consumption of vegetables (p = 0.002) and salty processed foods (p = 0.003) were the factors independently associated with hypertension. Conclusions: The factors associated with T2DM, pre-diabetes, and hypertension are potentially modifiable. Therefore, interventions which target lifestyle changes at primary health care and population levels are warranted to address the growing burden of these chronic conditions in Swaziland.

Background: The exact prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes in Swaziland remains unknown. Estimates suggest that the prevalence rate of type 2 diabetes mellitus is between 2.5 and 6.0% in Swaziland. The disparity in these estimates is due to a lack of quality data but the prevalence of diabetes is increasing in Swaziland. This study estimates the prevalence of type 2 diabetes mellitus and pre-diabetes among patients in a tertiary hospital in Manzini, Swaziland. Methods: A cross-sectional observational survey was used to estimate the crude and age-adjusted prevalence rates of diabetes and pre-diabetes (impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)) in the Manzini regional referral hospital of Swaziland. Diabetes was defined as a fasting blood glucose (FBG) ≥ 7.0 mmol/L (126 mg/dL) and pre-diabetes was defined as an FBG of 6.1-6.9 mmol/L (110-125 mg/dL) and an FBG < 7.0 mmol/L (< 126 mg/dL), respectively for IFG and IGT. A random sample of 385 participants was used. Data analysis was done using SPSS version 26 and the level of statistical significance was set at α < 0.05. Results: The crude prevalence of type 2 diabetes mellitus and pre-diabetes was 7.3% [95% CI 4.9-10.3] and 6.5% [95% CI 4.2-9.4], respectively, with clear gender differences in the prevalence of diabetes (men 1.6% vs women 5.7%, p = 0.001). On the other hand, significantly more men (3.6%) had pre-diabetes than women (2.9%) (p = 0.004). The overall age-adjusted prevalence rates of type 2 diabetes mellitus and pre-diabetes were 3.9 and 3.8%, respectively. Among the diabetic group, 3 (10.7%) had known T2DM, whereas 25 (89.3%) were newly diagnosed during the study. Advancing age, gender, raised blood pressure, abnormal body mass index, and wealth index were significant risk factors for T2DM or prediabetes. Conclusion: The prevalence of type 2 diabetes mellitus among adult outpatients in the Raleigh Fitkin Memorial hospital was higher than previously reported in the health facility in Manzini; suggesting the need for routine T2DM screening at outpatient departments.