How Serious is the Impact of Type II Diabetes in Rural Kenya?

Abstract

Over 50% of all adult hospital admissions and 55% of hospital deaths in Kenya are non-communicable, of which diabetes is among the leading. We aimed to describe the impact of type II diabetes at a rural community in Kenya. 200 healthy adult patients underwent random blood sucrose (RBS) testing after ethical approval by the Isiolo County Hospital. Diabetes was defined as RBS ≥11.1 mmol/l. A thorough history, physical examination and dipstick urinalysis for urine protein was done to identify risk factors and/or evidence of end organ damage. 32 patients (16%) had RBS ≥11.1 mmol/l. 12 patients (37.5%) never knew they were diabetic and those who knew 63% were not taking any medication. The most common risk factors were high fat diet (59.4%), sedentary lifestyle (46.8%) and family history of diabetes in first degree relative (37.5%). 43.7% of patients (n=14) had abdominal obesity while 21.9% (n=7) had various foot abnormalities. 8 patients (25%) had proteinuria of ≥ +1 on dipstick urinalysis. The 16% diabetes prevalence is among the highest recorded for a community living on ≤ 1 dollar/day. Further, evidence of end organ damage as depicted by massive proteinuria warrants urgent attention to this underprivileged group. It is hoped the results will form basis for future screening of diabetic nephropathy and other diabetes-related end organs involvement in this part of the world.

Prevalence of Diabetes Mellitus Type 2 and its Association with Demography, Socio-Economy and Nutritional Status for Women of Amagoro Division in Western Kenya

“…Participants who are unemployed are thrice more likely to suffer from DM2 as opposed to those in formal employment while those earning less than KES 5000 per month also stand higher chance of being diabetic than those on a higher income bracket. A similar finding was reported in Northern Kenya where low economic status was found to increase the risk for DM2 [21]. Being unemployed and thereby having low income may predispose an individual to depression or stress which has been shown to increase diabetes risk [29] possibly because people under stress may not take good care of themselves; they develop unhealthy lifestyle behaviors such as poor dietary habits in terms of quality and quantity of food, low exercise levels, smoking and alcohol abuse [30,31].…”

“…This could possibly be due to the cut-off values used which may not be appropriate for this population. Despite these findings, other studies conducted in different parts of Kenya involving different communities had established a positive association especially between abdominal obesity and DM2 [21,28]. Although they had low level of education, women in the FGDs were also aware of the link between excessive weight and a number of diseases including diabetes.…”

“…However, the prevalence in rural areas seems to be rising. Isiolo County, a rural population in Northern Kenya reported prevalence of 16% [21]. The rising prevalence could partly be due to increased awareness about the disease, improved diagnosis [25] and prevalence of human immunodeficiency virus (HIV)/AIDS [26] which was 6.4% in women of western Kenya in 2007 [24].…”

“…A prevalence of 12% and 16% has been reported in urban and rural Kenya respectively [3,21]. Due to such inconsistency in the results, more prevalence studies need to be conducted.…”

Adherence to Dietary Guidelines and Dietary Patterns of Type 2 Diabetic Patients in Moi Teaching and Referral Hospital, Kenya.

“…Type 2 diabetes mellitus (type 2 DM) is the most common form of diabetes in sub-Saharan Africa, constituting 90-95% of all cases of diabetes [6]. About 6% of adults in Ghana are affected with type 2 DM [7].…”