Modifiable and emerging risk factors for type 2 diabetes in Africa: a systematic review and meta-analysis protocol

Abstract

BackgroundType 2 diabetes mellitus (T2DM) remains a public health problem in low-income countries, including African countries. Risk factors of this disease in Africa are still unclear. This study will examine the modifiable and emerging risk factors associated with T2DM in Africa.MethodologyThe study will include a systematic review and meta-analysis of published and unpublished empirical studies, reporting quantitative data only. We will conduct a search on scientific databases (e.g. Global Health), general online search engines (e.g. Google Scholar) and key websites for grey literature using a combination of key countries/geographic terms, risk factors (e.g. overweight/obesity) and T2DM (including a manual search of the included reference lists). We will use the Comprehensive Meta-Analysis Software (CMA) version 2.0 for data management and analysis. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P).DiscussionThe systematic review and meta-analysis will provide a robust and reliable evidence base for policy makers and future research. This may help with identifying and implementing more cost-effective diabetes prevention strategies and improved resource allocation.Systematic review registrationThis protocol has been registered with the PROSPERO international prospective register of systematic reviews. The reference number is CRD42016043027.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0801-y) contains supplementary material, which is available to authorized users.

Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future

“…This needs to be urgently addressed given the morbidity, mortality, and costs associated with diabetes (Glover et al, 2012;Glezeva et al, 2015;Low Wang et al, 2016;Atun et al, 2017;Adibe et al, 2018;Lewis et al, 2018;Pheiffer et al, 2018;Rwegerera et al, 2018;Mapa-Tassou et al, 2019). Eighty percent of early deaths due to non-communicable diseases (NCDs) including diabetes and cardiovascular diseases (CVD) currently occur in lower and middle income countries (LMICs), with the morbidity and mortality of diabetes and other NCDs such as CVD likely to be greater than communicable disease by 2025 (Peer et al, 2014;Renzaho, 2015;Issaka et al, 2018). Overall, SSA currently has the highest rate of morbidity and mortality associated with diabetes world-wide (Pastakia et al, 2017).…”

“…This includes appraising key issues associated with co-morbidities with infectious diseases such as HIV and the resultant implications. There have been a number of systematic reviews looking at key issues surrounding the management of patients with diabetes in Africa including initiatives to strengthen healthcare systems (Brouwer et al, 2015;Atun et al, 2017;Hill et al, 2017;Issaka et al, 2018;Jaam et al, 2017;Nuche-Berenguer and Kupfer, 2018;Ong et al, 2018;Owolabi et al, 2018;Stephani et al, 2018;Wagnew et al, 2018;Asmelash and Asmelash, 2019;Manne-Goehler et al, 2019). We are also aware of the recent NCD research conference for Africa to share evidence and identifying research priorities (Juma et al, 2019).…”

Postprandial Metabolism is Impaired in Overweight Normoglycemic Young Adults without Family History of Diabetes

“…Insulin resistance is the early sign towards the onset of T2DM in most of the individuals. Risk factors such as obesity, physical inactivity, high fat-high calorie diet, tobacco, and more than moderate alcohol consumption can worsen an underlying genetic susceptibility for T2DM in insulin-resistant subjects 2 . The response of β-cells to insulin resistance is to increase insulin secretion to maintain normal glucose levels, resulting in hyperinsulinemia.…”

The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis

“…Figure 1 depicts the PRISMA ow chart. The protocol for this study has been previously published [3] and is registered with PROSPERO (Registration number CRD42016043027).…”

“…East vs West Africa) [4], as well as countries of common or different spoken language (e.g. French vs. English speakers) [3]. Comparative gures show that while the prevalence of diabetes in other continents is expected to increase by between 15% (Western Paci c) and 84% (South East Asia) from 2017 to 2045, the prevalence in Africa is predicted to increase by 156% within the same period [4].…”