Prevalence of abnormal glucose metabolism among adults attending an outpatient department at a tertiary referral hospital in Swaziland: a cross-sectional study

Abstract

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.

Epidemiology and Control of diabetes - tuberculosis comorbidity in Eswatini: protocol for the prospective study of tuberculosis patients on predictive factors, treatment outcomes and patient management practices

“…In Eswatini, literature on DM in the population and DM-TB comorbidity is scarce with easily accessible data being estimates by WHO and International Diabetes Federation (IDF). 25 Available studies have centred on HIV-NCD comorbidity and developing effective integration models to address the increasing cases of NCDs among HIV patients. 26 A 2020 study on the prevalence of abnormal blood glucose metabolism in adults indicated a 3.9% prevalence of type 2 DM (T2DM) in adults who attended the outpatient department of a tertiary hospital but no data is available on associated comorbidities with TB or HIV.…”

“…In Eswatini, literature on DM in the population and DM-TB comorbidity is scarce with easily accessible data being estimates by WHO and International Diabetes Federation (IDF) 25. Available studies have centred on HIV-NCD comorbidity and developing effective integration models to address the increasing cases of NCDs among HIV patients 26.…”

The prevalence of overweight/obesity and its association with household food insecurity among women living with HIV in rural Eswatini

“…In Eswatini, there has been a drastic increase in overweight and obesity rates over the past years, with women more overweight/obese than men [ 59 ]. Overweight and obesity have been found to be significant predictors of numerous NR-NCDs including type 2 diabetes mellitus, hypertension, cardiovascular disease, and certain cancers [ 1 , 60 , 61 ]. The increasing rates of overweight/obesity among WLHIV in rural households are disconcerting as they suggest an increased risk of NR-NCDs and further exacerbating challenges experienced by women in these communities [ 60 , 61 ].…”

“…Overweight and obesity have been found to be significant predictors of numerous NR-NCDs including type 2 diabetes mellitus, hypertension, cardiovascular disease, and certain cancers [ 1 , 60 , 61 ]. The increasing rates of overweight/obesity among WLHIV in rural households are disconcerting as they suggest an increased risk of NR-NCDs and further exacerbating challenges experienced by women in these communities [ 60 , 61 ]. With an increasing prevalence of overweight and obesity in food insecure households, there is a need to re-evaluate current strategies and develop multi-level targeted interventions that include prevention of excessive weight gain among women, particularly those living with HIV.…”

Modifiable risk factors associated with non-communicable diseases among adult outpatients in Manzini, Swaziland: a cross-sectional study

“…A detailed description of the examination procedures and the participants' characteristics has been provided elsewhere [16]. Briefly, 385 patients attending the OPD at Raleigh Fitkin Memorial Hospital in Manzini, Swaziland were included in the study.…”