Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis

Wyk, Victoria Pillay-van; Turawa, E B; Levitt, Naomi; Kengne, André Pascal; Bradshaw, Debbie

doi:10.3390/ijerph18115868

Cited by 53 publications

(43 citation statements)

References 46 publications

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“…This is especially true for hypertension, which is reported to have a higher prevalence in the country (46% women and 44% men) vs. 14% in this survey ( 42 ). Similarly, our estimate for diabetes was 4%, while a recent systematic review reported the prevalence of diabetes in South Africa to be close to 15% for people aged 25 years and older ( 43 ). The lower multimorbidity prevalence may be linked to how questions about self-reported disease conditions were asked.…”

Section: Discussionsupporting

confidence: 69%

Multimorbidity Patterns in a National HIV Survey of South African Youth and Adults

Roomaney

Wyk

Cois

et al. 2022

Front. Public Health

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IntroductionInformation pertaining to multimorbidity is frequently informed by studies from high income countries and it is unclear how these findings relate to low and middle income countries, where the burden of infectious disease is high. South Africa has a quadruple burden of disease which includes a high HIV prevalence and a growing burden of non-communicable diseases. This study aimed to analyse the prevalence and patterns (disease classes or clusters) of multimorbidity in South Africa.MethodsA secondary analysis of individuals over the age of 15 years who participated in the Fifth South African National HIV Prevalence, Incidence, Behavior and Communication Survey, 2017 (SABSSM 2017) was done. Six disease conditions were identified in the analysis (cancer, diabetes, heart disease, hypertension/high blood pressure, tuberculosis, and HIV). Chi-square tests were used to test for the differences in disease prevalence by sex. Common disease patterns were identified using a latent class analysis.ResultsThe sample included 27,896 participants, of which 1,837 had comorbidity or multimorbidity. When taking population-weighting into account, multimorbidity was present in 5.9% (95% CI: 5.4–6.4) of the population The prevalence of multimorbidity tended to be higher among females and increased with age, reaching 21.9% in the oldest age group (70+). The analyses identified seven distinct disease classes in the population. The largest class was “Diabetes and Hypertension” (36.3%), followed by “HIV and Hypertension” (31.0%), and “Heart disease and Hypertension” (14.5%). The four smaller classes were: “HIV, Diabetes, and Heart disease” (6.9%), “TB and HIV” (6.3%), “Hypertension, TB, and Cancer” (2.8%), and “All diseases except HIV” (2.2%).ConclusionAs the South African population continues to age, the prevalence of multimorbidity is likely to increase which will further impact the health care system. The prevalence of multimorbidity in the population was relatively low but reached up to 20% in the oldest age groups. The largest disease cluster was the combination of diabetes and hypertension; followed by HIV and hypertension. The gains in improving adherence to antiretrovirals amongst treatment-experienced people living with HIV, should be expanded to include compliance with lifestyle/behavioral modifications to blood pressure and glucose control, as well as adherence to anti-hypertension and anti-diabetic medication. There is an urgent need to improve the early diagnosis and treatment of disease in the South African population.

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Section: Discussionsupporting

confidence: 69%

Multimorbidity Patterns in a National HIV Survey of South African Youth and Adults

Roomaney

Wyk

Cois

et al. 2022

Front. Public Health

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“…The limited national data on FPG and the prevalence of diabetes in South Africans [11] meant that we had to model estimates from the few available national surveys and some small-area studies that used different methods to identify individuals with high FPG and diabetes (Table 1, and Table S1 in the appendix: https://www.samedical.org/ file/1846). The model allowed for differences by population group, with urban and rural categories for black Africans to allow for changes in urbanisation in this group during the study time period; other population groups had high urban proportions throughout the period.…”

Section: Researchmentioning

confidence: 99%

Estimating the changing burden of disease attributable to high fasting plasma glucose in South Africa for 2000, 2006 and 2012

van-Wyk

Cois²,

Kengne³

et al. 2022

S Afr Med J

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Background. Worldwide, higher-than-optimal fasting plasma glucose (FPG) is among the leading modifiable risk factors associated with all- cause mortality and disability-adjusted life years (DALYs) due to the direct sequelae of diabetes and the increased risk for cardiovascular and chronic kidney disease. Objectives. To report deaths and DALYs of health outcomes attributable to high FPG by age and sex for South Africa (SA) for 2000, 2006 and 2012. Methods. Comparative risk assessment methodology was used to estimate the burden attributable to high FPG. A meta-regression analysis was performed using data from national and small-area studies to estimate the population distribution of FPG and diabetes prevalence. Attributable fractions were calculated for selected health outcomes and applied to local burden estimates from the second South African National Burden of Disease Study (SANBD2). Age-standardised rates were calculated using World Health Organization world standard population weights. Results. We estimated a 5% increase in mean FPG from 5.31 (95% confidence interval (CI) 5.18 - 5.43) mmol/L to 5.57 (95% CI 5.41 - 5.72) mmol/L and a 75% increase in diabetes prevalence from 7.3% (95% CI 6.7 - 8.3) to 12.8% (95% CI 11.9 - 14.0) between 2000 and 2012. The age-standardised attributable death rate increased from 153.7 (95% CI 126.9 - 192.7) per 100 000 population in 2000 to 203.5 (95% CI 172.2 - 240.8) per 100 000 population in 2012, i.e. a 32.4% increase. During the same period, age-standardised attributable DALY rates increased by 43.8%, from 3 000 (95% CI 2 564 - 3 602) per 100 000 population in 2000 to 4 312 (95% CI 3 798 - 4 916) per 100 000 population in 2012. In each year, females had similar attributable death rates to males but higher DALY rates. A notable exception was tuberculosis, with an age-standardised attributable death rate in males double that in females in 2000 (14.3 v. 7.0 per 100 000 population) and 2.2 times higher in 2012 (18.4 v. 8.5 per 100 000 population). Similarly, attributable DALY rates were higher in males, 1.7 times higher in 2000 (323 v. 186 per 100 000 population) and 1.6 times higher in 2012 (502 v. 321 per 100 000 population). Between 2000 and 2012, the age-standardised death rate for chronic kidney disease increased by 98.3% (from 11.7 to 23.1 per 100 000 population) and the DALY rate increased by 116.9% (from 266 to 578 per 100 000 population). Conclusion. High FPG is emerging as a public health crisis, with an attributable burden doubling between 2000 and 2012. The consequences are costly in terms of quality of life, ability to earn an income, and the economic and emotional burden on individuals and their families. Urgent action is needed to curb the increase and reduce the burden associated with this risk factor. National data on FPG distribution are scant, and efforts are warranted to ensure adequate monitoring of the effectiveness of the interventions.

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“…The country is faced with a growing burden of HBP, concurrent with a rapid increase of T2D (i.e., raised glucose levels), another major source of morbidity and mortality, collectively owing to epidemiological transition, poor diets and inactive lifestyle [32][33][34]. T2D pooled prevalence of 15.25% has been reported in South Africans aged 25 years and older, irrespective of certain demographic factors, as well as diagnostic test and study design [35]. T2D and HBP overlap in the population and in most cases, the advancement of hypertension and T2D advance with time [26].…”

Section: Introductionmentioning

confidence: 99%

Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa

et al. 2022

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Despite the occupational nature of truckers predisposing them to cardiovascular diseases and risk factors, data is scarce on their prevalence of obesity and its association with developing hypertension (HBP) and diabetes in South Africa. Extracted from the original cross-sectional study of a sample of 312 employees in a logistics company, a census of 96 male truckers was used to determine the prevalence of obesity and its association with HBP and diabetes. WHO STEPwise approach was used to collect data, including systolic (SBP) and diastolic (DBP) blood pressure and anthropometry measurements. HBP is defined as SBP/DBP ≥ 140/90 mmHg, overweight/obesity as BMI ≥ 25 kg/m2, abdominal obesity by waist circumference as WC ≥ 90cm, waist-to-hip-ratio as WHR ≥ 0.90, and waist-to-height ratio as WHtR ≥ 0.5. Data were analysed using SPSS 22. The mean age of truckers was 46 years, 29% were smokers, and 57% alcohol users, while 26% were physically inactive. The prevalence of overweight (44%) and obesity (30%) were observed, while abdominal obesity was high; WC (59%), WHR (65%), and WHtR (80%). HBP (57%) was prevalent and diabetes was 14%. The odds of developing HBP were high for obese truckers by WC [AOR = 4.68; CI = 1.92–11.34)] and by WHtR [AOR = 5.49 CI = 1.74–17.27), while diabetes was associated with WHR (AOR = 1.19; CI = 1.19–31.21). This study showed an associative link between obesity, HBP, and diabetes among the truckers, which is informative for a relevant prevention programme tailored to their needs.

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Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis

Cited by 53 publications

References 46 publications

Multimorbidity Patterns in a National HIV Survey of South African Youth and Adults

Multimorbidity Patterns in a National HIV Survey of South African Youth and Adults

Estimating the changing burden of disease attributable to high fasting plasma glucose in South Africa for 2000, 2006 and 2012

Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa

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