The non-fatal disease burden caused by type 2 diabetes in South Africa, 2009

Abstract

BackgroundIncreasing urbanisation and rising unhealthy lifestyle risk factors are contributing to a growing diabetes epidemic in South Africa. In 2000, a study estimated diabetes prevalence to be 5.5% in those aged over 30. Accurate, up-to-date information on the epidemiology and burden of disease due to diabetes and its sequelae is essential in the planning of health services for diabetes management.ObjectiveTo calculate the non-fatal burden of disease in Years Lost due to Disability (YLD) due to diabetes and selected sequelae in South Africa in 2009. YLD measures the equivalent loss of life due to ill-health.MethodsA series of systematic literature reviews identified data on the epidemiology of diabetes and its sequelae in South Africa. The data identified were then applied to Global Burden of Disease (GBD) methodology to calculate the burden attributable to diabetes.ResultsPrevalence of type 2 diabetes in South Africa in 2009 is estimated at 9.0% in people aged 30 and older, representing approximately 2 million cases of diabetes. We modelled 8,000 new cases of blindness and 2,000 new amputations annually caused by diabetes. There are 78,900 YLD attributed to diabetes, with 64% coming from diabetes alone, 24% from retinopathy, 6% from amputations, 9% from attributable stroke disability, and 7% from attributable ischemic heart disease disability.ConclusionWe estimate that the prevalence of diabetes is increasing in South Africa. Significant disability associated with diabetes is demonstrated. Some of the attributed burden can be prevented through early detection and treatment.

Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?

“…20 A recent study reported the prevalence of DM (age standardised) to be about 20% amongst Indians living in a suburb near Durban. 21 Despite a high prevalence amongst Indian patients, the current trend in South Africa is an increase of T2DM in the urban-based, Black South Africans and a much earlier diagnosis, 6 which is a new phenomenon.…”

“…4 A recent study showed the prevalence of T2DM amongst South Africans above 30 years of age to be at around 9%, with 7.4% in men and 10.4% in women. 6 Blood glucose monitoring is important in optimising long-term outcomes towards reducing the co-morbid conditions that may arise in patients with T2DM. There is strong epidemiological evidence to use glycated haemoglobin (HbA1c) <7% as the target level and patients with T2DM with an HbA1c level of > 7.5% have a 2.5 to 5-fold greater relative risk of developing microvascular complications.…”

Decreased total antioxidant levels and increased oxidative stress in South African type 2 diabetes mellitus patients

“…7,8 The prevalence study by Bertram et al reported a potential rise in type 2 diabetes mellitus in South Africa from 5.5% in 2000 to 9% in 2009 in people aged 30 or older since the previous approximations. 9 Secondary studies by Bertram et al furthermore revealed that in South Africa around 55% of cases remained undiagnosed. 9 In a cross-sectional survey of 642 participants aged ≥ 31 years from an urban South African coloured community in Bellville South, Cape Town, T2DM was evaluated using the World Health Organization (WHO) criteria.…”

Preventing diabetic blindness: A priority for South Africa

“…[1] It is of concern that about 55% of people with diabetes are likely to suffer from diabetic retinopathy. [2] Diabetes is the third leading cause of blindness in SA, with retinopathy and cataracts [2] accounting for 8 000 new cases of vision impairment every year. In a 2010 survey in Cape Town, diabetic retinopathy was responsible for 8% of blindness and 11% of severe visual impairment.…”

“…[3] In LMICs, including SA, diabetic blindness creates a poverty cycle that disables breadwinners and burdens caregivers. The fact that timely treatment of diabetic retinopathy can reduce the risk of visual impairment by 90% [2] implies a need for screening and early detection. The Ophthalmology Society of South Africa has recommended a strategy for diabetic retinopathy screening using a validated grading system, an internet-based database and tracking system, and a patient-held 'scorecard' .…”