Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Abstract

While communicable diseases such as human immunodeficiency virus/acquired immune deficiency syndrome, malaria, and tuberculosis have continued to pose greater threats to the public health system in sub-Saharan Africa (SSA), it is now apparent that non-communicable diseases such as diabetes mellitus are undoubtedly adding to the multiple burdens the peoples in this region suffer. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes (90-95%), exhibiting an alarming prevalence among peoples of this region. Its main risk factors include obesity, rapid urbanization, physical inactivity, ageing, nutrition transitions, and socioeconomic changes. Patients in sub-Saharan Africa also show manifestations of beta-cell dysfunction and insulin resistance. However, because of strained economic resources and a poor health care system, most of the patients are diagnosed only after they have overt symptoms and complications. Microvascular complications are the most prevalent, but metabolic disorders and acute infections cause significant mortality. The high cost of treatment of T2DM and its comorbidities, the increasing prevalence of its risk factors, and the gaps in health care system necessitate that solutions be planned and implemented urgently. Aggressive actions and positive responses from well-informed governments appear to be needed for the conducive interplay of all forces required to curb the threat of T2DM in sub-Saharan Africa. Despite the varied ethnic and transitional factors and the limited population data on T2DM in sub-Saharan Africa, this review provides an extensive discussion of the literature on the epidemiology, risk factors, pathogenesis, complications, treatment, and care challenges of T2DM in this region.

Levels and Predictors of Adherence to Self-care Behaviour among Adult Type 2 Diabetics at Arba Minch General Hospital, Southern Ethiopia

“…Over the next 20 years, the developed world will see an increase of 20% in the number of adults living with diabetes and developing countries will see an increase of 69% [8,9]. Type 2 diabetes prevalence among 20-79-year-olds in African region is 4.9% with the majority of people with diabetes <60 years old [10]. Hence Sub-Saharan Africa faces a double burden of providing adequate care for both infectious diseases like malaria, tuberculosis and non-communicable diseases (NCDs) like diabetes and hypertension [11,12].…”

Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

“…Overweight or obesity, hypertension, and smoking have been identified as independent risk factors to diabetes in previous studies in Africa [7][8][9][10] positively and healthy [19,22,23]. The increasing level of obesity in Africa has been attributed to the changing demographic dynamics, urbanization, poverty, nutrition transition and changing lifestyles [12,23,24].…”

“…The increasing level of obesity in Africa has been attributed to the changing demographic dynamics, urbanization, poverty, nutrition transition and changing lifestyles [12,23,24]. Obesity is also associated with an increase in the body's energy requirement hence the associated increase in blood glucose and saturated fatty acids and possibly insulin resistance [25].…”

Stroke in type 2 diabetes mellitus patients admitted to emergency unit in Central African country (Congo): Preliminary findings

“…It is recognized that the major hyperglycemia is pejorative in the acute stage of cardiovascular complications of T2DM [7]. It plays also a role in the early development of complications [8]. The specificity of this major hyperglycemia in the black people is the presence of ketosis, thus defining the ketosis prone T2DM [1,9].…”

“…It is certain that the achievement of CT scan improves the initial emergency treatment and prognosis [14]. The poor glycemic control in patients contributes to the early onset of complications including stroke [8], and alters the prognosis [7] what motivated the transfer resuscitation in a large number in our series. In addition, the social level of patients limit access to care [6].…”