Diabetes and Other Disorders of Glycemia in a Rural South African Community

Prevalence and associated risk factors

  1. Ayesha A. Motala, MD1,
  2. Tonya Esterhuizen, MSC2,
  3. Eleanor Gouws, MPH3,
  4. Fraser J. Pirie, MD1 and
  5. Mahomed A.K. Omar, MD1
  1. 1Department of Endocrinology University of KwaZulu-Natal, Durban, South Africa
  2. 2Medical Research Administration, University of KwaZulu-Natal, Durban, South Africa
  3. 3South African Medical Research Council, Durban, South Africa
  1. Corresponding author: Dr. Ayesha A. Motala, motala{at}ukzn.ac.za

Abstract

OBJECTIVE—The purpose of this study was to determine the prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), and associated risk factors in a rural South African black community.

RESEARCH DESIGN AND METHODS—This was a cross-sectional survey conducted by random cluster sampling of adults aged >15 years. Participants had a 75-g oral glucose tolerance test using the 1998 World Health Organization criteria for disorders of glycemia.

RESULTS—Of 1,300 subjects selected, 1,025 subjects (815 women) participated (response rate 78.9%). The overall age-adjusted prevalence of diabetes was 3.9%, IGT 4.8%, and IFG 1.5%. The prevalence was similar in men and women for diabetes (men 3.5%; women 3.9%) and IGT (men 4.6%; women 4.7%) but higher in men for IFG (men 4.0%; women 0.8%). The prevalence of diabetes and IGT increased with age both in men and women, with peak prevalence in the 55- to 64-year age-group for diabetes and in the ≥65-year age-group for IGT. Of the cases of diabetes, 84.8% were discovered during the survey. In multivariate analysis, the significant independent risk factors associated with diabetes included family history (odds ratio 3.5), alcohol ingestion (2.8), waist circumference (1.1), systolic blood pressure (1.0), serum triglycerides (2.3), and total cholesterol (1.8); hip circumference was protective (0.9).

CONCLUSIONS—There is a moderate prevalence of diabetes and a high prevalence of total disorders of glycemia, which suggests that this community, unlike other rural communities in Africa, is well into an epidemic of glucose intolerance. There is a low proportion of known diabetes and a significant association with potentially modifiable risk factors.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 3 June 2008.

    E.G. is currently affiliated with UNAIDS, Geneva, Switzerland.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted May 21, 2008.
    • Received January 29, 2008.
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This Article

  1. Diabetes Care vol. 31 no. 9 1783-1788
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