Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012;7(9):e43336.
doi: 10.1371/journal.pone.0043336. Epub 2012 Sep 4.

Rising diabetes prevalence among urban-dwelling black South Africans

Nasheeta Peer  1 , Krisela Steyn, Carl Lombard, Estelle V Lambert, Bavanisha Vythilingum, Naomi S Levitt
Affiliations

Rising diabetes prevalence among urban-dwelling black South Africans

Nasheeta Peer et al. PLoS One. 2012.

Abstract

Objective: To examine the prevalence of and the association of psychosocial risk factors with diabetes in 25-74-year-old black Africans in Cape Town in 2008/09 and to compare the prevalence with a 1990 study.

Research design and methods: A randomly selected cross-sectional sample had oral glucose tolerance tests. The prevalence of diabetes (1998 WHO criteria), other cardiovascular risk factors and psychosocial measures, including sense of coherence (SOC), locus of control and adverse life events, were determined. The comparison of diabetes prevalence between this and a 1990 study used the 1985 WHO diabetes criteria.

Results: There were 1099 participants, 392 men and 707 women (response rate 86%). The age-standardised (SEGI) prevalence of diabetes was 13.1% (95% confidence interval (CI) 11.0-15.1), impaired glucose tolerance (IGT) 11.2% (9.2-13.1) and impaired fasting glycaemia 1.2% (0.6-1.9). Diabetes prevalence peaked in 65-74-year-olds (38.6%). Among diabetic participants, 57.9% were known and 38.6% treated. Using 1985 WHO criteria, age-standardised diabetes prevalence was higher by 53% in 2008/09 (12.2% (10.2-14.2)) compared to 1990 (8.0% (5.8-10.3)) and IGT by 67% (2008/09: 11.7% (9.8-13.7); 1990: 7.0% (4.9-9.1)). In women, older age (OR: 1.05, 95%CI: 1.03-1.08, p<0.001), diabetes family history (OR: 3.13, 95%CI: 1.92-5.12, p<0.001), higher BMI (OR: 1.44, 95%CI: 1.20-1.82, p = 0.001), better quality housing (OR: 2.08, 95%CI: 1.01-3.04, p = 0.047) and a lower SOC score (≤ 40) was positively associated with diabetes (OR: 2.57, 95%CI: 1.37-4.80, p = 0.003). Diabetes was not associated with the other psychosocial measures in women or with any psychosocial measure in men. Only older age (OR: 1.05, 95%CI: 1.02-1.08, p = 0.002) and higher BMI (OR: 1.10, 95%CI: 1.04-1.18, p = 0.003) were significantly associated with diabetes in men.

Conclusions: The current high prevalence of diabetes in urban-dwelling South Africans, and the likelihood of further rises given the high rates of IGT and obesity, is concerning. Multi-facetted diabetes prevention strategies are essential to address this burden.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: NL has received honoraria from Novartis for serving on the steering committee for the Navigator Trial and travel support from Novo Nordisk, Eli Lilly Laboratories and Sanofi Aventis. All other authors report no potential conflicts of interest, including specific financial interests, relevant to the subject of this manuscript. This study was partially funded by a commercial source (Servier Laboratories [South Africa]). This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Prevalence of glycaemic categories based on 1998 WHO criteria presented by age categories.
Footnote: IFG: impaired fasting glycaemia; IGT: impaired glucose tolerance.
Figure 2
Figure 2. Diabetes prevalence based on 1985 WHO criteria presented by age categories for men and women in 1990 and 2008/09.
Footnote: *1990: 65+ years, 2008/09: 65–74 years.
See this image and copyright information in PMC

References

    1. Mbanya JC, Motala AA, Sobngwi E, Assah FK, Enoru ST (2010) Diabetes in sub-Saharan Africa. Lancet 375: 2254–2266. - PubMed
    1. Levitt NS (2008) Diabetes in Africa: epidemiology, management and healthcare challenges. Heart 94: 1376–1382. - PubMed
    1. Bradshaw D, Norman R, Pieterse D, Levitt NS (2007) Estimating the burden of disease attributable to diabetes in South Africa in 2000. S Afr Med J 97: 700–706. - PubMed
    1. Levitt NS, Katzenellenbogen JM, Bradshaw D, Hoffman MN, Bonnici F (1993) The prevalence and identification of risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care 16: 601–607. - PubMed
    1. Mensah GA, Mokdad AH, Ford E, Narayan KM, Giles WH, et al. (2004) Obesity, metabolic syndrome, and type 2 diabetes: emerging epidemics and their cardiovascular implications. Cardiol Clin 22: 485–504. - PubMed

Publication types

MeSH terms