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. 2019 Oct 17:16:30-41.
doi: 10.1016/j.eclinm.2019.09.001. eCollection 2019 Nov.

Type 2 diabetes complications and comorbidity in Sub-Saharan Africans

Kenneth Ekoru  1 , Ayo Doumatey  1 , Amy R Bentley  1 , Guanjie Chen  1 , Jie Zhou  1 , Daniel Shriner  1 , Olufemi Fasanmade  2 , Godfrey Okafor  3 , Benjamin Eghan Jr  4 , Kofi Agyenim-Boateng  4 , Jokotade Adeleye  5 , Williams Balogun  5 , Albert Amoah  6 , Joseph Acheampong  4 , Thomas Johnson  2 , Johnnie Oli  3 , Clement Adebamowo  7 , Francis Collins  8 , Georgia Dunston  9 , Adebowale Adeyemo  1 , Charles Rotimi  1
Affiliations

Type 2 diabetes complications and comorbidity in Sub-Saharan Africans

Kenneth Ekoru et al. EClinicalMedicine. .

Abstract

Background: Context-specific evidence of the spectrum of type 2 diabetes (T2D) burden is essential for setting priorities and designing interventions to reduce associated morbidity and mortality. However, there are currently limited data on the burden of T2D complications and comorbidity in sub-Saharan Africa (SSA).

Methods: T2D complications and comorbidities were assessed in 2,784 participants with diabetes enrolled from tertiary health centres and contextualised in 3,209 individuals without diabetes in Nigeria, Ghana and Kenya. T2D complications and comorbidities evaluated included cardiometabolic, ocular, neurological and renal characteristics.

Findings: The most common complications/comorbidities among the T2D participants were hypertension (71%; 95% CI 69-73), hyperlipidaemia (34%; 95% CI 32-36), and obesity (27%; 95% CI 25-29). Additionally, the prevalence of cataracts was 32% (95% CI 30-35), diabetic retinopathy 15% (95% CI 13-17), impaired renal function 13% (95% CI 12-15), and erectile dysfunction (in men) 35% (95% CI 32-38). T2D population-attributable fraction for these comorbidities ranged between 6 and 64%.

Interpretation: The burden of diabetes complications and comorbidity is substantial in SSA highlighting the urgent need for innovative public health strategies that prioritise promotion of healthy lifestyles for prevention and early detection of T2D. Also needed are strategies to strengthen health care system capacities to provide treatment and care for diabetes complications.

Keywords: Co-morbidity; Complications; Epidemiology; Sub-Sahara Africa; Type 2 Diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig 1
Fig. 1
Prevalence of selected comorbidities and complications of type 2 diabetes across sites in sub-Saharan Africa.
Fig 2
Fig. 2
Prevalence of selected comorbidities and complications of type 2 diabetes across sites in sub-Saharan Africa.
Fig 3
Fig. 3
Population-attributable fraction (PAF) of T2D cardiometabolic complications and comorbidities in sub-Saharan Africa: the AADM Study.
See this image and copyright information in PMC

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