Demographic stratification of Type 2 diabetes and comorbidities in district healthcare in KwaZulu-Natal

Abstract

Background: Diabetes has been reported as the second leading cause of death and the top leading cause of death amongst women in South Africa; it is important to evaluate any epidemiological or demographic transition related to diabetes. This study evaluated the demographically stratified prevalence of type 2 diabetes mellitus (T2DM) and existing comorbidities amongst an outpatient population in a district healthcare facility in Kwazulu-Natal (KZN).Methods: This retrospective cross-sectional study was conducted at a district hospital, and a retrospective record review of all outpatients who reported to the hospital to be treated for T2DM between the period, August 2018–January 2019, was used. Data, such as age, sex, ethnicity and any coexisting morbidity, were collected from outpatient hospital registers and electronically captured using a record review tool.Results: There were significantly more female patients (3072) compared to male patients (1050) (p 0.001) with a mean age of 59.21 years. Hypertension (77.9%) and cardiovascular problems (11.16%) were most frequent. Approximately 84% of women presented with T2DM and either one or two morbidities simultaneously. Female patients were at significantly higher risk of presenting with hypertension (odds ratio [OR] = 1.44, 95% confidence interval [CI]: 1.20;1.71), whilst their risk for cardiovascular problems was significantly lower compared to male patients (OR = 0.67, 95% CI: 0.54;0.83).Conclusion: The prevalence of T2DM and comorbidities differed by demographic factors, such as sex, ethnicity and age. There is a need for flexible and adaptive approaches for the prevention and management of T2DM cases in order to allocate medical resources efficiently and according to the true burden of disease because of T2DM complications.

Gambaran Penyakit Penyerta pada Pasien Diabetes Mellitus Tipe-2 Lanjut Usia di RSUP Dr. M. Djamil Padang Periode Januari 2020 – Januari 2021

“…(2021) yang menemukan penyakit psikis pada pasien DM tipe-2 sebesar 2,81%. 31 Pada penelitian ini, penyakit lain-lainnya merupakan beberapa penyakit yang tidak dapat dikelompokkan ke jenis penyakit penyerta di atas, seperti katarak, kanker, fraktur, osteoartritis, psoriasis, dan lain sebagainya sehingga didapatkan persentasenya sebesar 4,2%.…”

“…yang memperlihatkan bahwa pada pasien diabetes mellitus tipe-2 lanjut usia dengan penyakit penyerta yakni hipertensi lebih tinggi ditemukan pada kelompok umur 65-74 tahun dari pada kelompok umur lainnya dan lebih banyak diderita oleh pasien berjenis kelamin perempuan. 31 Jenis penyakit penyerta terbanyak yang ditemukan pada pasien DM tipe-2 lanjut usia kelompok umur 70-79 tahun adalah penyakit infeksi. Berdasarkan jenis kelamin, jenis penyakit penyerta infeksi ini lebih banyak ditemukan pada pasien DM tipe-2 lanjut usia laki-laki dibandingkan perempuan.…”

Regional prevalence of hypertension among people diagnosed with diabetes in Africa, a systematic review and meta-analysis

“…Studies were representative of the five regions in Africa. There were more studies conducted in East (n = 15) [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], West (n = 10) [35][36][37][38][39][40][41][42][43][44], North (n = 4) [45][46][47][48], Central (n = 2) [49,50] and South Africa (n = 10) [51][52][53][54][55][56][57][58][59][60]. The included studies were published between 2002 and 2022 and the summary of findings is shown in Table 1.…”

Effect of COVID-19 lockdown on glycated haemoglobin testing and utilisation in KwaZulu-Natal, South Africa

“…4 The burden of diabetes mellitus in KwaZulu-Natal is increasing, and poor glycaemic control is a major contributor to this. 5 , 6 The Society for Endocrinology, Metabolism and Diabetes of South Africa’s 2017 guidelines define optimal glycaemic control as glycated haemoglobin (HbA1c) levels < 53 mmol/mol (< 7.0%), which is in keeping with global recommendations. 3 Only 8.3% of diabetic patients attending a regional hospital in KwaZulu-Natal and 5.3% of diabetic patients managed at a central hospital in KwaZulu-Natal achieved optimal glycaemic control.…”