Cardiovascular Complications of Diabetes Mellitus in Sub-Saharan Africa

Abstract

Background-Cardiovascular disease, the major cause of mortality and morbidity in modern societies, is set to overtake infectious diseases in the developing world as the most common cause of death. The increasing prevalence of major and emerging cardiovascular risk factors accounts for the growing burden of cardiovascular disease in the world. Diabetes in all its forms is one of the main cardiovascular risk factors. Two of 3 diabetic patients will die as a result of cardiovascular complications, and approximately 30% of patients treated in cardiovascular intensive care units have diabetes. Methods and Results-This review on the cardiovascular complications of diabetes in sub-Saharan Africa is a bibliographical MEDLINE search of published data over the past 2 decades. Diabetes-related cardiovascular disease complications are considered to be rare in Africa but are on the rise and are regularly associated with classic cardiovascular risk factors. Coronary heart disease may affect 5% to 8% of type 2 diabetic patients and cardiomyopathy, up to 50% of all patients. Close to 15% of patients with stroke have diabetes, and up to 5% of diabetic patients present with cerebrovascular accidents at diagnosis. Peripheral vascular disease prevalence varies across sites from 4% to 28%. Conclusions-It is obvious that diabetes mellitus and related cardiovascular complications are gaining more importance in sub-Saharan Africa. The relative contribution of putative risk factors is not well defined, and further research is therefore needed.

Diabetes care and complications in primary care in the Tshwane district of South Africa

“…(5) Various studies conducted in South Africa, Nigeria, Ghana, Cameroon and Tanzania and others, as well as review articles on diabetes in Africa, confirm both the increase in prevalence and the changing epidemiology of diabetes complications. (3,4,(6)(7)(8) The Burden of Disease study group (9) estimated in 2000 that 5.5% of South Africans aged ≥ 30 years had diabetes, and that 4.3% of all deaths in South Africa were due to diabetes. Furthermore, 14% of ischaemic heart disease, 10% of stroke, 12% of hypertensive disease and 12% of renal disease were attributable to diabetes.…”

Exercise Training Reduces Central Adiposity and Improves Metabolic Indices in HAART-Treated HIV-Positive Subjects in Rwanda: A Randomized Controlled Trial

“…Subsequently, there is a growing concern that CVD and diabetes risks, the main causes of morbidity and mortality in the developed world, may emerge, along with infectious diseases, as significant health concerns in HIV + individuals in sub-Saharan countries. 15 Cardiorespiratory exercise training (CET) is an established, cost-effective, and efficacious lifestyle modification that improves insulin sensitivity 16 and dyslipidemia 17 and reduces central adiposity or trunk fat, 18 leading to an improved cardiovascular and diabetic risk profile in HIV + individuals from Western countries. 19 Consequently, regular CET has been recommended in the guidelines for management of HIV-related dyslipidemia.…”

Palliative Effects of Daonil Supplemented with Tryptophan on Alloxan Induced Diabetic Rats

“…The effect of alloxan to chemically establish the diabetic condition was assessed by using 15 scalpel blade to make an incision in any of the four veins in the tail of the rat and glucose concentration was analysed from the blood sample. Blood glucose level greater than 150mg/dl in rats were considered diabetic [2]. But in this study the rats with a blood glucose level >250 mg/dl were considered to have developed experimental diabetes and were therefore selected for treatment.…”

“…These auto antibodies are detected in about 85-90% of individuals with this disease. Type 1 DM constitutes < 3% of diabetic patients in Nigeria [2].Type 2 DM also referred to as non-insulin dependent diabetes or adult onset diabetes is caused primarily by family history, excessive body weight and lack of enough exercise which results in the body tissues responding defectively to insulin secretion [3]. This form of diabetes accounts for approximately 90-95%.…”

“…There is growing prevalence of people living with diabetes in the world varying from country to country, race and ethnic group. In 2014, about 422million adults (or 8.5%) of the population had diabetes compared with 108millions (4.7%) in 1980 [2]. The number of people suffering from diabetes in Africa remain uncertain, however International Diabetes Foundation (IDF) estimate in 2000 put the figure at 7.5million diabetics adults between ages 20-79year which figure is going to be much larger in future years because WHO and IDF estimate that the number will double over the next 25 years in Africa.…”