Diabetes in tropical Africa: a prospective study, 1981-7. II. Course and prognosis.

McLarty, D.G.; Kinabo, Linna; Swai, A. B. M.

doi:10.1136/bmj.300.6732.1107

Cited by 60 publications

(45 citation statements)

References 14 publications

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“…DE-CODA study data indicate that Indians with diabetes in Mauritius had a higher RR of dying than individuals with diabetes in Europe and the U.S. This is consistent with the sparse information from low-income countries indicating a poor prognosis for individuals with diabetes, largely due to infection and acute metabolic complications (21,22). The number of deaths attributable to diabetes in SEAR D, affected by the size of the RRs selected for the calculations, can substantially alter global numbers because of the large population size and high diabetes prevalence in the region.…”

Section: Validationsupporting

confidence: 70%

The Burden of Mortality Attributable to Diabetes

et al. 2005

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OBJECTIVE -To estimate the global number of excess deaths due to diabetes in the year 2000.RESEARCH DESIGN AND METHODS -We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age-and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes. The results were validated with population-based observations and independent estimates of relative risk of death.RESULTS -The excess global mortality attributable to diabetes in the year 2000 was estimated to be 2.9 million deaths, equivalent to 5.2% of all deaths. Excess mortality attributable to diabetes accounted for 2-3% of deaths in poorest countries and over 8% in the U.S., Canada, and the Middle East. In people 35-64 years old, 6 -27% of deaths were attributable to diabetes.CONCLUSIONS -These are the first global estimates of mortality attributable to diabetes. Globally, diabetes is likely to be the fifth leading cause of death. Diabetes Care 28:2130 -2135, 2005D iabetes is a serious illness with multiple complications and premature mortality, accounting for at least 10% of total health care expenditure in many countries (1). However, routinely reported statistics based on death certification seriously underestimate mortality from diabetes (2), because individuals with diabetes most often die of cardiovascular and renal disease and not from a cause uniquely related to diabetes, such as ketoacidosis or hypoglycemia (3).Most international mortality statistics, including those published by the World Health Organization (WHO), are based solely on the "underlying cause of death" as recorded on the death certificate, even in the presence of other information. Complex methods have been developed for estimating cause-specific mortality for some conditions (AIDS, tuberculosis) but not for diabetes (4).Based on routine statistics, recent World Health Reports estimated mortality from diabetes in the world as 987,000 deaths for the year 2002 (5), which was 1.7% of total world mortality. There were estimated to be at least 170 million people with diabetes in the world in the year 2000 (6); therefore, mortality attributable to diabetes could be expected to be much higher, since diabetes is a serious and chronic condition. The aim of this study was to provide a more realistic estimate of the number of deaths attributable to diabetes. RESEARCH DESIGN AND METHODS Model and dataTo estimate the number of deaths attributable to diabetes in the year 2000, we used a software program, DisMod II, developed for the Global Burden of Disease 2000 study (7,8) and routinely used by WHO for disease estimates. The DisMod II disease model is that of a multistate life table that describes a single disease. There are two causes of death, from the disease and from "all othe...

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Section: Validationsupporting

confidence: 70%

The Burden of Mortality Attributable to Diabetes

et al. 2005

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“…In another study more than 65% patients had leukocytosis and in 55% patients there was no infection. 14 Infection was the commonest precipitating cause in this study. Noncompliance was the second most common cause.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis: Pattern of Precipitating Causes

et al. 2014

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“…These causes of mortality among T2DM patients in SSA were Copyright reported from outcome studies of T2DM in Zimbabwe [149], Ethiopia [150,151], and Tanzania [152] that indicated mortality rates from T2DM of 8-41% [41]. Acute complications include diabetic ketoacidosis, often due to insulin deficiency or delayed diagnosis [153], and hyperosmolar non-ketotic coma [154,155], while hypoglycaemia occurred in some patients who were on anti-diabetic drugs [156].…”

Section: Morbidity and Mortalitymentioning

confidence: 94%

Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Tuei

Maiyoh

2010

Diabetes Metabolism Res

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While communicable diseases such as human immunodeficiency virus/acquired immune deficiency syndrome, malaria, and tuberculosis have continued to pose greater threats to the public health system in sub-Saharan Africa (SSA), it is now apparent that non-communicable diseases such as diabetes mellitus are undoubtedly adding to the multiple burdens the peoples in this region suffer. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes (90-95%), exhibiting an alarming prevalence among peoples of this region. Its main risk factors include obesity, rapid urbanization, physical inactivity, ageing, nutrition transitions, and socioeconomic changes. Patients in sub-Saharan Africa also show manifestations of beta-cell dysfunction and insulin resistance. However, because of strained economic resources and a poor health care system, most of the patients are diagnosed only after they have overt symptoms and complications. Microvascular complications are the most prevalent, but metabolic disorders and acute infections cause significant mortality. The high cost of treatment of T2DM and its comorbidities, the increasing prevalence of its risk factors, and the gaps in health care system necessitate that solutions be planned and implemented urgently. Aggressive actions and positive responses from well-informed governments appear to be needed for the conducive interplay of all forces required to curb the threat of T2DM in sub-Saharan Africa. Despite the varied ethnic and transitional factors and the limited population data on T2DM in sub-Saharan Africa, this review provides an extensive discussion of the literature on the epidemiology, risk factors, pathogenesis, complications, treatment, and care challenges of T2DM in this region.

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Diabetes in tropical Africa: a prospective study, 1981-7. II. Course and prognosis.

Abstract: Objective-To determine the clinical course of diabetes mellitus in tropical Africa. Design

Cited by 60 publications

References 14 publications

The Burden of Mortality Attributable to Diabetes

The Burden of Mortality Attributable to Diabetes

Diabetic Ketoacidosis: Pattern of Precipitating Causes

Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

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