Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors

Abstract

Background Sub-Saharan Africa faces a rapid spread of diabetes mellitus type 2 (DM2) but its potentially specific characteristics are inadequately defined. In this hospital-based study in Kumasi, Ghana, we aimed at characterizing clinical, anthropometric, socio-economic, nutritional and behavioural parameters of DM2 patients and at identifying associated factors. Methods Between August 2007 and June 2008, 1466 individuals were recruited from diabetes and hypertension clinics, outpatients, community, and hospital staff. Fasting plasma glucose (FPG), serum lipids and urinary albumin were measured. Physical examination, anthropometry, and interviews on medical history, socio-economic status (SES), physical activity and nutritional behaviour were performed. Results The majority of the 675 DM2 patients (mean FPG, 8.31 mmol/L) was female (75%) and aged 40-60 years (mean, 55 years). DM2 was known in 97% of patients, almost all were on medication. Many had hypertension (63%) and microalbuminuria (43%); diabetic complications occurred in 20%. Overweight (body mass index > 25 kg/m 2 ), increased body fat (> 20% (male), > 33% (female)), and central adiposity (waist-to-hip ratio > 0.90 (male), > 0.85 (female)) were frequent occurring in 53%, 56%, and 75%, respectively. Triglycerides were increased (≥ 1.695 mmol/L) in 31% and cholesterol (≥ 5.17 mmol/L) in 65%. Illiteracy (46%) was high and SES indicators generally low. Factors independently associated with DM2 included a diabetes family history (adjusted odds ratio (aOR), 3.8; 95% confidence interval (95%CI), 2.6-5.5), abdominal adiposity (aOR, 2.6; 95%CI, 1.8-3.9), increased triglycerides (aOR, 1.8; 95%CI, 1.1-3.0), and also several indicators of low SES. Conclusions In this study from urban Ghana, DM2 affects predominantly obese patients of rather low socio-economic status and frequently is accompanied by hypertension and hyperlipidaemia. Prevention and management need to account for a specific risk profile in this population.

Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

“…Nevertheless, the prevalence rate was higher in comparison to Ghana and Nigeria, and lower in comparison to Kenya, which could be due to differences in population size, exposures to risk factors and study designs [9,10,[17][18][19][20] respectively. This is a pattern observed in other studies in Africa, which could reflect the ageing population in Africa [8,17]. By contrast, in our study, this association was not statically significant.…”

“…In our study, we did not find an association between marital status and the prevalence of diabetes, this association was found in other studies in Africa [7][8][9][10]. This can be explained by the fact that married seniors are most often conscientious in the face of different medical recommendations than those who live alone.…”

“…Overweight or obesity, hypertension, and smoking have been identified as independent risk factors to diabetes in previous studies in Africa [7][8][9][10] positively and healthy [19,22,23]. The increasing level of obesity in Africa has been attributed to the changing demographic dynamics, urbanization, poverty, nutrition transition and changing lifestyles [12,23,24].…”

“…The number of older adults with diabetes is increasing in sub-Saharan Africa due to increased lifespan and the increased prevalence of diabetes in the geriatric population [6]. Despite the demographic transition occurring in Africa, few studies have focused on understanding the magnitude of diabetes among older adults in specific countries [7,8]. For instance, the prevalence of diabetes has been estimated to be between 3.4 to 4.6%, 7.7 to 20%, and 5 to 8.8% for adults aged 50 years and more in Ghana, Kenya and South Africa respectively [9][10][11].…”

Diabetes-related foot disorders among adult Ghanaians

“…The location of Kumasi in the central point of the transportation network in Ghana makes it accessible to an estimated 10 million people from 6 out of the 10 regions of Ghana and other neighbouring countries. With an estimated prevalence of over 7%, Kumasi has one of the highest urban diabetes prevalence in the country [16]. …”