Type 2 diabetes mellitus in African women

Goedecke, Julia H.; Mtintsilana, Asanda; Dlamini, Siphiwe N.; Kengne, André Pascal

doi:10.1016/j.diabres.2016.11.017

Cited by 49 publications

(56 citation statements)

References 58 publications

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“…Interestingly, our ndings of a stronger association between BMI and T2DM has also been documented in other pathophysiological studies in African using methods such as dual energy X-ray absorptiometry [134,135]. Studies in South African women suggest that, for the same BMI, African women have less central fat, but greater peripheral fat accumulation than Caucasian women [133][134][135]. Sumner et al [136] also show that increasing waist circumference results in less visceral adipose tissue among African-American and African women than Caucasian women.…”

Section: Discussionsupporting

confidence: 85%

“…Waist circumference is a stronger indicator of intra-abdominal visceral fat than BMI, and closely linked to insulin resistance and hyperinsulinemia [133]. Interestingly, our ndings of a stronger association between BMI and T2DM has also been documented in other pathophysiological studies in African using methods such as dual energy X-ray absorptiometry [134,135]. Studies in South African women suggest that, for the same BMI, African women have less central fat, but greater peripheral fat accumulation than Caucasian women [133][134][135].…”

Section: Discussionsupporting

confidence: 69%

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The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis

Issaka¹,

Paradies²,

Cameron³

et al. 2020

Preprint

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Background Type 2 diabetes mellitus (T2DM) is a significant public health concern in many African countries. While the determinants underpinning T2DM are likely to be Africa-specific, knowledge of these risk factors is largely derived from developed countries. This is the first systematic review and meta-analysis to include biological, behavioural and psychosocial risk factors for T2DM in Africa. Methods Relevant scientific databases were searched, and data were extracted from 66 studies. Fifty- nine studies reported unadjusted data and were analysed using Comprehensive Meta-Analysis (CMA) software version 2.0. The Odds ratios (OR) and their 95% CIs for the associations between BMI indices (overweight, obesity), central obesity (waist circumference, waist to hip ratio), behavioural (alcohol, fruit and vegetable consumption, smoking), physical inactivity, and psychosocial factors (stress, anxiety, and depression) and T2DM were calculated using a random-effect model. Moderator effects of age, language-spoken, sub-regions and urban/rural location was assessed. Results A number of risk factors were associated with T2DM including, BMI-based definitions of obesity [OR = 3.22, 95% CI: 92.73, 3.80)], overweight [OR = 2.22, 95% CI: (1.90, 2.58)], or overweight/obesity [OR = 2.58, 95% CI: (1.76, 3.78)]; Central obesity as measured by waist circumference [OR = 2.51, 95% CI: (1.86, 3.37)], or waist to hip ratio [OR = 2.03, 95% CI: 1.51, 2.72]; psychosocial factors which includes stress [OR = 2.2, 95% CI: (1.46, 3.31)], depression [OR = 2.42, 95% CI: (1.14, 3.31)] and anxiety [OR = 2.05, 95% (CI:1.0, 4.18)] and physical inactivity [OR = 1.88, 95% CI: (1.53, 2.23)]. Current smoker [OR = 1.13, 95% CI: (0.84, 1.49)], alcohol consumption [OR = 1.10, 95% CI: (0.82, 1.47)] and inadequate fruit and vegetable consumption [OR = 0.81, 95% CI: (0.57, 1.16)] were not associated with T2DM. Locality (urban/rural), language spoken, and sub-region (East/West Africa) did not significantly moderate the associations between the risk factors and T2DM. Conclusion Obesity (defined by BMI) is most strongly associated with T2DM. Overweight, waist circumference and waist to hip ratio, physical inactivity, psychosocial risk factors defined as stress, depression, anxiety were all significantly associated with T2DM. These findings add novel meta-analyses of associations between diverse individual risk factors and T2DM within the African context.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 69%

The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis

Issaka¹,

Paradies²,

Cameron³

et al. 2020

Preprint

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“…Finally, important barriers to reduce T2D risk are differences in perceptions of body size and body image [86]. Indeed, black Africans have a greater body size tolerance than their white counterparts [87], and regard body fatness as a sign of health, beauty, respect, happiness, fertility and not having HIV (as reviewed previously [62,88]). Interestingly, we recorded changes in the perception of body size in the obese black South African women in response to the 12-week exercise intervention.…”

Section: Sociodemographic and Lifestyle Factorsmentioning

confidence: 99%

Pathogenesis of type 2 diabetes risk in black Africans: a South African perspective

Goedecke

Olsson

2020

J Intern Med

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The prevalence of type 2 diabetes (T2D) is higher in black Africans than their European counterparts. This review summarizes the research exploring the pathogenesis of T2D in populations of African ancestry compared to white Europeans and shows that the pathogenesis differs by ethnicity. Black Africans present with a phenotype of low insulin sensitivity and hyperinsulinaemia as a result of increased insulin secretion and reduced hepatic insulin clearance. Whether hyperinsulinaemia precedes insulin resistance or is merely a compensatory mechanism is yet to be determined. Black Africans have lower visceral adipose tissue and ectopic fat deposition and greater peripheral (gluteo‐femoral) fat deposition than their European counterparts. This suggests that black Africans are more sensitive to the effects of ectopic fat deposition, or alternatively, that ectopic fat is not an important mediator of T2D in black Africans. Importantly, ethnic disparities in T2D risk factors may be confounded by differences in sociocultural and lifestyle factors. Future longitudinal and dietary intervention studies, in combination with genetic analyses, are needed for a better understanding of the pathophysiology of T2D in black Africans. This will be key for effective prevention and management strategies.

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“…Various studies on black adult South African populations over the last 20 years have reported a high and increasing prevalence of risk factors for cardiovascular disease (CVD) [1–4]. In a study on urban-dwelling black South Africans, it was suggested that the rapid rise in type 2 diabetes (T2D) prevalence is strongly related to higher adiposity levels, as more than 80% of the diabetic participants were either overweight or obese, and also had higher measures of abdominal adiposity compared to the non-diabetic participants [2,5].…”

Section: Introductionmentioning

confidence: 99%

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Micklesfield

Kagura

Munthali

et al. 2018

Global Health Action

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Background: There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. Objective: To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. Methods: Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. Results: Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. Conclusions: The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.

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Type 2 diabetes mellitus in African women

Cited by 49 publications

References 58 publications

The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis

The association between various biological, behavioural and psychosocial factors and type 2 diabetes mellitus in Africa: a systematic review and meta-analysis

Pathogenesis of type 2 diabetes risk in black Africans: a South African perspective

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

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