|dc.description.abstract||Numerous sources including the World Health Organization (WHO) and International
Diabetes Federation (IDF) reported that a diabetes epidemic, with a parallel rise in
obesity and insulin resistance is presently enveloping the world. Type 2 diabetes mellitus
accounts for over 80% of all diabetics in most countries and has been recognized as a
global epidemic, with its prevalence increasing at a rapid rate in both developed and
developing countries. Up to 80% of type 2 diabetic cases can be preventable by
changing diet, increasing physical activity and improving the living environment. The
prevalence of diabetes in South Africa varies from one province to another and within
different population groups. The highest rates have been reported among Asian Indians
and the mixed ancestry populations, however, data is limited.
Urbanization and industrialization which come along with westernized lifestyles such as
sedentarism, consumption of high fat diets consequently resulting into obesity are some
of the factors implicated in the development of type 2 diabetes. With type 2 diabetes
prevalence rate increasing at an alarming rate, both in industrialized and also in
developing countries, every factor associated with the development of diabetes needs to
be explored and addressed.
Before progression to diabetes, the diabetic state is preceded by a glucose regulation
disorder commonly referred to as impaired glucose tolerance which may last for several
years. Another form of glucose metabolism disorder other than diabetes is impaired
fasting blood glucose level. While some cases of diabetes are often undiagnosed, it has
also been noted that for every one diagnosed diabetic, there could be another that is
undiagnosed. As has been shown in this study, many people could be walking with
diabetes which is undiagnosed.
The aims of this study were to determine: The prevalence of impaired fasting glucose
(IFG), impaired glucose tolerance (IGT), diabetes mellitus and the risk factors for
developing diabetes amongst the 35 – 65 year old population of Bellville South, Cape
Town South Africa.
In a cross-sectional survey, 600 subjects within the age group of 35-65 years selected
through stratified random sampling within the Bellville South area of Cape Town
underwent an oral glucose tolerance test. Diabetes, IGT and IFG were determined using
both the American Diabetes Association (ADA) and the revised WHO criteria. Subjects
also underwent several anthropometric measurements. Personal demographic, family,
health and lifestyle data were extrapolated by use of a questionnaire.
The prevalence of diabetes did vary between the two criterion used. The prevalence of
newly diagnosed diabetes was 77 (12.8%) using the WHO criteria and 62 (10.3%) using
the ADA criteria. Overall, the prevalence of diabetes was 25.6 % of which 12.8 % were
newly diagnosed. IGT was present in 24 (4.0%) whilst IFG was in 179 (29.8%) using the
WHO and ADA criterion respectively. Females were more affected than males and the
prevalence of diabetes increased with age. Although overweight did not differ
significantly between males and females, the latter were significantly more obese across
all age groups (p < 0.05). Presence of a first degree relative with diabetes mellitus,
particularly the father was significantly associated with development of diabetes, (odds
ratio = 2.092, 95% CI 1.109 – 3.949, p = 0.023). Though more than 40% of the
population studied was shown to engage in heavy drinking (30g of alcohol per day), it
was not associated with diabetes.
There has been a 10.4% increase in the prevalence of diabetes in this population group
compared to what was reported more than a decade ago. Of great concern is the
number of individuals with undiagnosed diabetes.||en_US