Diabetes in Sub-Saharan Africa
Type 2 diabetes is a global problem with major public health and socioeconomic challenges. From recent estimates of the International Diabetes Federation (IDF) [1], the number of adults with diabetes in the world currently stands at 415 million with a pro
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Diabetes in Sub-Saharan Africa Felix Assah and Jean Claude Mbanya
Overview Type 2 diabetes1 is a global problem with major public health and socioeconomic challenges. From recent estimates of the International Diabetes Federation (IDF) [1], the number of adults with diabetes in the world currently stands at 415 million with a projected rise to 642 million by 2040. An estimated 14.2 (9.5–29.4‡) million people aged 20–79 have diabetes in the subSaharan Africa (SSA) region, representing a regional prevalence of 2.1–6.7 %‡. SSA has the highest proportion of undiagnosed cases of diabetes; over two-thirds (66.7 %) of people with diabetes are unaware of their status. The majority of people with diabetes (58.8 %) live in cities, even though the population in the region (61.3 %) is predominantly rural. With increasing urbanisation and population ageing, diabetes will pose an even greater threat. It is expected that by 2040 there will be 34.2 million adults in the region living with diabetes, more than double the number in 2015 [1].
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This chapter will focus on type 2 diabetes and will be referred to as diabetes throughout. F. Assah, MD, PhD (*) • J.C. Mbanya, MD, PhD, FRCP Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon e-mail: [email protected]; [email protected]
Diabetes prevalence in adults is in general much higher on islands in sub-Saharan Africa, compared to the mainland. The highest prevalence is found in the Seychelles (17.4 % age-adjusted comparative prevalence, 17.4 % raw prevalence), followed by the island of Reunion (15.8 % ageadjusted, 18.2 % raw) and Comoros (9.9 % ageadjusted, 7.5 % raw). Some of Africa’s most populous countries have the highest numbers of people with diabetes, including South Africa (2.3 [1.2–4.6‡] million), Democratic Republic of Congo (1.8 [1.5–2.2‡] million), Nigeria (1.6 [1.2– 3.8‡] million) and Ethiopia (1.3 [0.8–3.5‡] million). Nearly half of all adults with diabetes in the region live in these four countries [1]. Despite the paucity of data from Africa, over the past few decades, diabetes, which was previously considered to be rare or unknown in rural Africa, has emerged as an important noncommunicable disease (NCD) in the region [2–4]. Global estimates and projections [1, 5–7] confirm the diabetes epidemic, through the increasing numbers of people with diabetes and impaired glucose tolerance (IGT). These reports not only show that diabetes in adults is a global problem but also that populations of developing countries, minority groups and disadvantaged communities in industrialised countries face the greatest risk. The large increase that is expected to occur in developing regions of the world has principally been attributed to population ageing and urbanisation [1, 5, 7].
© Springer International Publishing Switzerland 2017 S. Dagogo-Jack (ed.), Diabetes Mellitus in Developing Countries and Underserved Communities, DOI 10.1007/978-3-319-41559-8_3
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Epidemiology of Diabetes in Africa Historical Perspective In 1901, Doctor Coo
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