Diabetes and other disorders of glycemia in a rural South African community: prevalence and associated risk factors.
OBJECTIVE
The purpose of this study was to determine the prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), and associated risk factors in a rural South African black community.


METHODS
This was a cross-sectional survey conducted by random cluster sampling of adults aged >15 years. Participants had a 75-g oral glucose tolerance test using the 1998 World Health Organization criteria for disorders of glycemia.


RESULTS
Of 1,300 subjects selected, 1,025 subjects (815 women) participated (response rate 78.9%). The overall age-adjusted prevalence of diabetes was 3.9%, IGT 4.8%, and IFG 1.5%. The prevalence was similar in men and women for diabetes (men 3.5%; women 3.9%) and IGT (men 4.6%; women 4.7%) but higher in men for IFG (men 4.0%; women 0.8%). The prevalence of diabetes and IGT increased with age both in men and women, with peak prevalence in the 55- to 64-year age-group for diabetes and in the >or=65-year age-group for IGT. Of the cases of diabetes, 84.8% were discovered during the survey. In multivariate analysis, the significant independent risk factors associated with diabetes included family history (odds ratio 3.5), alcohol ingestion (2.8), waist circumference (1.1), systolic blood pressure (1.0), serum triglycerides (2.3), and total cholesterol (1.8); hip circumference was protective (0.9).


CONCLUSIONS
There is a moderate prevalence of diabetes and a high prevalence of total disorders of glycemia, which suggests that this community, unlike other rural communities in Africa, is well into an epidemic of glucose intolerance. There is a low proportion of known diabetes and a significant association with potentially modifiable risk factors.
Motala
Ayesha A
AA
Department of Endocrinology, University of KwaZulu-Natal, Durban, South Africa. motala@ukzn.ac.za
Esterhuizen
Tonya
T
Gouws
Eleanor
E
Pirie
Fraser J
FJ
Omar
Mahomed A K
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D044383:Black People / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology
D001786:Blood Glucose