title: Classification and dramatic epidemic of diabetes mellitus in Kinshasa Hinterland: the prominent role of type 2 diabetes and lifestyle changes among Africans.
abstract: BACKGROUND
  Classification of diabetes mellitus is not easily stated in Central Africa using the current diabetes classification of World Health Organization/American Diabetes Association. The objective of the study is to determine the prevalence, classification and risk factors of diabetes mellitus in Kinshasa Hinterland.
  
  
  METHODS
  A multilevel and stratified random sample cross-sectional study included 9770 black Africans (4580 men and 5190 women) aged 12 years and above in urban metropolitan (Kinshasa city) and rural (Kikwit) areas. Participants were examined and administered a structured questionnaire and a capillary whole blood glucose test was done.
  
  
  RESULTS
  The mean age of participants was 46 +/- 15 years. Overall crude and age adjusted prevalences of diabetes were 25% (n = 2472) and 18%, respectively. Using WHO/ADA classification, Type diabetes (80%) was commoner than undetermined form (12%), Type 1B (3.5%), Type 1A (2.5%) and Other specific types (2%). According to plasma insulin and plasma C-peptide levels, participants with undetermined form were classified Type 2 diabetics. Thus, the rate of Type 2 diabetes among diabetics was estimated 92%. Urban location, age, abdominal obesity arterial hypertension, physical inactivity, inappropriate diet (lack of fruits-vegetables, refined sugar, animal fat and protein, starvation, social inequalities, cigarette smoking, alcohol intake were significantly and positively associated with diabetes in general and type 2 diabetes in particular.
  
  
  CONCLUSIONS
  The high prevalence of diabetes is due to the unexpected high rates of type 2 diabetes, aging, urbanization, and sedentary lifestyle consequences. The majority of risk factors of diabetes are potentially modifiable by primary prevention.
authors.affiliation: Department of Internal Medicine, University of Kinshasa, DRC.
authors.forename: Lasi On'Kin J B
authors.initials: LO
authors.lastname: Kasiam
authors.forename: B
authors.initials: B
authors.lastname: Longo-Mbenza
authors.forename: Okwe A
authors.initials: OA
authors.lastname: Nge
authors.forename: Kabangu N
authors.initials: KN
authors.lastname: Kangola
authors.forename: Fuele S
authors.initials: FS
authors.lastname: Mbungu
authors.forename: Dipa G
authors.initials: DG
authors.lastname: Milongo
mesh_terms: D000328:Adult; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000145:classification* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D057185:Sedentary Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult