title: Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors.
abstract: BACKGROUND
  Sub-Saharan Africa faces a rapid spread of diabetes mellitus type 2 (DM2) but its potentially specific characteristics are inadequately defined. In this hospital-based study in Kumasi, Ghana, we aimed at characterizing clinical, anthropometric, socio-economic, nutritional and behavioural parameters of DM2 patients and at identifying associated factors.
  
  
  METHODS
  Between August 2007 and June 2008, 1466 individuals were recruited from diabetes and hypertension clinics, outpatients, community, and hospital staff. Fasting plasma glucose (FPG), serum lipids and urinary albumin were measured. Physical examination, anthropometry, and interviews on medical history, socio-economic status (SES), physical activity and nutritional behaviour were performed.
  
  
  RESULTS
  The majority of the 675 DM2 patients (mean FPG, 8.31 mmol/L) was female (75%) and aged 40-60 years (mean, 55 years). DM2 was known in 97% of patients, almost all were on medication. Many had hypertension (63%) and microalbuminuria (43%); diabetic complications occurred in 20%. Overweight (body mass index > 25 kg/m2), increased body fat (> 20% (male), > 33% (female)), and central adiposity (waist-to-hip ratio > 0.90 (male), > 0.85 (female)) were frequent occurring in 53%, 56%, and 75%, respectively. Triglycerides were increased (≥ 1.695 mmol/L) in 31% and cholesterol (≥ 5.17 mmol/L) in 65%. Illiteracy (46%) was high and SES indicators generally low. Factors independently associated with DM2 included a diabetes family history (adjusted odds ratio (aOR), 3.8; 95% confidence interval (95%CI), 2.6-5.5), abdominal adiposity (aOR, 2.6; 95%CI, 1.8-3.9), increased triglycerides (aOR, 1.8; 95%CI, 1.1-3.0), and also several indicators of low SES.
  
  
  CONCLUSIONS
  In this study from urban Ghana, DM2 affects predominantly obese patients of rather low socio-economic status and frequently is accompanied by hypertension and hyperlipidaemia. Prevention and management need to account for a specific risk profile in this population.
authors.affiliation: Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Danquah
authors.forename: George
authors.initials: G
authors.lastname: Bedu-Addo
authors.forename: Karl-Johann
authors.initials: KJ
authors.lastname: Terpe
authors.forename: Frank
authors.initials: F
authors.lastname: Micah
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Amoako
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Awuku
authors.forename: Ekkehart
authors.initials: E
authors.lastname: Dietz
authors.forename: Markus
authors.initials: M
authors.lastname: van der Giet
authors.forename: Joachim
authors.initials: J
authors.lastname: Spranger
authors.forename: Frank P
authors.initials: FP
authors.lastname: Mockenhaupt
mesh_terms: D050154:Adiposity / Q000502:physiology; D000328:Adult; D000419:Albuminuria / Q000209:etiology; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005215:Fasting / Q000097:blood; D005260:Female; D005869:Ghana / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000097:blood; D050177:Overweight / Q000453:epidemiology; D017678:Sex Distribution; D012923:Social Class; D014280:Triglycerides / Q000097:blood; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides