title: Diabetes mellitus in Zambia and the Western Cape province of South Africa: Prevalence, risk factors, diagnosis and management.
abstract: OBJECTIVE
  To determine the prevalence of and risk factors for diabetes mellitus and examine its diagnosis and management in the study communities.
  
  
  METHODS
  This is a population-based cross-sectional study among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Diabetes is defined as a random blood glucose concentration (RBG)⩾11.1mmol/L, or RBG<11.1mmol/L but with a self-reported prior diabetes diagnosis. For individuals with a prior diagnosis of diabetes, RBG<7.8mmol/L was considered to be an acceptable level of glycaemia.
  
  
  RESULTS
  Among 45,767 Zambian and 12,496 WC participants the age-standardised prevalence of diabetes was 3.5% and 7.2% respectively. The highest risk groups identified were those of older age and those with obesity. Of those identified to have diabetes, 34.5% in Zambia and 12.7% in WC were previously unaware of their diagnosis. Among Zambian participants with diabetes, this proportion was lower among individuals with better education or with higher household socio-economic position. Of all those with previously diagnosed diabetes, 66.0% in Zambia and 59.4% in WC were not on any diabetes treatment, and 34.4% in Zambia and 32.7% in WC had a RBG concentration beyond the recommended level, ⩾7.8mmol/L.
  
  
  CONCLUSIONS
  The diabetes risk factor profile for our study communities is similar to that seen in high-income populations. A high proportion of individuals with diabetes are not on diabetes treatment and of those on treatment a high proportion have high glycaemic concentrations. Such data may assist in healthcare planning to ensure timely diagnosis and management of diabetes.
authors.affiliation: LSHTM TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, South Africa. Electronic address: slbailey@doctors.org.uk.
authors.forename: Sarah Lou
authors.initials: SL
authors.lastname: Bailey
authors.affiliation: LSHTM TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Zambart, Ridgeway Campus, Lusaka, Zambia.
authors.forename: Helen
authors.initials: H
authors.lastname: Ayles
authors.affiliation: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, South Africa.
authors.forename: Nulda
authors.initials: N
authors.lastname: Beyers
authors.affiliation: LSHTM TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Godfrey-Faussett
authors.affiliation: Zambart, Ridgeway Campus, Lusaka, Zambia.
authors.forename: Monde
authors.initials: M
authors.lastname: Muyoyeta
authors.affiliation: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, South Africa.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: du Toit
authors.affiliation: University College London, Gower Street, London, UK.
authors.forename: John S
authors.initials: JS
authors.lastname: Yudkin
authors.affiliation: LSHTM TB Centre and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Floyd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
chemical_list: D001786:Blood Glucose
keywords: Cross-sectional study; Epidemiology; Southern Africa