title: Type 2 diabetes mellitus in African women.
abstract: Compared to global estimates, Sub-Saharan Africa (SSA) has the highest projected rates of increase in type 2 diabetes (T2D) over the next 25years. This is attributed to the ageing population, increasing urbanisation and the associated lifestyle changes. Although the prevalence does not differ by gender, deaths attributable to T2D in SSA are greater in women, likely due to differences in beliefs and access to care. Women in SSA also have greater risk factor burden for T2D than men, in particular obesity, which is explained in part by sociocultural factors. The pathogenesis of diabetes differs between African and Caucasian women, with implications for risk assessment. African women are more insulin resistant than their Caucasian counterparts, despite a more 'favourable' body fat distribution. Notably, women in SSA face the dual burden of T2D and HIV/AIDS. HIV positive women in SSA are typically young and obese, with the latter being exacerbated by anti-retroviral therapy (ART). Cultural perceptions regarding weight loss and limited financial resources are the major limitations to the management of T2D. Hence prevention is vital. However, there is a paucity of studies examining the effectiveness and sustainability of interventions to reduce T2D in SSA.
authors.affiliation: Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa. Electronic address: Julia.goedecke@mrc.ac.za.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Goedecke
authors.affiliation: Medical Research Council/University of Witwatersrand, Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Asanda
authors.initials: A
authors.lastname: Mtintsilana
authors.affiliation: Medical Research Council/University of Witwatersrand, Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Siphiwe N
authors.initials: SN
authors.lastname: Dlamini
authors.affiliation: Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
authors.forename: Andre Pascal
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology / Q000208:ethnology; D044383:Black People; D050218:Body Fat Distribution; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors
keywords: Adipose tissue biology; Body fat distribution; Detection and management of diabetes; Dual-burden of disease; Pathophysiology; Risk factors for diabetes