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Diabetes and intermediate hyperglycaemia in Kisantu, DR Congo: a cross-sectional prevalence study
  1. Muel Telo Muyer1,
  2. Erik Muls2,
  3. Mala Ali Mapatano1,
  4. Jean-Robert Makulo3,
  5. Moise Mvitu4,
  6. Wivine Kimenyembo4,
  7. Bien-Aimé Mandja1,
  8. Pierre Kimbondo5,
  9. Chris Bonketo Bieleli3,
  10. Dieudonné Kaimbo wa Kaimbo4,
  11. Frank Buntinx6,7
  1. 1Ecole de Santé Publique, Université de Kinshasa (UNIKIN), Centre National d'Epidémiologie du Diabète, Kinshasa, The Democratic Republique of Congo
  2. 2Department of Endocrinology, KULeuven, Leuven, Belgium
  3. 3Département de Médecine Interne, UNIKIN, Cliniques Universitaires, Kinshasa, The Democratic Republic of Congo
  4. 4Département des Spécialités, UNIKIN, Cliniques Universitaires, Service d'Ophthalmologie, Kinshasa, The Democratic Republic of Congo
  5. 5Service de Médecine Interne, Hôpital St-Luc, Kisantu, The Democratic Republic of Congo
  6. 6Department of General Practice, Catholic University Leuven, Leuven, Belgium
  7. 7Department of General Practice, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands
  1. *Correspondence to
    Frank Buntinx; frank.buntinx{at}med.kuleuven.be

Abstract

Objectives To study the prevalence and risk markers of diabetes mellitus and intermediate hyperglycaemia (IH) in Kisantu, a semirural town in Bas-Congo province, The Democratic Republic of Congo.

Design A cross-sectional population-based survey.

Settings A modified WHO STEPwise strategy was used. Capillary glycaemia was measured for fasting plasma glucose and 2-h-postload glucose. Both WHO/IDF (International Diabetes Federation) 2006 and American Diabetes Association (ADA) 2003 diagnostic criteria for diabetes and IH were used.

Participants 1898 subjects aged ⩾ 20 years.

Results Response rate was 93.7%. Complete data were available for 1759 subjects (86.9%). Crude and standardised (for Doll and UN population) prevalence of diabetes were 4.8% and 4.0–4.2%. Crude IH prevalence was 5.8% (WHO/IDF) and 14.2% (ADA). Independent risk markers for diabetes (p<0.01) were male (OR 2.5), age 50–69 years (OR 2.6), family history (OR 3.5), waist (OR 4.1) and alcohol consumption (OR 0.36). In receiver operating characteristic (ROC) analysis, prediction of diabetes was slightly better by waist than body mass index (BMI). IH defined according to WHO/IDF was associated with BMI (OR 2.6, p<0.001). IH defined according to ADA was associated (p<0.05) with waist (OR 1.4), education level (OR 1.6), BMI (OR 2.4) and physical activity (OR 0.7).

Conclusions Current prevalence of diabetes in DR Congo exceeds IDF projections for 2030. The lower glucose threshold used by ADA almost triples impaired fasting glucose prevalence compared to WHO/IDF criteria. The high proportion of disorders of glycaemia made up by IH suggests the early stages of a diabetes epidemic.

  • Intermediate Hyperglycaemia
  • Prevalence
  • Population Based Survey
  • Sub-Saharan Africa, Dr Congo

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