Correlates of pre-diabetes and Type 2 diabetes in Buffalo City Municipality, South Africa

Abstract

District health policies on non-communicable diseases are informed by reliable epidemiological data which are scarce in Buffalo City Metropolitan Municipality (BCMM), South Africa. This study addresses this evidence gap by examining the prevalence and correlates of pre-diabetes and type 2 diabetes among South African adult residents of BCMM. A cross-sectional survey of 998 adults (321 men and 677 women) attending the three largest out-patient clinics in BCMM was conducted using the World Health Organisation STEPwise Questionnaire. Glycaemic status was determined by analysing fasting blood glucose and use of diabetes medications. Multivariate logistic regression models were used to estimate the independent associations of sociodemographic, behavioural and cardiovascular risk factors with diabetes. The prevalence of prediabetes and diabetes was 14% and 24%, respectively. Age (p<0.000), marital status (p<0.000), employment status (p<0.000), level of income (p<0.000), level of education (p<0.000), alcohol consumption (p<0.000), physical activity (p<0.014), obesity (p<0.000) and hypertension (p<0.000) were significantly associated with diabetes mellitus. However, in the multivariate logistic regression analysis, after adjusting for confounders, only age (26 years and above) (AOR=1.9, CI= 1.4-2.7), ever married (AOR= 4.0, CI= 1.1-2.4), abdominal obesity (AOR= 1.9, CI= 1.2-2.9), alcohol use (AOR=1.6, CI= 1.1-2.4) and hypertension (AOR= 2.7, CI= 1.9-3.8) were the significant and independent predictors of diabetes mellitus. A high prevalence of diabetes found among the study participants could be attributed to modifiable risk factors and ageing. District health policies should be tailored toward addressing cardio-metabolic risk factors at both the primary health care and population levels.

Keywords: Diabetes mellitus type 2, pre-diabetes, hypertension, obesity, South Africa.