Diabetes and pre-diabetes among adults reaching health centers in Luanda, Angola: prevalence and associated factors

安哥拉罗安达卫生中心就诊成年人糖尿病和糖尿病前期患病率及相关因素

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Abstract

With the lack of surveys, surveillance program and/or statistical data, epidemiologic studies can provide a better understanding of diabetes in Sub-Saharan Africa. This was a cross-sectional survey to determine prevalence of diabetes and impaired fasting glucose (IFG) among adults attending six health centres in six different districts of Luanda (Angola) during August-November 2018, followed by a case-control study to assess the risk factors for IFG and diabetes in a subgroup of subjects not receiving treatment for diabetes. Factors associated with diabetes/IFG were assessed using a generalized ordered logit model and the effects were expressed as odds ratios (OR(1) for IFG/diabetes vs. no IFG/diabetes; OR(2) for diabetes vs. no diabetes) with 95% CI (confidence interval). Some 1,803 participants were included in the survey. Prevalence of diabetes was 12.0% (95%CI 10.5% to 13.5%) and prevalence of IFG was 9.0% (95%CI 7.7% to 10.4%). Older age (OR(1) = OR(2) 1.03, 95%CI 1.02 to 1.04), higher weight (OR(1) = OR(2) 1.01, 95%CI 1.01 to 1.03), having measured glycaemia before (OR(2) 2.07, 95%CI 1.29 to 3.31), feeling polyuria (OR(1) 1.93, 95%CI 1.13 to 3.28; OR(2) 2.18, 95%CI 1.32 to 3.59), feeling polydipsia (OR(1) 1.92, 95%CI 1.16 to 3.18), feeling weakness (OR(1) = OR(2) 2.22, 95%CI 1.39 to 3.55), consumption of free-sugars food/beverages (OR(1) = OR(2) 2.34, 95%CI 1.44 to 3.81) and time spent seated (OR(1) 1.80, 95%CI 1.17 to 2.76) were associated with increased likelihood of diabetes and/or IFG, while eating vegetables was associated with decreased likelihood of IFG or diabetes (OR(1) = OR(2) 0.69, 95%CI 0.47 to 0.99). In conclusion, the high prevalence of diabetes and IFG, with common unawareness of the disease, calls for appropriate interventions in Angolan urban settings. Further research may evaluate the impact of context-specific factors to enhance intervention strategies and feed the results into local health policies. In addition, such information may be useful for selecting high-risk subjects to test.

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