Browsing by Subject "type 2 diabetes"

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    Open Access
    Independent external validation and comparison of prevalent diabetes risk prediction models in a mixed-ancestry population of South Africa
    (BioMed Central Ltd, 2015) Masconi, Katya L; Matsha, Tandi; Erasmus, Rajiv; Kengne, Andre
    BACKGROUND: Guidelines increasingly encourage the use of multivariable risk models to predict the presence of prevalent undiagnosed type 2 diabetes mellitus worldwide. However, no single model can perform well in all settings and available models must be tested before implementation in new populations. We assessed and compared the performance of five prevalent diabetes risk models in mixed-ancestry South Africans. METHODS: Data from the Cape Town Bellville-South cohort were used for this study. Models were identified via recent systematic reviews. Discrimination was assessed and compared using C-statistic and non-parametric methods. Calibration was assessed via calibration plots, before and after recalibration through intercept adjustment. RESULTS: Seven hundred thirty-seven participants (27% male), mean age, 52.2years, were included, among whom 130 (17.6%) had prevalent undiagnosed diabetes. The highest c-statistic for the five prediction models was recorded with the Kuwaiti model [C-statistic 0.68: 95% confidence: 0.63-0.73] and the lowest with the Rotterdam model [0. 64 (0.59-0.69)]; with no significant statistical differences when the models were compared with each other (Cambridge, Omani and the simplified Finnish models). Calibration ranged from acceptable to good, however over- and underestimation was prevalent. The Rotterdam and the Finnish models showed significant improvement following intercept adjustment. CONCLUSIONS: The wide range of performances of different models in our sample highlights the challenges of selecting an appropriate model for prevalent diabetes risk prediction in different settings.
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    Open Access
    Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans
    (BioMed Central Ltd, 2012) Kengne, Andre; Limen, Serge; Sobngwi, Eugene; Djouogo, Catherine FT; Nouedoui, Christophe
    BACKGROUND: Available definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them. METHODS: We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. RESULTS: Mean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th-75th percentiles) was 3years (0.5-5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p<0.001). Overall concordance between both definitions was low to average 0.51 (95% confidence interval: 0.41-0.61). Combining the two sets of criteria marginally improved the yield beyond that provided by the IDF criteria alone in men, but not in the overall population and in women. CONCLUSIONS: The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.
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    Open Access
    The 8-year incidence of obesity and type 2 diabetes in five African-origin populations
    (2024) Conradie, Catharina Beatrix; Dugas, Lara
    Obesity and type 2 diabetes (T2D) have become worldwide pandemics, particularly in low middle-income countries and among African-origin populations. The Modeling of Epidemiological Transition Study (METS, 2009) enrolled 2,506 African-origin participants, aged 25-45, from five countries and its ancillary study; METS-Microbiome, continued yearly research visits in 2,085 participants (2018-2019). The countries represent the full epidemiological transition spectrum, represented by the Human Development Index: Ghana (low), South Africa and Jamaica, (middle), Seychelles (high) and the United States (US) (very high). Research visits included anthropometrics, body composition measurements, social history, socio-demographics and health questionnaires, physical activity by accelerometer and clinical measurements. Overall, 732 participants had complete measurements from both METS (baseline) and METS-Microbiome (follow-up). At baseline, the US participants had the highest obesity prevalence (61.0%) and Ghanaians the lowest (11.5%). However, the obesity prevalence increased significantly, most notably among the Ghanaians (125%; p<0.001), and Seychellois (60.7%; p<0.01). Significant obesity predictors included being females, waist circumference and fat mass (p<0.001). The interaction term for follow-up length and site was significant with higher odds of obesity compared to baseline; Ghana (OR 6.62, 95%CI 1.56-28.35), Jamaica (OR 4.57, 95%CI 1.06-8.88) and Seychelles (OR 4.31, 95%CI 1.12-16.57). The US participants had the highest T2D prevalence (10,0%) and Jamaicans (0%) at baseline. However, the Seychellois experienced a 600% increase in T2D prevalence (p<0.01) accompanied by the highest T2D and obesity incidence rate. The interaction term for follow up length and site was similarly significant with higher odds of T2D at follow-up; Seychellois (OR 10.00, 95%CI 1.83-54.52) and US (OR 2.33, 95%CI 1.17-4.66). Age (p=0.002) and waist circumference (p=0.016) were significant T2D predictors. In conclusion, the study underscores significant increases in obesity and T2D rates, not only in high-income countries but also in rapid transitioning settings, highlighting concerns about healthcare resources readiness for the growing global burden of non-communicable diseases.