Findings from Community-Based Screenings for Type 2 Diabetes Mellitus in at Risk Communities in Cape Town, South Africa: A Pilot Study

Jillian Hill, Nasheeta Peer, Deborah Jonathan, Mary Mayige, Eugene Sobngwi and Andre Pascal Kengne
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Jillian Hill: Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa
Nasheeta Peer: Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa
Deborah Jonathan: Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa
Mary Mayige: National Institute for Medical Research, Dar es Salaam 11000, Tanzania
Eugene Sobngwi: Department of Medicine, University of Yaounde, Yaounde 00000, Cameroon
Andre Pascal Kengne: Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa

IJERPH, 2020, vol. 17, issue 8, 1-15

Abstract: Completed and ongoing implementation activities globally advocate for community-based approaches to improve strategies for type 2 diabetes prevention. However, little is known about such strategies in the African region where there are higher relative increases in diabetes prevalence. We reported findings from the first 8-month pilot phase of the South African diabetes prevention program. The study was conducted across eight townships (four black and four mixed-ancestry communities) in Cape Town, South Africa, between August 2017 and March 2018. Participants were recruited using both random and self-selected sampling techniques because the former approach proved to be ineffective; <10% of randomly selected individuals consented to participate. Non-laboratory-based diabetes risk screening, using the African diabetes risk score, and based on targeted population specific cut-offs, identified potentially high-risk adults in the community. This was followed by an oral glucose tolerance test (OGTT) to confirm prevalent pre-diabetes. Among the 853 adults without prior diabetes who were screened in the community, 354 (43.4%) were classified as high risk, and 316 presented for further screening. On OGTT, 13.1% had dysglycemia, including 10% with screen-detected diabetes and 67.9% with glycated haemoglobin (HbA1c)-defined high risk. Participants with pre-diabetes ( n = 208) had high levels of common cardiovascular risk factors, i.e., obesity (73.7%), elevated total cholesterol (51.9%), and hypertension (29.4%). Self-referral is likely an efficient method for selecting participants for community-based diabetes risk screening in Africa. Post-screening management of individuals with pre-diabetes must include attention to co-morbid cardiovascular risk factors.

Keywords: diabetes risk; community screening; cardiovascular disease; hypertension; dyslipidemia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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