Mortality amongst children and adolescents with type 1 diabetes in sub‐Saharan Africa: The case study of the Changing Diabetes in Children Programme in Cameroon

The global incidence of type 1 diabetes mellitus in childhood is increasing, with the greatest rise occurring in younger children (under five years of age). Data suggest that the annual rise is of the order of 3% and that changes in incidence figures are also occurring in those countries that have traditionally had low incidence rates of type 1 diabetes. Data collated for the IDF Diabetes Atlas suggest that one-quarter of all children with type 1 diabetes reside in Southeast Asia and more than a fifth are from Europe. However, data ascertainment from developing countries in sub-Saharan Africa and South America can be poor, so these figures may be misleading. Table 13.4.7.1 summarizes the data from 2007 examining incidence and prevalence by region (where available) (1). The reasons for the increasing prevalence of childhood diabetes are unclear. Improvements in diagnosis and management in developing countries may account for some of the increasing prevalence in these parts of the world. Some studies also suggest that the rise in type 1 diabetes may reflect the rise in childhood obesity, and that type 1 and type 2 diabetes may represent points on a spectrum of disease: the so-called ‘accelerator hypothesis’. Type 2 diabetes is also becoming common in children, associated with increasing rates of obesity and physical inertia. Whatever the causes, the challenges of the management of diabetes in children and young people are significant. Audit data highlight significant problems, with many children experiencing poor glycaemic control (2). This chapter aims to explore the special considerations of diabetes in the young.

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Assessing health systems for type 1 diabetes in sub-Saharan Africa: developing a 'Rapid Assessment Protocol for Insulin Access'

BMC Health Services Research ◽

10.1186/1472-6963-6-17 ◽

2006 ◽

Vol 6 (1) ◽

Cited By ~ 20

Author(s):

David Beran ◽

John S Yudkin ◽

Maximilian de Courten

Keyword(s):

Type 1 Diabetes ◽

Health Systems ◽

Rapid Assessment ◽

Sub Saharan Africa ◽

Assessment Protocol ◽

Sub Saharan

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TYPE 1 DIABETES DILEMMA IN SUB-SAHARAN AFRICA

Medico Research Chronicles ◽

10.26838/medrech.2018.5.6.443 ◽

2018 ◽

Vol 5 (6) ◽

pp. 421

Author(s):

Sanjay Sud

Keyword(s):

Type 1 Diabetes ◽

Sub Saharan Africa ◽

Sub Saharan

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Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

International Journal of Endocrinology ◽

10.1155/2015/761759 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 22

Author(s):

Thomas Ngwiri ◽

Fred Were ◽

Barbara Predieri ◽

Paul Ngugi ◽

Lorenzo Iughetti

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Clinical History ◽

Sub Saharan Africa ◽

Poor Control ◽

Few Data

Background. Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children and adolescents worldwide. While data about prevalence, treatment, and complications are recorded in many countries, few data exist for Sub-Saharan Africa. The aim of this study was to determine the degree of control in patients with T1DM aged 1–19 years over a 6-month period in 3 outpatient Kenyan clinics. It also sought to determine how control was influenced by parameters of patient and treatment.Methods. Eighty-two children and adolescents with T1DM were included in the study. Clinical history regarding duration of illness, type and dose of insulin, and recent symptoms of hypoglycemia/hyperglycemia were recorded. Glycaemia, HbA1c, and ketonuria were tested. HbA1c of 8.0% and below was defined as the cut-off for acceptable control.Results. The median HbA1c for the study population was 11.1% (range: 6.3–18.8). Overall, only 28% of patients had reasonable glycemic control as defined in this study. 72% therefore had poor control. It was also found that age above 12 years was significantly associated with poor control.Conclusions. African children and with T1DM are poorly controlled particularly in adolescents. Our data strongly support the necessity of Kenya children to receive more aggressive management and follow-up.

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Diabetes in sub-Saharan Africa and in Africans

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.1408 ◽

2011 ◽

pp. 1805-1811

Author(s):

Eugène Sobngwi

Keyword(s):

Type 1 Diabetes ◽

International Diabetes Federation ◽

Sub Saharan Africa ◽

African Continent ◽

Clinical Presentations ◽

Atypical Diabetes ◽

Sub Saharan ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

The prevalence of diabetes is drastically increasing in every part of the African continent where repeated surveys have been conducted. According to the International Diabetes Federation (IDF), the number of affected people in Africa will double within 20 years, from 12 million in 2010 to 24 million in 2030. Similarly, an increase is being observed in African diasporas of Western countries. In addition, there are some clinical presentations of diabetes that are predominantly observed in populations of African descent and that are difficult to classify. The most characteristic is ketosis-prone atypical diabetes, previously identified under ‘idiopathic type 1 diabetes’, which may represent up to 15% of all newly diagnosed diabetes in African-origin populations. This chapter, therefore, focuses on epidemiological specificities of diabetes in Africa, on the clinical specificities, and on atypical clinical presentations.

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