JOHANNESBURG – The African continent is characterised by a population in the process of transition. As more and more people experience a change in lifestyle, embracing the Western way of life as opposed to more traditional customs, so too are they more exposed to a number of chronic conditions and illnesses that were less of a threat in decades gone by.
According to Professor Andre Kengne, Director: Non-Communicable Diseases Research Unit at the South African Medical Research Council, ‘diabesity’ – the term for diabetes occurring in the context of obesity – is on the increase in Africa as a result of a growing overweight population and is the result of lifestyle changes, unhealthy food choices and a decrease in physical activity. “Coupled to obesity comes the threat of related illnesses such as diabetes.”
Presenting at the upcoming Public Health Conference at Africa Health Exhibition & Congress, by Informa Life Sciences Exhibitions, on the topic of “Diabesity – trends in the overweight and diabetes in Africa”, Professor Kengne explains that this is an area of medicine which is still relatively unknown in the African setting.
Research conducted over the past 20 years has not delved into the extent to which diabetes affects women between the ages of 16 and 49. However, according to a recent overview jointly conducted by the University of Cape Town, Non-Communicable Diseases Research Unit and Witwatersrand University, seven percent of African women aged 15 to 54 years are currently suffering from diabetes.
The key driver of the increase in diabetes amongst women of child bearing age is lifestyle change, says Kengne. “There are a number of reasons for this changing lifestyle on the African continent, amongst them poverty, lack of access to nutritious food and the dearth of both knowledge and financial means to make healthy food choices, not to mention the increased availability of unhealthy fast food offerings as Western diets become more popular.”
Diabetes is not only impacting adult women. As children and adolescents become overweight earlier in life, they are at an increased risk of developing several chronic illnesses including diabetes.
Even pregnant women are at risk of developing gestational diabetes (GDM) which poses significant risk to both mother and foetus as well as increased neonatal risks, reports Dr Sumaiya Adam, Consultant in Obstetrics & Gynaecology at the University of Pretoria and a speaker at the Medical Obstetrics Conference on Diabetes in Pregnancy.
But what is particularly concerning, reveals Kengne, is that over two thirds of in Africa remain undiagnosed and therefore untreated. In cases where treatment is received, the disease has often progressed too far down the line and the quality of care is not optimal.
Adam agrees that under and undiagnosed diabetes incidents in pregnant women is a problem leading to long-term negative health outcomes in children including childhood obesity, Type 2 DM and metabolic syndrome.
What is needed, argues Kengne, is better access to diagnosis and treatment. To better manage diabetes, he says, requires both an improvement in the current knowledge of how to postpone the disease, and better still, to prevent the diseases from taking hold. “At this stage, we are working on the first study dealing with prevention in a South African context,” he reveals. Sadly however, little has been done in terms of education and prevention on the continent overall.
That said, Kengne cautions against taking a negative attitude, saying there is no reason why this situation cannot be changed. He cites the recent introduction of a sugar tax in South Africa as a successful example of what can be done to reduce the incidence of obesity and chronic disease in Africa.
Early diagnosis is key, and to this end, there is a need for proactive action at all stages of an individual’s life cycle, says Kengne. He explains what he terms the Life Course approach to the prevention, diagnosis and treatment of diabetes, which should essentially start at the phase of planned pregnancy.
“This entails ensuring the expectant mother follows the correct diet, is not exposed to any health risks and that her weight and that of the baby are monitored throughout the pregnancy. This approach to health and diet should be taken throughout the lives of mother and child,” he says.
Obesity and related diabetes that presents early in life is far harder to manage, he points out. “Our mistake is to wait until people have already developed the disease, rather than using an approach which promotes healthy choices and will prevent it from developing in the first place.”