Prevalence of type 2 diabetes and other cardiovascular risk factors in Mayotte in 2008: The MAYDIA study

Abstract

Aim Mayotte, a French overseas territory located in the Indian Ocean, has never had a previous estimate of diabetes prevalence, but has recently undergone socioeconomic changes leading to lifestyle modifications. For this reason, a survey was carried out in 2008 to estimate the prevalence of diabetes and cardiovascular risk factors in the island's population. Methods A three-step, randomized sample of 1268 individuals, aged 30–69 years, was home-screened, using capillary blood glucose and capillary HbA 1c, weight, height, waist circumference and two blood-pressure measurements. Those with a history of diabetes, glucose ≥1 g/L (fasting) or ≥1.40 g/L (non-fasting), or HbA 1c ≥ 6%, and a subgroup of those with normal results were examined at a healthcare centre to measure venous HbA 1c and glucose, and to diagnose diabetes, using an oral glucose tolerance test. Results The weighted prevalence of diabetes (venous plasma glucose ≥1.26 g/L at fasting and/or ≥2 g/L at 2 h, or treatment with oral hypoglycaemic agents or insulin) was 10.5% (95% CI: 8.2–13.4%). This increased with age from 3% at age 30–39 years to 26% at age 60–69 years, with no gender differences. Also, more than 50% of those with diabetes were unaware of it, while half of those treated for diabetes still had HbA 1c levels >7%. The prevalence of overweight (BMI: 25–29 kg/m 2) was estimated to be 35% in men and 32% in women, while obesity (≥ 30 kg/m 2) was estimated to be 17% in men and 47% in women. Conclusion The high prevalence of obesity combined with a high prevalence of diabetes indicates a potential for further increases in the prevalence of diabetes and cardiovascular disease in Mayotte. Preventative action against obesity, diabetes and hypertension is required now, as well as plans for appropriate healthcare delivery in the island.