Abstract
BackgroundDiabetes is a major health problem and cause of death worldwide. It is predicted that the prevalence of diabetes will increase from 415 million in 2015 to 642 million in 2040. However, the burden of diabetes in low- and middle-income countries is not clearly understood, particularly its interaction with other chronic illnesses. This study investigates the self-reported prevalence of and factors associated with diabetes and cardiovascular comorbidity in South Africa.MethodsData used in this study are from the 2012 South African National Health and Nutrition Examination Survey; a nationally representative cross-sectional household survey (N = 25,532). Diabetes and cardiovascular disease comorbidity was defined as the coexistence of diabetes plus one or more cardiovascular diseases reported at the time of the survey. This study makes use of multinomial logistic regression models to analyse the relationship between diabetes - cardiovascular disease comorbidity and several predictors including race, income, socio-economic status and obesity.ResultsAccording to the survey data we analysed, 5% of South Africans aged 15 and above had self-reported diabetes in 2011–2012. Among those with self-reported diabetes, 73% had at least one additional cardiovascular chronic illness. Diabetes and its cardiovascular disease comorbidity was more prevalent in Africans (66%), females (66%), those who lived in urban areas (75%), had secondary education (44%) and were unemployed (62%). Factors strongly associated with diabetes - cardiovascular disease comorbidity were older age (Odds ratio [OR] 1.09; 95% Confidence Interval [CI] 1.06–1.12), high household income (0.27; 0.10–0.76) versus low income, moderate (0.33; 0.11–0.96) and good self-rated health (0.24; 0.08–0.68) versus bad self-rated health, occasional (0.29; 0.10–0.88) and regular smokers (0.25; 0.12–0.53) versus non-smokers and physical activity (0.15; 0.03–0.68) versus no physical activity.ConclusionThe study provides insight into the factors associated with cardiovascular disease comorbidity in diabetic individuals. The findings indicate that there are differences in the factors associated with diabetes and those associated with diabetes - cardiovascular disease comorbidity. This provides information, which can be used to design programmes that encourage healthy lifestyles in people living with diabetes.
Highlights
Diabetes is a major health problem and cause of death worldwide
The findings indicate that there are differences in the factors associated with diabetes and those associated with diabetes - cardiovascular disease comorbidity
Of the 1000 people who reported diabetes, approximately 73% had at least one of the Cardio-vascular disease (CVD) chronic illnesses included in the study, whilst 27% reported having diabetes and no CVD chronic illness included in the study
Summary
It is predicted that the prevalence of diabetes will increase from 415 million in 2015 to 642 million in 2040. The burden of diabetes in lowand middle-income countries is not clearly understood, its interaction with other chronic illnesses. The prevalence of diabetes is expected to increase from 415 million in 2015 to 642 million in 2040 [1]. Diabetes and its related illnesses is an increasing cause of premature death and it is estimated to have caused significantly more deaths in 2015 than in 2005. In South Africa, diabetes ranked third amongst the top 10 causes of death in 2014 [4]. The statistics of the rising prevalence and mortality due to diabetes globally makes it one of the biggest public health concerns of the twenty-first century [1]
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