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Open Access Research article

Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors

Ina Danquah12, George Bedu-Addo3, Karl-Johann Terpe1, Frank Micah3, Yaw A Amoako3, Yaw A Awuku3, Ekkehart Dietz4, Markus van der Giet5, Joachim Spranger6 and Frank P Mockenhaupt1*

Author Affiliations

1 Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Berlin, Germany

2 Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

3 Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

4 Institute of Biometry and Clinical Epidemiology, Charité - University Medicine Berlin, Berlin, Germany

5 Department of Medicine IV - Nephrology, Charité - University Medicine Berlin, Berlin, Germany

6 Department of Endocrinology, Diabetes and Nutritional Medicine, Charité - University Medicine Berlin, Berlin, Germany

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BMC Public Health 2012, 12:210  doi:10.1186/1471-2458-12-210

Published: 20 March 2012

Abstract

Background

Sub-Saharan Africa faces a rapid spread of diabetes mellitus type 2 (DM2) but its potentially specific characteristics are inadequately defined. In this hospital-based study in Kumasi, Ghana, we aimed at characterizing clinical, anthropometric, socio-economic, nutritional and behavioural parameters of DM2 patients and at identifying associated factors.

Methods

Between August 2007 and June 2008, 1466 individuals were recruited from diabetes and hypertension clinics, outpatients, community, and hospital staff. Fasting plasma glucose (FPG), serum lipids and urinary albumin were measured. Physical examination, anthropometry, and interviews on medical history, socio-economic status (SES), physical activity and nutritional behaviour were performed.

Results

The majority of the 675 DM2 patients (mean FPG, 8.31 mmol/L) was female (75%) and aged 40-60 years (mean, 55 years). DM2 was known in 97% of patients, almost all were on medication. Many had hypertension (63%) and microalbuminuria (43%); diabetic complications occurred in 20%. Overweight (body mass index > 25 kg/m2), increased body fat (> 20% (male), > 33% (female)), and central adiposity (waist-to-hip ratio > 0.90 (male), > 0.85 (female)) were frequent occurring in 53%, 56%, and 75%, respectively. Triglycerides were increased (≥ 1.695 mmol/L) in 31% and cholesterol (≥ 5.17 mmol/L) in 65%. Illiteracy (46%) was high and SES indicators generally low. Factors independently associated with DM2 included a diabetes family history (adjusted odds ratio (aOR), 3.8; 95% confidence interval (95%CI), 2.6-5.5), abdominal adiposity (aOR, 2.6; 95%CI, 1.8-3.9), increased triglycerides (aOR, 1.8; 95%CI, 1.1-3.0), and also several indicators of low SES.

Conclusions

In this study from urban Ghana, DM2 affects predominantly obese patients of rather low socio-economic status and frequently is accompanied by hypertension and hyperlipidaemia. Prevention and management need to account for a specific risk profile in this population.