Estimating the Prevalence of Asymptomatic Type 2 Diabetes in Kinshasa, Democratic Republic of Congo

Abstract

Introduction
In the Democratic Republic of Congo (DRC), a large part of the
population has no access to modern healthcare. Therefore, most people
with asymptomatic type 2 diabetes and prediabetes go without the
required early medical and lifestyle interventions. The risk for
developing major complications increases the longer a person stays in
the asymptomatic phase without intervention. Thus, it is essential to
invest in the early detection of type 2 diabetes and prediabetes in order
to mitigate morbidity and mortality.
Objectives
The aim of this study was to screen asymptomatic participants for type 2 diabetes in Kinshasa,
Democratic Republic of Congo (DRC) in order to determine, 1) the prevalence of asymptomatic
diabetes and 2) the prevalence of prediabetes; and 3) to identify predictor metrics for hyperglycemia
conditions.
Methods
A cross-sectional design was used to collect data from a convenient sample of 972 adults (20 years-old
and above) participants from four communes of Kinshasa. Multiple Regression, Logistic Regression,
and Probit Regression analyses were used to find metrics which are predictors of hyperglycemia.
Results
The mean age of the sample (N=972) was 46 years, with male’s participants accounting for 60.4 % of
the total. The prevalence of prediabetes and diabetes were 18.0% and 8.4%, respectively. Close to half
of participants diagnosed with diabetes had a positive history of either diabetes or hypertension.
Results of Multiple Regression, Logistic Regression, and Probit Regression analyses show that “waist
to hip ratio” and “hypertension” are directly linked to the probability for someone to have
hyperglycemia. This finding contrasts the widely accepted observation that the BMI (obesity) is the
most important predictor for developing diabetes in affluent regions of the world. These results
highlight the need for more studies of the prevalence of diabetes and its risk factors for populations
challenged by poverty.
Conclusion
The prevalence of type 2 diabetes and prediabetes are high in Kinshasa. Strong data from further
screening studies are needed in order to inform policies as well as prevention and control programs
for type 2 diabetes and prediabetes. The waist-to-hip ratio and hypertension are better metrics than
the standard BMI for predicting the development of diabetes in the population of Kinshasa, which is
representative of populations living in urban areas in the Democratic Republic of Congo