Chronic Diseases of Lifestyle Research Unit, South African Medical Research Council, Durban, South Africa.
Chronic Diseases of Lifestyle Research Unit, South African Medical Research Council, Cape Town, South Africa.
Diabetes Res Clin Pract. 2014 Feb;103(2):197-205. doi: 10.1016/j.diabres.2013.11.006. Epub 2013 Dec 1.
The Africa Region (AFR), where diabetes was once rare, has witnessed a surge in the condition. Estimates for type 1 diabetes suggest that about 39,000 people suffer from the disease in 2013 with 6.4 new cases occurring per year per 100,000 people in children <14 years old. Type 2 diabetes prevalence among 20-79-year-olds is 4.9% with the majority of people with diabetes <60 years old; the highest proportion (43.2%) is in those aged 40-59 years. Figures are projected to increase with the numbers rising from 19.8 million in 2013 to 41.5 million in 2035, representing a 110% absolute increase. There is an apparent increase in diabetes prevalence with economic development in AFR with rates of 4.4% in low-income, 5.0% in lower-middle income and 7.0% in upper-middle income countries. In addition to development and increases in life-expectancy, the likely progression of people at high risk for the development of type 2 diabetes will drive the expected rise of the disease. This includes those with impaired glucose tolerance, the prevalence of which is 7.3% among 20-79-year-olds in 2013. Mortality attributable to diabetes in 2013 in AFR is expected to be over half a million with three-quarter of these deaths occurring in those <60 years old. The prevalence of undiagnosed diabetes remains unacceptably high at 50.7% and is much higher in low income (75.1%) compared to lower- and upper-middle income AFR countries (46.0%). This highlights the inadequate response of local health systems which need to provide accessible, affordable and optimal care for diabetes.
非洲区域（AFR）曾经很少见糖尿病，但现在这种疾病的发病率急剧上升。1 型糖尿病的估计表明，2013 年约有 3.9 万人患有该病，每 10 万 14 岁以下儿童每年有 6.4 例新发病例。20-79 岁人群的 2 型糖尿病患病率为 4.9%，大多数糖尿病患者年龄小于 60 岁；年龄在 40-59 岁的人群比例最高（43.2%）。预计这些数字将增加，从 2013 年的 1980 万增加到 2035 年的 4150 万，绝对增长 110%。随着 AFR 经济的发展，糖尿病的患病率明显上升，低收入国家为 4.4%，中下收入国家为 5.0%，中上收入国家为 7.0%。除了发展和预期寿命的增加外，发展为 2 型糖尿病高风险人群的进程也将推动这种疾病的预期上升。这包括糖耐量受损者，2013 年 20-79 岁人群的患病率为 7.3%。2013 年 AFR 因糖尿病导致的死亡率预计将超过 50 万，其中四分之三的死亡发生在年龄小于 60 岁的人群中。未确诊糖尿病的患病率仍然高得令人无法接受，为 50.7%，在低收入国家（75.1%）明显高于中下收入和中上收入 AFR 国家（46.0%）。这突显了当地卫生系统的应对不足，这些系统需要为糖尿病患者提供可及、负担得起和最佳的护理。
