Godman Brian, Basu Debashis, Pillay Yogan, Mwita Julius C, Rwegerera Godfrey Mutashambara, Anand Paramadhas Bene D, Tiroyakgosi Celda, Okwen Patrick Mbah, Niba Loveline Lum, Nonvignon Justice, Sefah Israel, Oluka Margaret, Guantai Anastasia N, Kibuule Dan, Kalemeera Francis, Mubita Mwangana, Fadare Joseph, Ogunleye Olayinka O, Distiller Larry A, Rampamba Enos M, Wing Jeffrey, Mueller Debjani, Alfadl Abubakr, Amu Adefolarin A, Matsebula Zinhle, Kalungia Aubrey, Zaranyika Trust, Masuka Nyasha, Wale Janney, Hill Ruaraidh, Kurdi Amanj, Timoney Angela, Campbell Stephen, Meyer Johanna C
Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.
Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Front Pharmacol. 2020 Mar 20;11:108. doi: 10.3389/fphar.2020.00108. eCollection 2020.
There has been an appreciable increase in the number of people in Africa with metabolic syndrome and Type 2 diabetes (T2DM) in recent years as a result of a number of factors. Factors include lifestyle changes, urbanisation, and the growing consumption of processed foods coupled with increasing levels of obesity. Currently there are 19 million adults in Africa with diabetes, mainly T2DM (95%), estimated to grow to 47 million people by 2045 unless controlled. This has a considerable impact on morbidity, mortality and costs in the region. There are a number of issues to address to reduce the impact of T2DM including improving detection rates and current access to services alongside addressing issues of adherence to prescribed medicines. There are also high rates of co-morbidities with infectious diseases such as HIV and tuberculosis in patients in Africa with T2DM that require attention.
Document ongoing activities across Africa to improve the care of patients with T2DM especially around issues of identification, access, and adherence to changing lifestyles and prescribed medicines. In addition, discussing potential ways forward to improve the care of patients with T2DM based on ongoing activities and experiences including addressing key issues associated with co-morbidities with infectious diseases.
Contextualise the findings from a wide range of publications including internet based publications of national approaches coupled with input from senior level government, academic and other professionals from across Africa to provide future guidance.
A number of African countries are actively instigating programmes to improve the care of patients with T2DM starting with improved diagnosis. This recognises the growing burden of non-communicable diseases across Africa, which has been neglected in the past. Planned activities include programmes to improve detection rates and address key issues with diet and lifestyle changes, alongside improving monitoring of care and activities to enhance adherence to prescribed medicines. In addition, addressing potential complexities involving diabetes patients with infectious disease co-morbidities. It is too early to fully assess the impact of such activities.
There are a number of ongoing activities across Africa to improve the management of patients with diabetes including co-morbidities. However, more needs to be done considering the high and growing burden of T2DM in Africa. Ongoing research will help further benefit resource allocation and subsequent care.
近年来，由于多种因素，非洲患有代谢综合征和2型糖尿病（T2DM）的人数显著增加。这些因素包括生活方式的改变、城市化、加工食品消费的增加以及肥胖率的上升。目前，非洲有1900万成年人患有糖尿病，主要是T2DM（95%），预计到2045年将增至4700万人，除非得到控制。这对该地区的发病率、死亡率和成本产生了相当大的影响。为降低T2DM的影响，有许多问题需要解决，包括提高检测率、改善当前的服务可及性以及解决患者对处方药的依从性问题。非洲患有T2DM的患者中，与艾滋病病毒和结核病等传染病合并存在的比率也很高，需要引起关注。
记录非洲各地正在开展的活动，以改善T2DM患者的护理，特别是在识别、服务可及性以及适应生活方式改变和遵医嘱服药方面的问题。此外，根据正在开展的活动和经验，讨论改善T2DM患者护理的潜在途径，包括解决与传染病合并存在相关的关键问题。
结合包括各国方法的网络出版物在内的广泛出版物中的研究结果，并纳入非洲高级政府官员、学者和其他专业人士的意见，以提供未来指导。
一些非洲国家正在积极启动改善T2DM患者护理的项目，首先是改善诊断。这认识到非洲非传染性疾病负担日益加重，而这在过去一直被忽视。计划开展的活动包括提高检测率的项目、解决饮食和生活方式改变方面的关键问题、改善护理监测以及加强对处方药依从性的活动。此外，还要解决糖尿病合并传染病患者可能面临的复杂问题。全面评估这些活动的影响还为时过早。
非洲各地正在开展多项活动以改善糖尿病患者包括合并症患者的管理。然而，鉴于非洲T2DM负担沉重且不断加重，仍有更多工作要做。正在进行的研究将有助于进一步优化资源分配和后续护理。
