Diabetes in sub-Saharan Africa

The Lancet

Volumn 375, Issue 9733, 2010, Pages 2254-2266

  Mbanya, Jean Claude N ^a   Motala, Ayesha A ^b   Sobngwi, Eugene ^a,c   Assah, Felix K ^d   Enoru, Sostanie T ^e  

^a UNIVERSITY OF YAOUNDÉ I   (Cameroon)

^b UNIVERSITY OF KWAZULU NATAL   (South Africa)

^c NEWCASTLE UNIVERSITY   (United Kingdom)

^d ADDENBROOKE S HOSPITAL   (United Kingdom)

^e Hopital Central de Yaounde   (Cameroon)

Author keywords

[No Author keywords available]

Indexed keywords

CYTOTOXIC T LYMPHOCYTE ANTIGEN 4; HLA ANTIGEN; ORAL ANTIDIABETIC AGENT; TOLL LIKE RECEPTOR 3;

AFRICA; AGE DISTRIBUTION; AWARENESS; CORONARY ARTERY DISEASE; DIABETIC KETOACIDOSIS; DIABETIC RETINOPATHY; DIET; DISEASE CONTROL; GENE FREQUENCY; GENETIC ASSOCIATION; GENETIC POLYMORPHISM; GEOGRAPHIC DISTRIBUTION; GLUCOSE TOLERANCE; GLYCEMIC CONTROL; HEALTH CARE ACCESS; HEALTH CARE AVAILABILITY; HEALTH CARE FACILITY; HETEROZYGOSITY; HUMAN; HYPERGLYCEMIA; INNATE IMMUNITY; INSULIN DEPENDENT DIABETES MELLITUS; INSULIN RELEASE; INSULIN RESISTANCE; LIFESTYLE MODIFICATION; MASS SCREENING; MICROANGIOPATHY; MORTALITY; NON INSULIN DEPENDENT DIABETES MELLITUS; OBESITY; PATHOGENESIS; PHYSICAL ACTIVITY; PREVALENCE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SOCIAL STATUS; URBAN RURAL DIFFERENCE; URBANIZATION;

EID: 77953821203     PISSN: 01406736     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0140-6736(10)60550-8     Document Type: Review

References (130)

1. McLarty D.G., Pollitt C., and Swai A. Diabetes in Africa. Diabet Med 7 (1990) 670-684
2. Motala A.A., Omar M., and Pirie F.J. Epidemiology of diabetes in Africa. In: Ekoe J.-M., Rewers M., Williams R., and Zimmet P. (Eds). The epidemiology of diabetes mellitus. 2nd edn. (2008), Wiley, Chichester 133-146
3. Levitt N.S. Diabetes in Africa: epidemiology, management and health care challenges. Heart 4 (2008) 1376-1382
4. National diabetes data group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28 (1979) 1039-1057
5. WHO. WHO expert committee on diabetes mellitus, second report (technical report series no 646) (1980), World Health Organization, Geneva
6. WHO. Diabetes mellitus: report of a WHO study group (technical report series no 727) (1985), World Health Organization, Geneva
7. King H., and Rewers M. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults: WHO ad hoc diabetes reporting group. Diabetes Care 16 (1993) 157-177
8. Amos A.F., McCarty D.J., and Zimmet P. The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabet Med 14 suppl 5 (1997) S1-S85
9. King H., Aubert R.E., and Herman W.H. Global burden of diabetes: prevalence, numerical estimates and projections. Diabetes Care 21 (1998) 1414-1431
10. Wild S., Roglic G., Green A., Sicree R., and King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27 (2004) 1047-1053
11. IDF. Diabetes atlas. 3rd edn. (2006), International Diabetes Federation, Brussels
12. IDF. Diabetes atlas. 4th edn. (2009), International Diabetes Federation, Brussels
13. UN-OHRLLS. Least developed countries: country profiles. http://www.un.org/special-rep/ohrlls/ldc/list.htm (accessed Feb 2, 2010).
14. World Bank. Key development data and statistics. http://data.worldbank.org/about/country-classifications/country-and-lending-groups#Sub_Saharan_Africa (accessed May 30, 2010).
15. Afoke A.O., Ejeh N.M., Nwonu E.N., Okafor C.O., Udeh N.J., and Ludvigsson J. Prevalence and clinical picture of IDDM in Nigerian Igbo school children. Diabetes Care 15 (1992) 1310-1312
16. Elamin A., Omer M.I., Hofvander Y., and Tuvemo T. Prevalence of IDDM in school children in Khartoum, Sudan. Diabetes Care 12 (1989) 430-432
17. Swai A., Lutale J., and McLarty D.G. Diabetes in tropical Africa: a prospective study 1981-7. BMJ 300 (1990) 1103-1106
18. Elamin A., Omer M.I., Zein K., and Tuvemo T. Epidemiology of childhood type I diabetes in Sudan, 1987-1990. Diabetes Care 15 (1992) 1556-1559
19. Omar M., and Asmal A.C. Patterns of diabetes mellitus in young African and Indians in Natal. Trop Geogr Med 36 (1984) 133-138
20. Kalk W.J., Huddle K.R.L., and Raal F.J. The age of onset and sex distribution of insulin-dependent diabetes mellitus in Africans in South Africa. Postgrad Med J 69 (1993) 552-556
21. Lester F.T. The clinical pattern of diabetes mellitus in Ethiopians. Diabetes Care 7 (1984) 6-11
22. Fisch A., Pichard E., Prazuck T., Leblanc H., Sidibe Y., and Brücker G. Prevalence and risk factors of diabetes mellitus in the rural regions of Mali (West Africa): a practical approach. Diabetologia 30 (1982) 859-862
23. Teuscher T., Rosman J.B., Baillod P., and Teuscher A. Absence of diabetes in a rural West African population with a high carbohydrate/cassava diet. Lancet 329 (1987) 765-768
24. Ohwovoriole A.E., Kuti J.A., and Kabiawu S. Casual blood glucose levels and prevalence of undiscovered diabetes mellitus in Lagos Metropolis Nigerians. Diabetes Res Clin Pract 4 (1988) 153-158
25. Erasmus R.T., Fakeye T., Olukoga O., et al. Prevalence of diabetes mellitus in a Nigerian population. Trans R Soc Trop Med Hyg 83 (1989) 417-418
26. Cooper R.S., Rotimi C.N., Kaufman J.S., et al. Prevalence of NIDDM among populations of the African diaspora. Diabetes Care 20 (1997) 343-348
27. Ducorps M., Baleynaud S., Mayaudon H., Castagne C., and Bauduceau B. A prevalence survey of diabetes in Mauritania. Diabetes Care 19 (1996) 761-763
28. Mbanya J.C., Ngogang J., Salah J.N., Minkoulou E., and Balkau B. Prevalence of NIDDM and impaired glucose tolerance in a rural and urban population in Cameroon. Diabetologia 40 (1997) 824-829
29. Olatunbosun S.T., Ojo P.O., Fineberg N.S., and Bella A.F. Prevalence of diabetes mellitus and impaired glucose tolerance in a group of urban adults in Nigeria. J Natl Med Assoc 90 (1998) 293-301
30. Mbanya J.C., Cruickshank J.K., Forrester T., et al. Standardized comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain. Diabetes Care 22 (1999) 434-440
31. Ahrén B., and Corrigan C.B. Prevalence of diabetes mellitus in northwestern Tanzania. Diabetologia 26 (1984) 333-336
32. McLarty D.G., Kitange H.M., Mtinangi B.L., et al. Prevalence of diabetes and impaired glucose tolerance in rural Tanzania. Lancet 333 (1989) 871-875
33. Elbagir M.N., Eltom M.A., Elmahadi E., Kadam I., and Berne C. A population-based study of the prevalence of diabetes and impaired glucose tolerance in adults in northern Sudan. Diabetes Care 19 (1996) 1126-1128
34. Elbagir M.N., Eltom M.A., Elmahadi E., Kadam I., and Berne C. A high prevalence of diabetes mellitus and impaired glucose tolerance in the Danagla community in northern Sudan. Diabet Med 15 (1998) 164-169
35. Omar M., Seedat M.A., Motala A.A., Dyer R.B., and Becker P. The prevalence of diabetes mellitus and impaired glucose tolerance in a group of urban South African Blacks. S Afr Med J 83 (1993) 641-643
36. Levitt N.S., Katzenellenbogen J.M., Bradshaw D., Hoffman M.N., and Bonnici F. The prevalence and identification of risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care 16 (1993) 601-607
37. Mollentze W.F., Moore A.J., Steyn A.F., et al. Coronary heart disease risk factors in a rural and urban Orange Free State black population. S Afr Med J 85 (1995) 90-96
38. Aspray T.J., Mugusi F., Rashid S., et al., for the essential non-communicable disease health intervention project. Rural and urban differences in diabetes prevalence in Tanzania: the role of obesity, physical inactivity and urban living. Trans R Soc Trop Med Hyg 94 (2000) 637-644
39. Amoah A.G., Owusu S.K., and Adjei S. Diabetes in Ghana: a community based prevalence study in Greater Accra. Diabetes Res Clin Pract 56 (2002) 197-205
40. Baldé N.M., Diallo I., Baldé M.D., et al. Diabetes and impaired fasting glucose in rural and urban populations in Futa Jallon (Guinea): prevalence and associated risk factors. Diabetes Metab 33 (2007) 114-120
41. Motala A.A., Esterhuizen T., Gouws E., Pirie F.J., and Omar M.A. Diabetes mellitus and other disorders of glycaemia in a rural South Africa community: prevalence and associated risk factors. Diabetes Care 31 (2008) 1783-1788
42. Christensen D.L., Friis H., Mwaniki D.L., et al. Prevalence of glucose intolerance and associated risk factors in rural and urban populations of different ethnic groups in Kenya. Diabetes Res Clin Pract 84 (2009) 303-310
43. Anon. Report of the Expert Committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 20 (1997) 1183-1197
44. The expert committee on the diagnosis and classification of diabetes mellitus. Follow up report on the diagnosis of diabetes mellitus. Diabetes Care 26 (2003) 3160-3167
45. Alberti K.G.M.M., and Zimmet P.Z. Definition, diagnosis and classification of diabetes mellitus and its complications, part 1: diagnosis and classification of diabetes mellitus-provisional report of a WHO consultation. Diabet Med 15 (1998) 539-553
46. WHO. STEPS country reports. http://www.who.int/chp/steps/reports/en/ (accessed Feb 3, 2010).
47. Dowse G., Zimmet P., and King H. Relationship between prevalence of impaired glucose tolerance and NIDDM in a population. Diabetes Care 14 (1991) 968-974
48. Levitt N.S., Unwin N.C., Bradshaw D., et al. Application of the new ADA criteria for the diagnosis of diabetes to population studies in sub-Saharan Africa. Diabet Med 17 (2000) 381-385
49. Mbanya J.C., and Sobngwi E. Diabetes microvascular and macrovascular disease in Africa. J Cardiovasc Risk 10 (2003) 97-102
50. Kengne A.P., Amoah A.G., and Mbanya J.C. Cardiovascular complications of diabetes mellitus in sub-Saharan Africa. Circulation 112 (2005) 3592-3601
51. WHO. STEPwise approach to chronic disease risk factor surveillance: Cameroon burden of diabetes project, baseline survey report (2004). http://www.who.int/chp/steps/cameroon/en/index.html (accessed April 23, 2010).
52. Sobngwi E., Mauvais-Jarvis F., Vexiau P., Mbanya J.C., and Gautier J.F. Diabetes in Africans, part 2: ketosis prone atypical diabetes mellitus. Diabetes Metab 28 (2002) 5-12
53. Umpierrez G.E., Smiley D., and Kitabchi A.E. Narrative review: ketosis-prone type 2 diabetes mellitus. Ann Intern Med 114 (2006) 350-357
54. Balasubramanyam A., Nalini R., Hampe C.S., and Maldonado M. Syndromes of ketosis-prone diabetes mellitus. Endocr Rev 29 (2008) 292-302
55. Alberti K.G.M.M. Tropical pancreatic diabetes. In: Gill G., Mbanya J.C., and Alberti K.G. (Eds). Diabetes in Africa (1997), FSG Communications, Cambridge
56. Osei K., Schuster D.P., Amoah A.G., and Owusu S.K. Diabetes in Africa: pathogenesis of type 1 and type 2 diabetes mellitus in sub-Saharan Africa-implications for transitional populations. J Cardiovasc Risk 10 (2003) 85-96
57. Mbanya J.C., Sobngwi E., and Mbanya D. HLA-DRB1, -DQA1, -DQB1 and DPB1 susceptibility. Eur J Immunogenet 28 (2001) 459-462
58. Pirie F.J., Pegoraro R., Motala A.A., et al. Toll-like receptor 3 gene polymorphisms in South African blacks with type 1 diabetes. Tissue Antigens 66 (2005) 125-130
59. Osei-Hyiaman D., Hou L., Zhiyin R., et al. Association of a novel point mutation (C159G) of the CTLA4 gene with type 1 diabetes in West Africans but not in Chinese. Diabetes 50 (2001) 2169-2171
60. McLarty D.G., Athaide I., Bottazzo G.F., Swai A.M., and Alberti K.G. Islet cell antibodies are not specifically associated with insulin-dependent diabetes in Tanzanian Africans. Diabetes Res Clin Pract 9 (1990) 219-224
61. Oli J.M., Bottazzo G.F., and Doniach D. Islet cell antibodies in Nigerian diabetics. Lancet 315 (1980) 1090
62. Omar M., Bottazzo G.F., and Asmal A.C. Islet cell antibodies and other autoantibodies in South African blacks and Indians with insulin dependent diabetes mellitus (IDDM). Horm Metab Res 18 (1986) 26-28
63. Panz V.R., Kalk W.J., Zouvanis M., and Joffe B.I. Distribution of autoantibodies to glutamic acid decarboxylase across the spectrum of diabetes mellitus seen in South Africa. Diabet Med 17 (2000) 524-527
64. Lutale J., Thordarson H., Holm P., Eide G., and Vetvik K. Islet cell autoantibodies in African patients with type 1 and type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study. J Autoimmune Dis 27 (2007) 4
65. Rotimi C.N., Chen G., Adeyemo A.A., et al. A genome-wide search for type 2 diabetes susceptibility genes in West Africans: the Africa America Diabetes Mellitus (AADM) Study. Diabetes 53 (2004) 838-841
66. Chen Y., Kittles R., Zhou J., et al. Calpain-10 gene polymorphisms and type 2 diabetes in West Africans: the Africa America Diabetes Mellitus (AADM) Study. Ann Epidemiol 15 (2005) 153-159
67. Chen G., Adeyemo A., Zhou J., et al. Genome-wide search for susceptibility genes to type 2 diabetes in West Africans: potential role of C-peptide. Diabetes Res Clin Pract 78 (2007) e1-e6
68. Helgason A., Pálsson S., Thorleifsson G., et al. Refining the impact of TCF7L2 gene variants on type 2 diabetes and adaptive evolution. Nat Genet 39 (2007) 218-225
69. Tong Y., Lin Y., Zhang Y., et al. Association between TCF7L2 gene polymorphisms and susceptibility to type 2 diabetes mellitus: a large Human Genome Epidemiology (HuGE) review and meta-analysis. BMC Med Genet 10 (2009) 15
70. Ramaiya K.L., Swai A.B., McLarty D.G., and Alberti K.G. Impaired glucose tolerance and diabetes mellitus in Hindu Indian immigrants in Dar-es-Salaam. Diabet Med 8 (1991) 738-744
71. Swai A.B., McLarty D.G., Sherrif F., et al. Diabetes and impaired glucose tolerance in an Asian community in Tanzania. Diabetes Res Clin Pract 8 (1990) 227-234
72. Omar M., Seedat M.A., Dyer R.B., Motala A.A., Knight L.T., and Becker P.J. South African Indians show a high prevalence of NIDDM and bimodality in plasma glucose distribution patterns. Diabetes Care 17 (1994) 70-73
73. Levitt N.S., Steyn K., Lambert E.V., et al. Modifiable risk factors for type 2 diabetes mellitus in a peri-urban community in South Africa. Diabet Med 16 (1999) 946-950
74. United Nations Population Fund. State of world population 2007: unleashing the potential of urban growth. http://www.unfpa.org/swp/2007/english/introduction.html (accessed Feb 27, 2010).
75. UN Department of Economic and Social Affairs, and Population Division. World urbanization prospects: the 2007 revision (2008). http://www.un.org/esa/population/publications/wup2007/2007wup.htm (accessed April 27, 2010).
76. Popkin B.M., and Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord 28 (2004) S2-S9
77. Omran A.R. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Q 83 (2005) 731-757
78. Mayosi B.M., Flisher A.J., Lalloo U.G., Sitas F., Tollman S.M., and Bradshaw D. The burden of non-communicable diseases in South Africa. Lancet 374 (2009) 934-947
79. Unwin N., McLarty D., and Machibya H. Changes in blood pressure and lipids associated with rural to urban migration in Tanzania. J Hum Hypertens 20 (2006) 704-706
80. Sobngwi E., Mbanya J.C., Unwin N.C., et al. Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon. Int J Epidemiol 33 (2004) 769-776
81. Teo K., Chow C.K., Vaz M., Rangarajan S., and Yusuf S. The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. Am Heart J 158 (2009) 1-7
82. Amoah A.G. Sociodemographic variations in obesity among Ghanaian adults. Public Health Nutr 6 (2003) 751-757
83. Ziraba A.K., Fotso J.C., and Ochako R. Overweight and obesity in urban Africa: a problem of the rich or the poor. BMC Public Health 9 (2009) 465
84. Ntandou G., Delisle H., Agueh V., and Fayomi B. Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa. Nutr Res 29 (2009) 180-189
85. Agyemang C., Owusu-Dabo E., de Jonge A., Martins D., Ogedegbe G., and Stronks K. Overweight and obesity among Ghanaian residents in The Netherlands: how do they weigh against their urban and rural counterparts in Ghana?. Public Health Nutr 12 (2009) 909-916
86. Neilson H.K., Robson P.J., Friedenreich C.M., and Csizmadi I. Estimating activity energy expenditure: how valid are physical activity questionnaires?. Am J Clin Nutr 87 (2008) 279-291
87. Wareham N.J., and Rennie K.L. The assessment of physical activity in individuals and populations: why try to be more precise about how physical activity is assessed?. Int J Obes Relat Metab Disord 22 (1998) S30-S38
88. Assah F.K., Ekelund U., Brage S., Mbanya J.C., and Wareham N.J. Free-living physical activity energy expenditure is strongly related to glucose intolerance in Cameroonian adults independently of obesity. Diabetes Care 32 (2009) 367-369
89. Kolbe-Alexander T.L., Lambert E.V., Harkins J.B., and Ekelund U. Comparison of two methods of measuring physical activity in South African older adults. J Aging Phys Act 14 (2006) 98-114
90. Cole A.H., and Ogbe J.O. Energy intake, expenditure and pattern of daily activity of Nigerian male students. Br J Nutr 58 (1987) 357-367
91. Luke A., Dugas L.R., Ebersole K., et al. Energy expenditure does not predict weight change in either Nigerian or African American women. Am J Clin Nutr 89 (2009) 169-176
92. Singh J., Prentice A.M., Diaz E., et al. Energy expenditure of Gambian women during peak agricultural activity measured by the doubly-labelled water method. Br J Nutr 62 (1989) 315-329
93. Dugas L.R., Cohen R., and Carstens M.T. Total daily energy expenditure in black and white, lean and obese South African women. Eur J Clin Nutr 63 (2009) 667-673
94. Heini A.F., Minghelli G., Diaz E., Prentice A.M., and Schutz Y. Free-living energy expenditure assessed by two different methods in rural Gambian men. Eur J Clin Nutr 50 (1996) 284-289
95. Huss-Ashmore R., Goodman J.L., Sibiya T.E., and Stein T.P. Energy expenditure of young Swazi women as measured by the doubly-labelled water method. Eur J Clin Nutr 43 (1989) 737-748
96. Christensen D.L. Glucose intolerance in relation to body composition, physical activity and other predictors among the Luo, Kamba and Maasai of Kenya [PhD Thesis] (2008), University of Copenhagen, Copenhagen
97. Assah F.K. Physical activity, cardiorespiratory fitness and metabolic health in Cameroon [PhD Thesis] (2009), University of Cambridge, Cambridge
98. Bourne L.T., Lambert E.V., and Steyn K. Where does the black population of South Africa stand on the nutrition transition?. Public Health Nutr 5 (2002) 157-162
99. Mennen L.I., Jackson M., Sharma S., et al. Habitual diet in four populations of African origin: a descriptive paper on nutrient intakes in rural and urban Cameroon, Jamaica and Caribbean migrants in Britain. Public Health Nutr 4 (2001) 765-772
100. Vorster H.H., Venter C.S., Wissing M.P., and Margetts B.M. The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study. Public Health Nutr 8 (2005) 480-490
101. Levitt N.S., and Bradshaw D. The impact of HIV/AIDS on type 2 diabetes prevalence and diabetes healthcare needs in South Africa: projections for 2010. Diabet Med 23 (2006) 103-104
102. Brown T.T., Cole S.R., Li X., et al. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study. Arch Intern Med 165 (2005) 1179-1184
103. De Wit S., Sabin C.A., Weber R., et al. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Diabetes Care 31 (2008) 1224-1229
104. Young F., Critchley J.A., Johnstone L.K., and Unwin N.C. A review of co-morbidity between infectious and chronic disease in Sub Saharan Africa: TB and diabetes mellitus, HIV and metabolic syndrome, and the impact of globalization. Global Health 5 (2009) 9
105. Joffe B.I., Panz V.R., Wing J.R., Raal F.J., and Seftel H.C. Pathogenesis of non-insulin-dependent diabetes mellitus in the black population of southern Africa. Lancet 340 (1992) 460-462
106. Oli J.M., Adeyemo A.A., Okafor G.O., et al. Basal insulin resistance and secretion in Nigerians with type 2 diabetes mellitus. Metab Syndr Relat Disord 7 (2009) 595-599
107. Mbanya J.C., Pani L.N., Mbanya D.N., Sobngwi E., and Ngogang J. Reduced insulin secretion in offspring of African type 2 diabetic parents. Diabetes Care 23 (2000) 1761-1765
108. Schuster D.P., Kien C.L., and Osei K. Differential impact of obesity on glucose metabolism in black and white American adolescents. Am J Med Sci 316 (1998) 361-367
109. Sumner A.E., Kushner H., Sherif K.D., Tulenko T.N., Falkner B., and Marsh J.B. Sex differences in African-Americans regarding sensitivity to insulin's glucoregulatory and antilipolytic actions. Diabetes Care 22 (1999) 71-77
110. Sobngwi E., Effoe V., Boudou P., Njamen D., Gautier J.-F., and Mbanya J.-C. Waist circumference does not predict circulating adiponectin levels in sub-Saharan women. Cardiovasc Diabetol 6 (2007) 31
111. McFarlane S.I., Chaiken R.L., Hirsch S., Harrington P., Lebovitz H.E., and Banerji M.A. Near-normoglycaemic remission in African-Americans with type 2 diabetes mellitus is associated with recovery of beta cell function. Diabet Med 18 (2001) 10-16
112. Mauvais-Jarvis F., Sobngwi E., Porcher R., et al. Ketosis-prone type 2 diabetes in patients of sub-Saharan African origin: clinical pathophysiology and natural history of beta-cell dysfunction and insulin resistance. Diabetes 53 (2004) 645-653
113. Banerji M.A., Chaiken R.L., and Lebovitz H.E. Long-term normoglycemic remission in black newly diagnosed NIDDM subjects. Diabetes 45 (1996) 337-341
114. Choukem S.P., Sobngwi E., Fetita L.S., et al. Multitissue insulin resistance despite near-normoglycemic remission in Africans with ketosis-prone diabetes. Diabetes Care 31 (2008) 2332-2337
115. Chiou C.C., Chung W.H., Hung S.I., Yang L.C., and Hong H.S. Fulminant type 1 diabetes mellitus caused by drug hypersensitivity syndrome with human herpesvirus 6 infection. J Am Acad Dermatol 54 1 suppl (2006) S14-S17
116. Sobngwi E., Choukem S.P., Agbalika F., et al. Ketosis-prone type 2 diabetes mellitus and human herpesvirus 8 infection in sub-Saharan Africans. JAMA 299 (2008) 2770-2776
117. Sobngwi E., Gautier J.F., Kevorkian J.P., et al. High prevalence of glucose-6-phosphate dehydrogenase deficiency without gene mutation suggests a novel genetic mechanism predisposing to ketosis-prone diabetes. J Clin Endocrinol Metab 90 (2005) 4446-4451
118. Whiting D.R., Hayes L., and Unwin N.C. Diabetes in Africa: challenges to health care for diabetes in Africa. J Cardiovasc Risk 10 (2003) 103-110
119. Beran D., and Yudkin J.S. Diabetes care in sub-Saharan Africa. Lancet 368 (2006) 1689-1695
120. Kiawi E., Edwards R., Shu J., Unwin N., Kamedjeu R., and Mbanya J.C. Knowledge, attitudes, and behavior relating to diabetes and its main risk factors among urban residents in Cameroon: a qualitative survey. Ethn Dis 16 (2006) 503-509
121. Awah P.K., Kengne A.P., Fezeu L.L., and Mbanya J.C. Perceived risk factors of cardiovascular diseases and diabetes in Cameroon. Health Educ Res 25 (2007) 23-29
122. Renzaho A. Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa. Health Place 10 (2004) 105-113
123. Gill G.V., Price C., Shandu D., Dedicoat M., and Wilkinson D. An effective system of nurse-led diabetes care in rural Africa. Diabet Med 25 (2008) 606-611
124. Kengne A.P., Fezeu L., Sobngwi E., et al. Type 2 diabetes management in nurse-led primary healthcare settings in urban and rural Cameroon. Prim Care Diabetes 3 (2009) 181-188
125. Sobngwi E., Lekoubou A.L., Dehayem M.Y., et al. Evaluation of a simple management protocol for hyperglycaemic crises using intramuscular insulin in a resource-limited setting. Diabet Metab 35 (2009) 404-409
126. Gill G.V., Mbanya J.C., Ramaiya K.L., and Tesfaye S. A sub-Saharan African perspective of diabetes. Diabetologia 52 (2009) 8-16
127. Mbanya J.C., and Mbanya D. Diabetes cost in sub-Saharan Africa. J Cardiovasc Risk 10 (2003) 191-193
128. Elrayah H., Eltom M., Bedri A., Belal A., Rosling H., and Ostenson C.G. Economic burden on families of childhood type 1 diabetes in urban Sudan. Diabetes Res Clin Pract 70 (2005) 159-165
129. Kirigia J.M., Sambo H.B., Sambo L.G., and Barry S.P. Economic burden of diabetes mellitus in the WHO African region. BMC Int Health Hum Rights 9 (2009) 6
130. Justin-Temu M., Nondo R.S., Wiedenmayer K., Ramaiya K.L., and Teuscher A. Anti-diabetic drugs in the private and public sector in Dar es Salaam, Tanzania. East Afr Med J 86 (2009) 110-114