Diabetes mellitus is a major public health problem in Africa but also presents with some atypical clinical phenotypes that require specific management strategies. However, this part of the world, with its health systems adapted to dealing with communicable disease, faces the challenge of inadequate availability and allocation of resources for noncommunicable diseases that often have a more chronic course. Other major challenges encountered are the lack of adequate education of patients about the disease and its treatment, the late presentation of patients to health facilities, the lack of adequate diagnostic facilities, the unavailability of diabetes medications in some instances and their unaffordability when available, and inadequate data on the actual burden of the disease and treatment coverage. Despite the specificities of diabetes mellitus in Africa, many countries still rely on guidelines essentially used in developed countries.
Nevertheless, there has been significant progress in the treatment of diabetes in Africa in recent years with expansion in coverage and types of diabetes care services. The creation of national diabetes registries, diabetes associations, and national diabetes programs and the adoption of contextualized guidelines for the management of diabetes in several countries in Africa, together with the expansion of the multidisciplinary approach to treatment of this chronic disease, have been increasingly gaining grounds in Africa. However much still remains to be done in this part of the world concerning diabetes management. To this effect, the African regional branch of the International Diabetes Federation, through the African Diabetes Declaration, has summoned governments and agencies involved in diabetes care in Africa to uphold standards of diabetes care with regard to prevention, early detection, availability, and affordability of treatment.
KeywordsAfrica Diabetes management Clinical guidelines Health beliefs Standards of diabetes care Health-seeking behaviors
- 1.International Diabetes Federation. IDF Diabetes Atlas. 7th ed; Brussels: International Diabetes Federation; 2015.Google Scholar
- 2.Choukem SP, Sobngwi E, Gautier JF. Les particularités du diabète chez le sujet originaire d’Afrique Noire. Sang Thromb Vaiss. 2007;19(10):513–8.Google Scholar
- 6.Pastakia SD, Pekny CR, Manyara SM, Fischer L. Diabetes in sub-Saharan Africa – from policy to practice to progress: targeting the existing gaps for future care for diabetes [Internet]. Diabetes Metab Syndr Obes. 2017;10, 247–263. [cited 2017 Aug 7]. Available from: https://www.dovepress.com/diabetes-in-sub-saharan-africa-from-policy-to-practice-to-progress-tar-peer-reviewed-article-DMSO
- 7.IDF Africa Region Task Force on Type 2 Diabetes Clinical Practice Guidelines. Type 2 diabetes clinical practice guidelines for sub-Saharan Africa. Dar es salaam: International Diabetes Federation Africa Region; 2006.Google Scholar
- 8.The 2012 SEMDSA guideline for the management of type 2 diabetes. J Endocrinol Metab Diabetes South Afr. 2012;17(1):S1–94.Google Scholar
- 9.Diabetes Association of Nigeria (DAN). Clinical practice guidelines for diabetes management in Nigeria. Lagos: Diabetes Association Of Nigeria; 2013.Google Scholar
- 10.The 2017 SEMDSA guidelines for the management of type 2 diabetes. J Endocrinol Metab Diabetes South Afr. 2017;22(1):1–182.Google Scholar
- 14.International Diabetes Federation. IDF clinical practice recommendations for managing type 2 diabetes in primary care. Brussels: International Diabetes Federation; 2017.Google Scholar
- 17.International Diabetes Federation. Management of gestational diabetes in the community. Training manual for community health workers. Brussels: International Diabetes Association; 2015.Google Scholar
- 19.Dahjio Y, Noubiap JJN, Azabji-Kenfack M, Essouma M, Loni GE, Onana AE, et al. Impact of a 12-week aerobic exercise training program on anthropometric and metabolic parameters of a group of type 2 diabetes Cameroonian women aged ≥50 years. Ann Transl Med [Internet]. 2016 [cited 2017 Sep 4];4(19). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075844/.
- 28.Majaliwa ES, Elusiyan BJ, Adesiyun OO, Laigong P, others. Type 1 diabetes mellitus in the African population: epidemiology and management challenges. Acta Bio Medica Atenei Parm. 2009;79(3):255–9.Google Scholar
- 32.Hakeem AO. The dynamics of diabetes care in Africa. J Glob Diabetes Clin Metab. 2017:2(2);1–3.Google Scholar
- 38.Kengne AP, Sobngwi E, Fezeu L, Awah PK, Dongmo S, Mbanya J-C. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa. Pan Afr Med J [Internet]. 2009 [cited 2017 Sep 6];3. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984281/.
- Setel PW. Non-communicable diseases, political economy, and culture in Africa: anthropological applications in an emerging pandemic. Ethn Dis. 2003;13(2):S149–57. (Examines the need for anthropological perspectives on the causes, prevention, and control of NCDs, such as diabetes, in Africa).PubMedGoogle Scholar