Diabetes is an increasing problem in sub-Saharan Africa. Type 2 diabetes, the most common form, is becoming more prevalent owing to rising rates of obesity, physical inactivity and urbanisation. Type 1 diabetes exists in two major forms in the region: type 1A or autoimmune and type 1B or ketosis-prone type 2 diabetes. At present there are scanty epidemiological data on either. The current morbidity of diabetes is primarily due to the high rates of microvascular complications, while macrovascular complications, once rare, are becoming more common, particularly in the urban setting. Further, despite the HIV epidemic, the total number of people with diabetes in the region is expected to grow because of changing demography. A concerted multisectoral effort will be critical to ensuring improvement in healthcare delivery for people with diabetes in the region.
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Competing interests: NSL has received honoraria for speaking engagements from Servier Laboratories, Novo Nordisk and Novartis and for attending Steering Committee meetings for a pharmaceutical trial for prevention of type 2 diabetes.
Funding: Novartis, Lilly and Aventis are providing funds to the unit for pharmaceutical trials used in the prevention or treatment of type 2 diabetes. Novo Nordisk provides funds for a community diabetes educator. NSL has received funds from Servier Laboratories towards the costs of a diabetes prevalence study.