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Professor NS Levitt recently reviewed the epidemiology, management
and health care challenges related to diabetes in Africa , however not
including data from the Seychelles. We would like to add some information
from the Republic of Seychelles, an island state located 1800 km east of
Kenya where more than 80% of the population is of African descent.
Based on two independent population-based surveys in 1989 an...
Based on two independent population-based surveys in 1989 and 2004,
the prevalence of diabetes (fasting blood glucose >=7 mmol/l and/or
treatment) increased from 6.2% to 9.6% in men and from 6.1% to 9.2% in
women [2-4]. The prevalence reached 11.5 % in 2004 when also considering
results of the oral glucose tolerance test. The prevalence of obesity
increased markedly in the interval [4,5] and overweight accounted for 49%
of all cases of diabetes in 2004 . Furthermore, pre-diabetes was found
in an additional 22% of the population .
Of all cases of diabetes in the population aged 25-64, 54% were aware
of the diagnosis . However less than a fifth of diabetic persons under
treatment had blood glucose, blood pressure and blood cholesterol below
the recommended targets . Furthermore, we found that persons with pre-
diabetes already had worsened levels of several cardiometabolic risk
factors and were therefore at increased cardiovascular risk . We also
confirmed the strong association between diabetes and microalbuminuria in
the Seychelles  and found a high prevalence of the metabolic syndrome
Our figures further contribute to map the "diabesity" epidemic in the
African region. Limited therapeutic control among diabetic patients in the
Seychelles is challenging since this occurred while the population is well
aware of diabetes following sustained awareness campaigns since the late
1980s and health care, including medications in all major therapeutic
classes, is provided at no direct cost through an easily accessible
network of health centers. The situation in the Seychelles may provide a
good case study for current and future trends in rapidly developing
countries in the continent and, possibly, for middle-income countries in
Conflict of interest statement: We declare that we have no conflict
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