#2 Life style related risk factors of diabetes mellitus type 2 and tuberculosis in South Africa
Meet Tsolofelo Msimango and Melanie Pandoor, both live in South Africa. Whereas Melanie suffers from diabetes mellitus type 2 (T2DM) and has recently undergone an amputation, Tsolefelo was diagnosed with TB after experiencing symptoms of coughing, feeling ill and losing apetite. And they’re not the only ones suffering from these diseases in Southern Africa. In this article we focus on South Africa where the prevalence of both diseases is high and much research has been conducted. And since it’s predicted that the burden of both diseases will increase over time, focus on prevention is important. But what exactly are the risk factors of both diseases related to life style? Read more to find an answer to this question…
Diabetes type-2
T2DM is associated with factors related to an unhealthy lifestyle. For instance obesity, inactivity, high blood pressure, smoking and lastly high levels of triglycerides. In South Africa the prevalence of these risk factors are fastly on the rise due to urbanization. The process of urbanization leads to the normalization of a more western diet and lifestyle. This includes eating more processed food with too many saturated fats, sugar and salt and not exercising enough. Nowadays 54% of all habitants in South Africa are overweight, and 28.3% are obese. It’s estimated that due to these bad habits around 65% of men and women are pre-diabetic, meaning that they have abnormal blood glucose levels and are at high risk of developing diabetes. This besides the large group in South Africa that already has T2DM.
It’s well known that improving your lifestyle can prevent and even lead to long term remission of T2DM, but are pre,- and diabetics in South Africa aware of this? A study shows that of all participants (diabetics) 93% showed poor knowledge in regard to exercise and healthy diet and weight. And during the lockdown, due to covid-19, it’s seen that the prevalence of obesity is now increasing even more rapidly caused by the limitation of psychical inactivity and more intake of unhealthy foods. Thus the lockdown can lead to even more cases of T2DM, which is a concerning trend considering that diabetics are disproportianetely affected by covid-19.
Tuberculosis
Smoking, besides being a risk factor for diabetes, does also increase the risk of acquiring a TB infection and the risk for disease development afterwards. This is relevant since around 20% of the South African population, older than 15, smokes. In contrast to diabetes, underweight and undernutrition are well known risk factors for tuberculosis. With every BMI point lower, there’s a 14% incidence increase in TB. Because however obesity is becoming more and more prevalent, we mustn’t forget that undernutrition still affects many individuals in South Africa. In 2016 24.3% of all males aged 5–19 and 15.3% of females in that age group were underweight. Other lifestyle related risk factors are alcohol use (>40 g/day) and indoor air pollution as a consequence of cooking and smoking indoors.
It is said that overweight is a protective factor in correlation to the development of TB. This statement however needs to be taken in careful consideration since being overweight comes with a high chance of morbidity and mortality. For instance T2DM (which is highly correlated to overweight), that’s actually a risk factor for the development of TB.
All in all we see that malnutrition, whether it is overnutrition or undernutrition, is a big contributor to the development of both diseases. And that the risk factors related to lifestyle have a high prevalence in the South African population and are therefore important determinants. Needless to say change is necessary. As for Tsholofelo she was finally cured after a year of being treated in the hospital and is now back home, living with her mother and daughter. In the video it is shown that Melanie now understood how she developed the disease, but only after it was too late and severe complications occurred.
Next week on our blog we’ll discuss the health care related to diabetes and tuberculosis to help women such as Tsolofelo and Melanie.
Written by Molly Mascini
