AVAILABILITY OF DATA AND MATERIALS : This study utilized existing survey datasets that are in the public domain and
freely available from https://www.dhsprogram.com/data/dataset_admin/
login_main.cfm with the permission from the DHS Program.BACKGROUND : Diabetes prevalence, as well as that of pre-diabetes, is rapidly increasing in South Africa. Individuals
with pre-diabetes have a high risk of developing type 2 diabetes, which is reversible with a change in lifestyle. If left
untreated, diabetes can lead to serious health complications. Our objective was to assess the prevalence of diabetes
and pre-diabetes, and to investigate the associated risk factors of each in the South African population.
METHOD : This study made use of the South African Demographic Health Survey 2016 data. The study participants
included 6442 individuals aged 15 years and older. A generalized additive mixed model was employed to account for
the complex survey design of the study as well as well spatial autocorrelation in the data.
RESULTS : The observed prevalence of pre-diabetes and diabetes was 67% and 22%, respectively. Among those who
had never been tested for diabetes prior to the survey, 10% of females and 6% of males were found to be diabetic,
and 67% of both males and females were found to be pre-diabetic. Thus, a large proportion of the South African
population remains undiagnosed. The model revealed both common and uncommon factors significantly associated
with pre-diabetes and diabetes. This highlights the importance of considering diabetic status as a three-level
categorical outcome, rather than binary. In addition, significant interactions between some of the lifestyle factors,
demographic factors and anthropometric measures were revealed, which indicates that the effects each these factors
have on the likelihood of an individual being pre-diabetic or diabetic is confounded by other factors.
CONCLUSION : The risk factors for diabetes and pre-diabetes are many and complicated. Individuals need to be aware
of their diabetic status before health complications arise. It is therefore important for all stakeholders in government
and the private sector of South Africa to get involved in providing education and creating awareness about diabetes.
Regular testing of diabetes, as well as leading a healthy lifestyle, should be encouraged.The South African Medical Research Council through its Division of Research Capacity Development under the Biostatistics Capacity Development partnership with the Belgian Development Agency (Enabel) under its framework of Building Academic Partnerships for Economic Development (BAPED).am2023Statistic
