Abstract:
Background: The Diabetes Management and Information Center in Nairobi has conducted
population surveys among rural and urban Kenyans during the last decade. They have reported a
rise in the prevalence of diabetes among rural Kenyans from 3% in 2003 to 7% in 2007. Our study
was undertaken to investigate rural factors for type 2 diabetes and determine those that could be
responsible for this rise in prevalence.
Objectives: To describe the risk factors for type 2 diabetes mellitus among patients attending the
outpatient clinics in a rural mission hospital in Kenya.
Method: Forty-five diabetics and forty-five non-diabetics, resident in this rural hospital’s catchment
area for at least 10 years, were randomly selected from patients attending outpatient clinics. Diabetics
in a stable condition (not requiring hospitalisation), whose fasting blood sugars were below 6.1
mmol/L, were matched for age and gender with the non-diabetics who came to the hospital for
outpatient services. A pilot-tested questionnaire on demography, current and past dietary habits,
social habits, and family history was used to collect data. Waist circumference, height and weight
were measured and BMI calculated. Data was analysed using SPSS for Windows. The Kruskal–
Wallis test was used to compare the medians for the continuous variables, while the chi-squared test
was used for the categorical variables. The z-test was used to calculate the relative risk.
Results: Ninety participants (26 males, 64 females). The mean age was 61.8 for diabetics and 61.4 for
non-diabetics. Childhood starvation (relative risk 2.08, p = 0.0090) and use of cassava for sustenance
during childhood starvation (relative risk 3.12, p = 0.0090) were identified as risk factors. Diabetes
in close relatives, another risk factor for this population (relative risk 2.2, p = 0.0131). Abdominal
obesity was a risk factor for this population (in females relative risk 2.0, p = 0.0010).
Conclusion: The risk factors for type 2 diabetes mellitus described in this rural population include
advancing age, diabetes in a first-degree relative and abdominal obesity. This is similar to what
has been cited in other studies. At variance, we found that more than 50% of the diabetics reported
having suffered malnutrition/starvation in childhood, with more than half of them reporting their
dependence on cassava as the only food source during starvation.
