[Diabetes mellitus in sub-Saharan Africa: epidemiological aspects and management issues].

In contradiction with long-standing conventional wisdom that it is a rich country's disease, diabetes mellitus is increasingly a major concern in developing countries, especially in sub-Saharan Africa. Care facilities have not kept pace with the sharp increase in diabetes mellitus. The WHO has predicted a worldwide rise in the prevalence of diabetes that is expected to affect 300 million people by 2025. This progression is more flagrant in developing countries particularly in sub-Saharan Africa. In these countries, the expansion of diabetes is part of a broader epidemiological transition from transmissible diseases to non-transmissible diseases. A number of factors are causing this transition including aging of the population, sedentary lifestyle, and obesity. Aside from obesity, arterial hypertension is the main cardiovascular risk factor associated with diabetes. Alone or in association with other risk factors, diabetes mellitus accounts for high morbidity especially due to cardiovascular and kidney complications. Management in sub-Saharan Africa faces a number of issues: poor understanding of the extent of the problem, high cost of medications, socio-economic setting that is poorly suited to maintaining a proper diabetic diet, and limitations in infrastructure and personnel. The rapid increase in the prevalence of diabetes mellitus in sub-Saharan Africa is a serious challenge. There is an urgent need to obtain accurate figures about the extent of the pandemia as a basis for training an adequate number of health care personnel and implementing sufficient resources to allow local management. Meeting this challenge will require enhancement of the awareness and participation of all players involved in public health.