The magnitude of diabetes and its association with obesity in the slums of Nairobi, Kenya: results from a cross-sectional survey

ObjectivesTo assess the prevalence, awareness, treatment and control of diabetes and to examine the relationship of obesity with raised blood glucose in the slums of Nairobi, Kenya. MethodsWe used data from a cross-sectional population-based survey, conducted in 2008-2009, involving a random sample of 5190 (2794 men and 2396 women) adults aged 18years living in two slums - Korogocho and Viwandani - in Nairobi. ResultsThe prevalence (weighted by sampling and response rates) of diabetes was 4.8% (95%CI 4.0-5.7) in women and 4.0% (95%CI 3.3-4.7) in men. Less than a quarter of those found to have diabetes were aware of their condition among which just over half of men and three-quarters of women reported being on any treatment in the 12months preceding the survey. Overall, fewer than 5% of all people with diabetes had their blood sugar under control. Obesity and overweight were significantly associated with increased odds (1.7, 95%CI 1.1-2.6) of raised blood glucose only among women while adjusting for important covariates. ConclusionThe prevalence of diabetes in this impoverished population is moderately high, while the levels of awareness, treatment and control are quite low. In this population, obesity is an important risk factor for raised blood glucose particularly among women. Prevention and control strategies that target modifiable risk factors for diabetes and increase access to treatment and control in such disadvantaged settings are urgently needed.