Challenges for diagnosing and monitoring diabetes in ressource- limited countries (DR Congo)

Diabetes prevalence is rising dramatically in limited-resource countries, particularly in DR Congo. An estimated number of 14.2 million adults (aged between 20 and 79 years old) are suffering from diabetes mellitus, which represents a regional prevalence of 2.1–6.7%. In the near future, sub-Saharan Africa is expected to undergo the largest proportional increase in diabetes mellitus, with an estimated number of 41.5 million affected Africans in 2035.

For decades, available resources have been allocated to the management of infectious diseases. Despite the increase in the prevalence of diabetes mellitus, little attention has been paid to the correct diagnosis of this disease in developing countries. About 50% of people living with diabetes mellitus in sub-Saharan Africa remain undiagnosed. Poor glycemic control increases the risk of diabetes complications and is associated with a high mortality rate.

The published report from Diabetes International Expert Committees in 2009 (American Diabetes Association and European Diabetes Association) recommended plasma glucose measurement [either a fasting plasma glucose (FPG) concentration ≥126 mg/dL (7.0 mM), a random plasma glucose concentration ≥200 mg/dL (11.1 mM) or a 2-hour plasma glucose value ≥200 mg/dL in the 75 g oral glucose tolerance test (OGTT)] or an HbA1c ≥48 mmol/mol for the diagnosis of diabetes mellitus.