Prevalence of diabetes and its associated factors in Cape Verde: an analysis of the 2020 WHO STEPS survey on non-communicable diseases risk factors.

Background: Type 2 diabetes mellitus (T2DM) represents a significant global health challenge, with its prevalence steadily rising across diverse populations. Understanding the factors associated with T2DM is crucial for effective prevention and management strategies. In Cape Verde, an archipelago nation off the coast of West Africa, the burden of T2DM is of particular concern, yet comprehensive studies investigating its determinants in this context remain sparse. This study aims to narrow the knowledge gap by assessing the prevalence of prediabetes, T2DM and its associated factors among the adult Cape Verdean population.

Methods: Data from the WHO STEPs survey were used. We analyzed data from 1,936 adults aged 18-69 years. The outcome variable was diabetes status computed using the fasting blood glucose (mg/dl). The data was weighted before the analysis to account for sampling biases. Multinomial logistic regression models were computed in STATA version 18.

Results: The overall prevalence of prediabetes and T2DM was 7.8% (95% CI: 6.1-9.9) and 3.9% (95% CI: 3.1-4.9), respectively. Increasing age was associated with a higher odd of prediabetes and T2DM with the highest odds observed among older adults [(prediabetes: AORs = 3.20, 95%CI: 1.88-5.54) and T2DM: AOR = 3.51, 95%CI: 1.71-7.18)]. Additionally, high total cholesterol levels were linked to increased odds of T2DM (AOR = 2.48, 95%CI: 1.64-3.76). Individuals who consumed less than four servings of vegetables daily had higher odds of T2DM (AOR = 1.74, 95%CI: 1.12-2.71) while being overweight/obese was associated with higher odds of prediabetes (AOR = 1.57, 95%CI: 1.10-2.23). Urban residents had higher odds of T2DM than rural residents (AOR = 1.92, 95%CI: 1.23-3.00). Also, higher educational attainment was associated with lower odds of T2DM only (AOR = 0.33, 95%CI: 0.12-0.88) but not statistically significant for prediabetes.

Conclusion: Based on the findings, we conclude that ageing, overweight/obesity, vegetable consumption and total cholesterol level are important predictors of pre-diabetes and T2DM in Cape Verde. As such, weight management and cholesterol management should be integral parts of T2DM prevention strategies. Additionally, clinicians and diabetes societies in Cape Verde must make the promotion of vegetable consumption a key component of their health advice and advocacy.

Clinical trial number: Not applicable.