Evidence map›Paper›PMID 40021304›Full record

ArticleThe Lancet. Global health2025

Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.

Raylton P Chikwati, Nigel J Crowther, Michèle Ramsay, Lisa K Micklesfield, Shane A Norris, Kagiso P Seakamela, Engelbert A Nonterah, Godfred Agongo, Shukri F Mohamed, Isaac Kisiangani and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. A Combination ofNutrients · 2026
    Article
  2. Article
  3. Guangdong Biobank Cohort (GDBC) study.European journal of epidemiology · 2026
    Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Raylton P ChikwatiSydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: raylton.chikwati@wits.ac.za.
Nigel J CrowtherDepartment of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Michèle RamsaySydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Lisa K MicklesfieldSAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Shane A NorrisSAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; School of Human Development and Health, University of Southampton, Southampton, UK.
Kagiso P SeakamelaDikgale Mamabolo Mothiba (DIMAMO) Population Health Research Centre, University of Limpopo, Polokwane, South Africa.
Engelbert A NonterahNavrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Department of Epidemiology, School of Public Health, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
Godfred AgongoNavrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
Shukri F MohamedChronic Disease Management Unit, African Population and Health Research Centre, Nairobi, Kenya.
Isaac KisianganiChronic Disease Management Unit, African Population and Health Research Centre, Nairobi, Kenya.
Palwende R BouaSydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso; Medical Research Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia.
Alisha N WadeResearch in Metabolism and Endocrinology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
AWI-Gen and the H3Africa Consortium

Funding

Shared Core: Biobanking, Bioinformatics and Data ManagementU54HG006938 · NHGRI · WITS HEALTH CONSORTIUM (PTY), LTD · PI RAMSAY, MICHELE MICHELE · 2012 to 2022
$12.2M
Endocrine and metabolic diseases in rural South Africa-establishing burden and improving detectionK43TW010698 · FIC · WITS HEALTH CONSORTIUM (PTY), LTD · PI WADE, ALISHA NICOLE · 2017 to 2021
$581k
FIC NIH HHS K43 TW010698NHGRI NIH HHS U54 HG006938
6 · The paper itself

Abstract

backgroundThe incidence of type 2 diabetes in sub-Saharan Africa is expected to increase, but few longitudinal studies have characterised its risk factors. This study aimed to determine the incidence of type 2 diabetes over 33 481 person-years and identify its principal risk factors in middle-aged adults (ie, those aged 40-60 years) from four sub-Saharan African countries.

methodsLongitudinal data were available from 6553 participants aged 40-60 years at baseline from study centres in South Africa, Kenya, Ghana, and Burkina Faso. Sociodemographic, behavioural, clinical, and biochemical data were collected at baseline and after an interval of 5-6 years. The prevalence of type 2 diabetes was determined at each timepoint and diabetes incidence was calculated. A two-stage individual participant data meta-analysis was used to identify baseline risk factors for incident diabetes.

findingsThe overall incidence of type 2 diabetes was 14·6 (95% CI 13·4-16·0) cases per 1000 person-years. The incidence was highest in South Africa with 21·8 (19·5-24·4) cases per 1000 person-years, and lowest in west Africa with 5·5 (4·4-6·9) cases per 1000 person-years. Baseline glucose (adjusted odds ratio 1·37; 95% CI 1·16-1·42), being male (1·32; 1·12-1·54), family history of type 2 diabetes (1·22; 1·01-1·46), unemployment (1·19; 1·03-1·37), hypertension (1·21; 1·01-1·45), BMI (1·03; 1·02-1·04), and waist circumference (1·02; 1·01-1·03), were associated with a higher risk of incident type 2 diabetes, while adequate baseline physical activity (0·87; 0·76-1·00) was associated with lower risk.

interpretationThe high incidence of type 2 diabetes in this middle-aged sub-Saharan Africa population is influenced by several modifiable risk factors that should inform interventions to mitigate the disease burden.

fundingNational Institutes of Health, Department of Science and Innovation (South Africa), and the South African Medical Research Council.

Indexed as

Diabetes Mellitus, Type 2AdultAfrica South of the SaharaFemaleHumansIncidenceLongitudinal StudiesMaleMiddle AgedPrevalenceRisk Factors

Identifiers

PMID40021304
PMCPMC12079105

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.