Evidence mapPaperPMID 37756263Full record

ArticlePLOS global public health2023

Waist circumference and glycaemia are strong predictors of progression to diabetes in individuals with prediabetes in sub-Saharan Africa: 4-year prospective cohort study in Malawi.

Wisdom P Nakanga, Amelia C Crampin, Joseph Mkandawire, Louis Banda, Rob C Andrews, Andrew T Hattersley, Moffat J Nyirenda, Lauren R Rodgers

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Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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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

4 citing papers in PubMed.

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4 · The record

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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

8 authors.

Wisdom P NakangaNational Institute for Health Research (NIHR), Exeter Clinical Research Facility, University of Exeter, Exeter, United Kingdom.ORCID https://orcid.org/0000-0002-8383-0178
Amelia C CrampinMalawi Epidemiology and Intervention Research Unit (MEIRU), Karonga and Lilongwe, Malawi.
Joseph MkandawireMalawi Epidemiology and Intervention Research Unit (MEIRU), Karonga and Lilongwe, Malawi.ORCID https://orcid.org/0000-0002-2576-1741
Louis BandaMalawi Epidemiology and Intervention Research Unit (MEIRU), Karonga and Lilongwe, Malawi.
Rob C AndrewsNational Institute for Health Research (NIHR), Exeter Clinical Research Facility, University of Exeter, Exeter, United Kingdom.ORCID https://orcid.org/0000-0003-4939-1738
Andrew T HattersleyNational Institute for Health Research (NIHR), Exeter Clinical Research Facility, University of Exeter, Exeter, United Kingdom.
Moffat J NyirendaLondon School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom.ORCID https://orcid.org/0000-0003-2120-4806
Lauren R RodgersInstitute of Health Research, University of Exeter Medical School, Exeter, United Kingdom.ORCID https://orcid.org/0000-0002-5040-3073

Funding

Medical Research Council MC_UP_1204/16Medical Research Council MC_UU_00033/3
6 · The paper itself

Abstract

Sub-Saharan Africa is projected to have the highest increase in the number of people with diabetes worldwide. However, the drivers of diabetes in this region have not been clearly elucidated. The aim of this study was to evaluate the incidence of diabetes and the predictors of progression in a population-based cohort with impaired fasting glucose (IFG) in Malawi. We used data from an extensive rural and urban non-communicable disease survey. One hundred seventy-five, of 389 individuals with impaired fasting glucose (IFG) at baseline, age 48 ±15 years and body mass index 27.5 ±5.9 kg/m2 were followed up for a median of 4.2 years (714 person-years). Incidence rates were calculated, and predictors of progression to diabetes were analysed using multivariable logistic regression models, with overall performance determined using receiver operator characteristics (ROC) curves. The median follow-up was 4.2 (IQR 3.4-4.7) years. Forty-five out of 175 (26%) progressed to diabetes. Incidence rates of diabetes were 62.9 per 1000 person-years 95% CI, 47.0-84.3. The predictors of progression were higher; age (odds ratio [OR] 1.48, P = 0.046), BMI (OR 1.98, P = 0.001), waist circumference (OR 2.50,P<0.001), waist-hip ratio (OR 1.40, P = 0.03), systolic blood pressure (OR 1.56, P = 0.01), fasting plasma glucose (OR 1.53, P = 0.01), cholesterol (OR 1.44, P = 0.05) and low-density lipoprotein cholesterol (OR 1.80, P = 0.002). A simple model combining fasting plasma glucose and waist circumference was predictive of progression to diabetes (ROC area under the curve = 0.79). The incidence of diabetes in people with IFG is high in Malawi and predictors of progression are like those seen in other populations. Our data also suggests that a simple chart with probabilities of progression to diabetes based on waist circumference and fasting plasma glucose could be used to identify those at risk of progression in clinical settings in sub-Saharan Africa.

Identifiers

PMID37756263
PMCPMC10529551

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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 Socratic graph.