Data from: Prevalence and unmet need for diabetes care across the care continuum in a national sample of South African adults: evidence from the SANHANES-1, 2011-2012

South Africa faces an epidemic of chronic non-communicable diseases (NCDs), yet national surveillance is limited due to the lack of recent data. We used data from the first comprehensive national survey on NCDs—the South African National Health and Nutrition Examination Survey (SANHANES-1 (2011–2012))—to evaluate the prevalence of and health system response to diabetes through a diabetes care cascade. We defined diabetes as a Hemoglobin A1c equal to or above 6.5% or currently on treatment for diabetes. We constructed a diabetes care cascade by categorizing the population with diabetes into those who were unscreened, screened but undiagnosed, diagnosed but untreated, treated but uncontrolled, and treated and controlled. We then used multivariable logistic regression models to explore factors associated with diagnosed and undiagnosed diabetes. The age-standardized prevalence of diabetes in South Africans aged 15+ was 10.1%. Prevalence rates were higher among the non-white population and among women. Among individuals with diabetes, a total of 45.4% were unscreened, 14.7% were screened but undiagnosed, 2.3% were diagnosed but untreated, 18.1% were treated but uncontrolled, and 19.4% were treated and controlled, suggesting that 80.6% of the diabetic population had unmet need for care. The diabetes care cascade revealed significant losses from lack of screening, between screening and diagnosis, and between treatment and control. These results point to significant unmet need for diabetes care in South Africa. Additionally, this analysis provides a benchmark for evaluating efforts to manage the rising burden of diabetes in South Africa.

南非正面临慢性非传染性疾病（chronic non-communicable diseases, NCDs）的流行态势，但由于缺乏近期数据，全国疾病监测工作仍存在局限。本研究采用南非首次全国性慢性非传染性疾病综合调查——南非全国健康与营养检查调查（South African National Health and Nutrition Examination Survey, SANHANES-1，2011–2012年）的数据，以糖尿病照护级联（diabetes care cascade）为分析框架，评估南非糖尿病患病率及医疗系统的糖尿病应对情况。本研究将糖化血红蛋白（Hemoglobin A1c）水平≥6.5%，或目前正在接受糖尿病治疗的人群定义为糖尿病患者。通过将糖尿病患者划分为未筛查、已筛查但未确诊、已确诊但未治疗、已接受治疗但血糖未达标、已接受治疗且血糖达标五类，本研究构建了糖尿病照护级联模型。随后采用多变量logistic回归模型，探究与确诊及未确诊糖尿病相关的影响因素。15岁及以上南非人群的年龄标化糖尿病患病率为10.1%，非白人人群与女性群体的患病率更高。在糖尿病患者中，共计45.4%未接受筛查，14.7%已筛查但未确诊，2.3%已确诊但未接受治疗，18.1%已接受治疗但血糖未达标，19.4%已接受治疗且血糖达标；这意味着80.6%的糖尿病患者存在未被满足的照护需求。糖尿病照护级联分析显示，筛查不足、筛查至确诊环节的患者流失，以及治疗至血糖达标环节的患者流失，均造成了显著的患者损耗。上述结果表明，南非糖尿病照护存在显著的未被满足的需求。此外，本分析可为评估南非应对日益加重的糖尿病负担的相关工作提供基准参照。