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.