THE PREVALENCE OF DIABETES MELLITUS AMONG ADULTS IN A RURAL COMMUNITY IN NORTH CENTRAL NIGERIA

ABSTRACT

Objective: The objective of this study was to determine the prevalence of diabetes mellitus, and risk factors associated with diabetes mellitus among adults living in Zawan community. The study was also to determine the relationship of blood glucose levels with age, Body Mass Index, waist circumference, hip circumference and waist-hip ratio. Design: The study was a cross-sectional descriptive study.

Subjects: 750 subjects were recruited for the study between February and May 2005.

Method: Detail of sociodemographic information, family and personal history were taken using a questionnaire. Physical examination and diabetes mellitus screening were done.

Results: Overall prevalence of diabetes mellitus in this study was 4.1% (male diabetics 5.2%, female diabetics 3.0%). Age, parental history of diabetes mellitus, alcohol intake and waist-hip ratio were identified as risk factors associated with diabetes mellitus in this study. Age, waist circumference, and waist- hip ratio have a poor correlation with Random Plasma Glucose level Conclusion: The prevalence of diabetes mellitus in Zawan community was 4.1%. Diabetes mellitus remains a common undetected medical condition in our rural community.

TABLE OF CONTENTS

Title page                                                                                              i

Declaration                                                                                            ii

Certification                                                                                          iii

Dedication                                                                                             v

Acknowledgement         vi  Table of contents         vii

List of Tables and Figures                                                                     viii

Abbreviations                                                                                        x

Abstract                                                                                                 xi

Chapter one: Introduction                                                                      1

Chapter two: Literature Review                                                             6

Chapter three: Subjects and Methods                                                    17

Chapter four: Results                                                                             28

Chapter five: Discussion and Conclusion                                               69

References                                                                                             76

                                           CHAPTER ONE

INTRODUCTION

 1.1 Background

 

 

Diabetes mellitus (DM) is defined as a metabolic disorder of multiple aetiology characterised by chronic hyperglycaemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in secretion

and/or insulin action.^{1, 2}

The classical symptoms are excessive thirst, polyuria, nocturia, and otherwise unexplained weight loss.^2-4 It can also manifest through the presence of its many related complications. ^5-8 Diabetes mellitus may be asymptomatic, especially type 2 (DM), in which case the diagnosis may be made on routine blood or urine glucose testing.^1,2,4

The recent advances in the understanding of the aetiology and pathogenesis of diabetes mellitus have led to revised classification of diabetes mellitus to

type 1, type 2, other specific types and gestational.^{2, 9}

Diabetes mellitus right from the ancient time until date remains a serious medical problem because its complications include blindness, renal failure, diabetic foot leading to amputation of limbs, and even death .¹⁰ Diabetes mellitus also imposes a high economic burden on individuals and society in all countries. ¹¹ However, early diagnosis and the use of modern treatment modality improve the life span of most diabetics. The essential components of such treatment modality are education, counselling, self monitoring, self management, and pharmacological treatment with insulin or oral antidiabetic

agents.10, 12-14

1.2 Classification of diabetes mellitus

The recent advances in the understanding of the aetiology and pathogenesis of diabetes mellitus have led to revised classification of diabetes mellitus to type 1, type 2, other specific types and gestational.^{2, 9}

 

1.2.1 Type 1 diabetes mellitus

This is a chronic disorder due primarily to the beta cell destruction.^2,9

1.2.2 Type 2 diabetes mellitus

This can be described as a syndrome characterised by insulin deficiency,

insulin resistance and increased hepatic glucose output.^2,9

1.2.3 Other specific types of diabetes mellitus

This include a long list where the cause of diabetes is known.^2,9 These are subcategorised into: genetic defects of beta cell function; diseases of the exocrine pancreas; endocrinopathies; drug or chemical induced; infections ; uncommon forms of immune-mediated diabetes; and other genetic syndromes.⁹

1.2.4 Gestational diabetes mellitus

This is restricted to women in whom onset or recognition of diabetes occur first during pregnancy.^2,9 It excludes diabetic women who became

pregnant.^2,9

 

1.3 Definition of research problem

Diabetes mellitus is a worldwide problem. It was estimated in 1997 that about 124 million were affected by diabetes worldwide.¹⁵ WHO estimates that the figure will rise to 300 million by 2025.¹⁶ Currently, there is a worldwide explosion of incidence of type 2 diabetes, now reaching epidemic proportion, with an estimated doubling of the world diabetic population from 110 millions in 1994 to 221 millions by 2010.¹⁵ 

          The overall prevalence of diabetes mellitus in Africa is estimated to be 1-2%.¹⁷The pattern of distribution of diabetes shows higher rates among people of developing countries, and in lower socioeconomic groups of developed countries¹⁸; and it is estimated that by the year 2025, more than 3/4 of people with diabetes will be inhabitants of developing countries.¹⁹

In Nigeria, the expert committee on non- communicable diseases estimated the prevalence of diabetes to be 2.2 %. ²⁰ In Jos, an urban community in North Central Nigeria, the prevalence of DM in adult was estimated to be 3.1 %.²¹The prevalence in Mangu, a rural community in Plateau State, North Central Nigeria, was estimated to be 0.6 %.²⁰

This increase and pattern of distribution of diabetes make the disease condition an obvious public health problem.

 

1.4 Relevance/Justification for the study

Diabetes mellitus still remains a major health concern as declared by

the World Health Organization.^{17, 22}In Nigeria, rural and urban population

studies on the prevalence of diabetes have been carried out.^{20, 21, 23,24}Most of these Nigerian studies were done more than ten years ago before the introduction of the new diagnostic criteria by WHO^{2, 9}: Hence, there is the need to carry out a prevalence study in a rural community using the new diagnostic criteria. The result of this study would be very useful to the physician especially the family physician in appreciating the rising prevalence of the disease and developing an attitude for routine screening of patients for Diabetes Mellitus. This improved knowledge will not only add quality but also years to the life of our patients.

1.4 Objective of study

General objective: To determine the prevalence of diabetes                                       mellitus among adults leaving in Zawan                                       community of Jos-South, Plateau State,

Nigeria.

 

 

Specific objectives: (a) To identify risk factors associated with

Diabetes Mellitus in the community                                 (b) To determine relationship of blood                                      glucose levels with age, Body Mass                                      Index (BMI), waist circumference, hip                                       circumference and waist hip ratio.

THE PREVALENCE OF DIABETES MELLITUS AMONG ADULTS IN A RURAL COMMUNITY IN NORTH CENTRAL NIGERIA

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