Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria

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Abstract

Objectives: This study aimed to assess the prevalence rates of type 2 diabetes and to determine potential associated risk factors of the disease in Port Harcourt, Nigeria. Research design and methods: Five hundred and two (502) subjects aged above 40 years, obtained by a two-stage cluster sampling technique participated in this survey. Casual (random) plasma glucose estimations were done for all subjects after relevant personal data were obtained. Subjects with casual plasma glucose (CPG) ≥7.0 mmol/l had oral glucose tolerance tests (OGTT) done. Fasting and 2 h post glucose load blood samples were analyzed for plasma glucose levels. Results: Thirty-four (34) subjects had diabetes, giving a crude prevalence rate of 6.8% (CI=4.6–9.0%), and standardized rate of 7.9%. The crude prevalence rates were 7.7 and 5.7% for males and females, respectively. Of the 34 diabetic subjects seen, 14 (41.2%) of them were not previously known to have diabetes; 83.7% of these were asymptomatic. Body mass index (BMI) ≥25 kg/m2 and WHR≥0.85, family history of diabetes, physical inactivity, heavy consumption of alcohol, older age as well as high social status and Hausa–Fulani or Ibibio origin were associated with significantly higher prevalence of type 2 diabetes. Conclusion: The prevalence of type 2 diabetes in Port Harcourt is relatively high. Changing lifestyle associated with industrialization may explain this. A significant proportion of the diabetic subjects are asymptomatic and undiagnosed. The risk factors as shown in our study clearly emphasize the point that type 2 diabetes is to a large extent a preventable disease.

Introduction

Although there is a paucity of data on the prevalence of diabetes in Nigeria and other African countries, available data suggest that diabetes is emerging as a major health problem in Africa, including Nigeria [1]. The prevalence of diabetes in Port Harcourt is unknown [2], [3] but studies show that diabetes is a considerable cause of morbidity and mortality in Port Harcourt [2], [3], [4]. In the University of Port Harcourt Teaching Hospital (UPTH) diabetes accounted for approximately 14% of all new cases seen in the Medical Clinics in 1994, and over 18% of all the Medical outpatient consultations in the same year [5].

Port Harcourt, the capital of the oil rich Rivers State of Nigeria is a cosmopolitan city with a projected population of over half a million people [6].

The city has undergone rapid transformation in recent times as a result of the boost in petroleum and other industries, and increasing influx of people from all over the world. Lifestyle is becoming increasingly westernized. It became pertinent, therefore, to study the prevalence of and assess risk factors for type 2 diabetes in Port Harcourt.

Section snippets

Study population

Port Harcourt is located in the Niger Delta region of Nigeria. It is the center of the petroleum industry in Nigeria. The ethnic groups in Port Harcourt include Ikwerre, Ijaw, Ogoni and other Nigerian tribes such as Ibo, Yoruba and Hausa–Fulani. Expatriates from different parts of the world also live in Port Harcourt, which has many municipalities. This survey was carried out in the old township area of Port Harcourt. This area was chosen because it is well planned, which made sampling and

Results

Five hundred and two of the 748 subjects selected for this study, participated in the survey, giving a response rate of 67.1%. Non-responders were not followed-up in this study. The data of subjects studied are given below:

  • a

    Ethnic group distribution: Twenty-two (22) ethnic nationalities were represented in the sample. The Ijaws comprised 47.4%, the Ibos 18.9%, the Yorubas 7.8%, the Hausa Fulanis 6.6%, the Ikwerres 4.4% and the other tribes 14.9% of the population.

  • b

    Age and sex distribution: The

Discussion

The crude and standardized prevalence rates of type 2 diabetes in this study was 6.8 and 7.9%, respectively. This is close to the crude rate of 7.2% reported for the Lagos mainland by the National non-communicable disease survey [11]. Although the National standardized rate is 2.2% in Nigeria, the crude prevalence rate is 7.4% in those aged 45 years and above who live in urban areas. However, it is noteworthy that other cities in Nigeria have lower rates than that in Port Harcourt. For

Conclusion

The prevalence of type 2 diabetes in this study population is fairly high. 40% of the subjects with diabetes are undiagnosed, over 80% of these are asymptomatic. Some of the identified risk factors for type 2 diabetes are modifiable, making type 2 diabetes a potentially preventable disease. It would be prudent, therefore, to recommend screening of subjects at risk and lifestyle modification to reduce the prevalence of type 2 diabetes in Port Harcourt.

Acknowledgements

We wish to thank Steve Blum for the statistical analysis of this work and Mrs Ladi Nyenwe for her support. We are also grateful to Mr Karibi Botoye for supervising the Laboratory analysis. This survey was supported in part by grant from UPTH Port Harcourt, Nigeria.

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