Risk Factors of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Resource-Constrained Setting of a Primary Care Clinic in Eastern Nigeria

Abstract

Background: As the case detection of pre-diabetes(PD) increases worldwide, screening for its risk factors which overlap with those of type 2 diabetes mellitus(DM) is an important primary care challenge that is often neglected especially in under-resourced setting. Aim: This study was designed to determine the prevalence and risk factors of prediabetes among adult Nigerians with essential hypertension in a resource-constrained setting of a primary care clinic in Eastern Nigeria. Materials and Methods: A cross-sectional study carried out on 320 consecutive adult Nigerians with essential hypertension who were screened for PD and 106 of them who had PD and met the inclusion criteria were age and sex matched with 106 non-hypertensive and non-diabetic control. Demographic and some risk factors of PD were obtained using a pretested, structured and interviewer-administered questionnaire. Pre-diabetes was defined as fasting plasma glucose of 100-125 mg/dL and /or plasma glucose level of 140-199 mg/dL two hours after a 75g oral glucose load. Results: One hundred and six (33.1%) out of the 320 hypertensive patients screened had PD. Obesity (P=0.001), positive family history of DM (P=0.001) and inadequate physical activity (P=0.001) were significantly associated with PD. The most significant predictor of PD was obesity(OR=12.50(2.38-34.48), P=0.001).The obese patients were twelve and half times more likely to have PD compared to their non-obese counterparts. Conclusion: There was high prevalence of PD in adult hypertensive study population. Obesity, family history of DM and inadequate physical activity were proximate independent risk factors. The presence of these risk factors should therefore provide guide for screening adult Nigerians with essential hypertension for PD in primary care.

Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria

“…[23] The earlier in the pre-morbid phase that pre-diabetes is detected in adult hypertensive patients, the better the prognosis and outcome of its management. [11][12][13] Establishing a baseline for the blood glucose and checking them during patients visits appropriately can provide the clinicians with an excellent means of educating their hypertensive patients on lifestyle modifications and other diverse clinical care.…”

“…Pre-diabetes is a medical condition in which the blood glucose level is higher than the normal value but not high enough to meet the criteria for the diagnosis of Diabetes mellitus. [11] It is characterized by fasting plasma glucose 100 -125 mg/dL and/or plasma glucose level 140 -199 mg/dL two hours after a 75g oral glucose load. [6] These conditions are known as impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) respectively.…”

Aktivitas fisik, stress, dan asupan makanan terhadap tekanan darah pada wanita prediabetes

“…Seseorang dikatakan prediabetes apabila mengalami salah satu atau kedua kondisi berikut: glukosa darah puasa terganggu (GDPT dimana GDP: 100-125 mg/dL) dan toleransi glukosa terganggu (TGT dimana GDPP: 140-199 mg/dL). [1][2][3][4][5] Penderita prediabetes lebih berisiko berkembang menjadi Diabetes Mellitus Tipe 2 (DMT2). Progresivitas prediabetes menjadi DMT2 sebesar 6-10% per tahun.…”

“…13 Banyak faktor yang menyebabkan terjadinya hipertensi pada prediabetes, antara lain adalah meningkatnya usia, adanya riwayat keluarga yang mengalami diabetes, obesitas terutama obesitas sentral, inflamasi dan stress oksidatif, resistensi insulin, kurangnya aktivitas fisik, stress, asupan makan yang tidak baik (tinggi asupan sodium dan lemak, rendah asupan kalsium, serat, kalium, dan magnesium), merokok, konsumsi alkohol, dan hiperlipidemia. 3,[14][15][16][17][18] Diantara faktor tersebut, faktor yang dapat diubah adalah kurangnya aktivitas fisik, stress, dan asupan makan.…”

“…Kurangnya aktivitas fisik menyebabkan penurunan efektivitas insulin dan buruknya penggunaan glukosa dan lemak di dalam sel. 3 Banyak penelitian yang telah menunjukkan bahwa aktivitas fisik yang rendah berhubungan dengan hipertensi dan prediabetes, tetapi penelitian di Indonesia menunjukkan hal yang sebaliknya dimana aktivitas fisik tidak berhubungan dengan prediabetes sehingga bukan merupakan faktor risiko terjadinya prediabetes. 2 Selain itu, pada era modern dimana kehidupan dipermudah dengan adanya teknologi dan sarana transportasi membuat seseorang lebih cenderung untuk memiliki aktivitas yang rendah.…”