Screening for diabetes mellitus in a Nigerian family practice population

Abstract

BackgroundDiabetes mellitus is a non-communicable disease with a rising prevalence worldwide. Most of the increase in prevalence is projected to be in the developing countries. As it is recognised that the onset of the disease and its complications predate the symptoms, it is expedient that screening procedures are undertaken to diagnose the disease in the individual as early as possible to minimise the risk of complications. Diabetes mellitus is a chronic disease necessitating life-long therapy, usually with drugs. This creates a life-long financial burden on the family, especially in low socio-economic communities in West Africa, where the majority of the population still lives on less than one dollar a day. This affects the wellbeing of the entire family, hence the need for early detection, prompt and adequate management of the disease and avoidance of its complications. MethodsThe study is an incidental screening to determine the prevalence of diabetes mellitus, its risk factors and the clinical characteristics of diabetics in a Nigerian family practice population. Four hundred and twenty subjects aged 15 years or older were recruited by systematic random sampling in a family practice in South West Nigeria over a three-month period. Data collected include the subjects' socio-demographic data, family history of diabetes mellitus and hypertension, and history of tobacco and alcohol use. The subjects' weight and height were measured and their body mass index (BMI) calculated. Each subject was examined for peripheral neuropathy, lens opacity and hypertension. Fasting blood glucose was measured using a glucometer and urine was tested for albumin. Those with a fasting blood glucose of greater than 6.1 had a fasting blood glucose determination by the standard spectrophotometric method. ResultsTen (2.38%) subjects were known diabetics, while 57 (13.6%) were known hypertensives. Ten (2.38%) new diabetics were identified, and 7.5% of the females compared to 5.8% of the males were diabetic. Alcohol intake, obesity, age above 44 years and a positive parental history of diabetes were the significant risk factors (p < 0.01) for diabetes in the study. Proteinuria and peripheral neuropathy were the significant complications (p < 0.01). ConclusionsIt is concluded that diabetes is a common problem in our practice, with a prevalence of 4.76%, half of which was previously undiagnosed. Alcohol intake, obesity, positive parental history and age over 44 years were the identified risk factors. Peripheral neuropathy, proteinuria and high blood pressure were the identified complications. It is recommended that routine screening of people at high risk of diabetes mellitus in family practice be commenced. The glucometer, a relatively cheap item of equipment in the practice, is a highly useful, sensitive and specific tool for this purpose. Pract 2007;49(8):15 SA Fam

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

“…Thus at primary care level, family history of diabetes mellitus may help tailor health promotion, health maintenance and risk reduction messages for this special group of hypertensive patients. [40] Inadequate physical was found to have a significant association with pre-diabetes. This could be related to the reports that physical inactivity leads to decrease insulin effectiveness and poor utilization of glucose and fats in the body cells.…”

Effect of self-monitoring of blood glucose on glycaemic outcome among type 2 diabetic patients

“…2 The burden of diabetes is increasing in low-and middle-income countries like Nigeria with more money being spent on complications due to poorly controlled diabetes. 3,4 Nigeria has a reported prevalence rate of 2.2% with regional differences. 4 Self-monitoring of blood glucose (SMBG) is defined as the collection by diabetic patients of detailed information about their blood glucose levels at many time points during the day on a day-to-day basis in order to aid adjustments in therapy and lifestyle activities and ultimately improve glycaemic control and prevent diabetes-related complications.…”

“…3,4 Nigeria has a reported prevalence rate of 2.2% with regional differences. 4 Self-monitoring of blood glucose (SMBG) is defined as the collection by diabetic patients of detailed information about their blood glucose levels at many time points during the day on a day-to-day basis in order to aid adjustments in therapy and lifestyle activities and ultimately improve glycaemic control and prevent diabetes-related complications. 5 It is said to be structured SMBG when the blood glucose data are gathered according to a defined regimen, interpreted, and then utilised to make appropriate pharmacologic and/or lifestyle adjustments.…”

Periodontal characteristics of diabetic patients with tooth mobility

“…The prevalence of DM in South Western Nigeria is 4.76% with 2.38% as undiagnosed DM. [3] The prevalence of undiagnosed DM in the outpatient dental clinic of University of Benin Teaching Hospital (UBTH) and University College Hospital is 4.5% [4] and 4.4%, [5] respectively.…”