EPIDEMIOLOGY OF DIABETES AND IMPAIRED FASTING GLUCOSE IN A RURAL COMMUNITY OF NIGERIAN NIGER DELTA REGION.
BACKGROUND
The prevalence of diabetes mellitus is reaching epidemic rates globally. It had an estimated global incidence of 220 million in 2010. Different studies in SSA and Nigeria in particular have reported increasing prevalence of diabetes in the rural areas. This may be attributed to the rapid 'westernization' of lifestyle in the rural African community.Only few rural survey have been conducted in the Nigeria oil-rich Niger Delta region necessitating this study with the aim of determining the prevalence of diabetes and impaired fasting glucose (IFG).


METHODS
This was a cross-sectional survey involving 500 subjects aged 15 years and above in a typical rural community of Rivers State, Niger Delta region of Nigeria. A questionnaire administered by face-to-face interview was used to assess socio-demographic characteristics of the subjects. Medical history such as prior knowledge of blood sugar status and family history of diabetes were all elicited by the questionnaire. Anthropometric and blood pressure measurements were taken in a standardized manner and body mass indices (BMI) calculated as weight in kilogram divided by the square of height in meters. Venous blood glucose was measured by the glucose oxidase method. Diabetes mellitus was defined using fasting plasma glucose (FPG) ≥ 7.0 mmol/l (126 mg/dl) and individuals who were previously known to have diabetes based on history of treatment were also classified to have diabetes. Lipid profile and uric acid of patients were also checked.


RESULTS
There were 156 males and 344 females with male to female ratio of 1:2.3.The females were relatively of younger age than the males (40.62 ± 16.6 years versus 42.84 ± 17.8).The overall mean age was 41.32 ± 17. The mean fasting plasma glucose among those with diabetes was 11.14?4. 00mmol/L while the mean for the subjects with impaired fasting glucose was 6.31 ± 0.25 mmol/l. The prevalence of diabetes was 2.2% with no significant gender difference (2.6% in males versus 2.0% in females; χ2 = 0.35; p = 0.84). The prevalence of Impaired fasting glucose (IFG) was 2.4%with no significant gender difference (Female 2.6% versus males 1.9%; p = 0.88). The mean fasting glucose increased significantly with blood pressure (p = 0.05), waist circumference (p < 0.001), uric acid level (0.02), triglyceride level (< 0.001) and age (p = 0.02).The correlation analyses showed that age, systolic blood pressure, waist-hip-ratio and triglycerides are positively correlated with diabetes and impaired fasting glucose in this study.


CONCLUSIONS
There is a low prevalence of diabetes and IFG in this rural community which may be associated to the high level of physical activity found among the study subjects in this community. However, this study confirmed that increasing age, abdominal obesity, systolic blood pressure and triglyceride level have positive relationship with the prevalence of diabetes and IFG. There is hence more need for intensified screening for diabetes, pre-diabetes and associated risk factors in order to curb or at least reduce diabetes prevalence and its attendant complications.
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Alikor
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Emem-Chioma
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data
D001786:Blood Glucose