2型糖尿病(T2DM)是一种全球公共卫生疾病,在低收入和中等收入国家,未诊断的糖尿病前期和糖尿病负担日益增加。尤其是尼日利亚。糖尿病前期和糖尿病是心血管并发症的既定危险因素。然而,关于尼日利亚目前这些疾病的患病率的数据很少,基于2009年WHO推荐的血红蛋白A1c(HbA1c)诊断。我们的目的是确定糖尿病前期的患病率,糖尿病,尼日利亚成年人群中使用HbA1c的未诊断糖尿病。
横截面,在尼日利亚的选定州进行了多地点人口研究(即,Ekiti,拉各斯,Osun,Oyo,和Kwara州)涉及农村和城市社区居民中的2,708名成年人(≥18岁),没有事先诊断为糖尿病前期或糖尿病。患有持续急性或衰弱疾病的参与者被排除在外。数据是使用面试官管理的预先测试收集的,半结构化问卷。社会人口学,临床(体重,高度,血压,等。),并获得参与者的实验室特征,包括HbA1c。使用STATA版本16分析数据。
参与者的平均年龄为48.1±15.8岁,65.5%为女性。糖尿病前期和未确诊的糖尿病总体患病率分别为40.5%和10.7%,分别,高血压患病率为36.7%。糖尿病前期的患病率在拉各斯最高(48.1%),在Ekiti最低(36.7%),而Kwara的糖尿病患病率最高(14.2%),Ekiti的患病率最低(10%)。参与者的年龄之间存在显着关联(p<0.001),性别(p=0.009),教育状况(p=0.008),职业(p<0.001),部落(p=0.004),婚姻状况(p<0.001),血压(p<0.001),以及他们的糖尿病或糖尿病前期状态。糖尿病和糖尿病前期的独立预测因素包括体重增加过多,久坐的生活,和衰老。45-54岁年龄组的参与者糖尿病前期和糖尿病总患病率最高(26.6%)。
超过一半的受访者患有糖尿病前期和糖尿病,未诊断的糖尿病患病率很高。一项全国性的筛查活动将促进成年尼日利亚人早期发现糖尿病前期和未诊断的糖尿病。健康教育活动可能是社区环境中提高对糖尿病危险因素知识的有效工具,以降低血糖异常的患病率。
Type 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c.
A cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16.
The mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p< 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p< 0.001), tribe (p = 0.004), marital status (p< 0.001), blood pressure (p< 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45-54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes.
Over half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia.