Original Article Evaluation of ADL and BMI in the management of diabetes mellitus at secondary and tertiary health facilities Ezekiel U. Nwose a, b, * , Benjamin Ekotogbo a , Christabel N. Ogbolu a , Meyiwa Mogbusiaghan a , Otovwe Agofure a , Eunice O. Igumbor a a Department of Public & Community Health, Novena University, Ogume, Nigeria b School of Community Health, Charles Sturt University, Orange, Australia article info Article history: Received 30 April 2019 Accepted 24 May 2019 Keywords: Diabetes care Integrated care Metabolic syndrome Occupational information Physical activities of daily living abstract Aims: Physical activities of daily living (ADL) constitutes one of diabetes management options. This study aimed to assess the extent that ADL and BMI are evaluated among diabetes patients in hospital practice. Method: This was a clinical observational baseline study in two hospitals. Audit of medical files was performed to assess if BMI and occupations were recorded (N ¼ 112). Afterwards, ‘N ¼ 38’ who consented to participate in prospective study were conveniently sampled to assess ADL in relation to accessible metabolic syndrome tests. A validated questionnaire was used to collect data, which were analysed using SPSS version 20. Results: Audit shows 55/112 of clients’ occupation were taken, of which 31% has BMI record. Those with lipid profile results are without blood pressure and vice versa. In the cross-sectional assessment, 74% are in physically demanding ADL occupations, but affirmed inactivity is 98% on leisure exercise. Further, 47% have BMI >25 kg/m 2 and were consistently less active on all leisure ADL relative to those with BMI <25 kg/m 2 (p < 0.02). Conclusion: This report highlights oversight in clinical practice, whereby accessible metabolic syndrome parameters and occupation of clients living with diabetes are being assessed inconsistently. This implies an unmet need in the integration BMI and occupational information to improve diabetes self- management. © 2019 Published by Elsevier Ltd on behalf of Diabetes India. 1. Introduction Diabetes is one of the largest global health emergencies of the 21st century. It is among the top 10 causes of death globally and together with the other three major non-communicable diseases (NCDs) (cardiovascular disease, cancer and respiratory disease) account for over 80% of all premature NCD deaths [1].The Inter- national Diabetes Federation (IDF) estimates the global prevalence of diabetes mellitus to be 151 million in 2006, 285 million is 2009, 366 million in 2011, and 425 million people aged 20e79 years are living with diabetes [2]. This dramatic increase in diabetes has occurred in all countries in rural as well as urban areas. Accurate global, regional and country level estimates and projections of diabetes prevalence are necessary for prevention and treatment strategies to be planned and monitored, and to assess progress towards reaching the target set by the global action plan for non-communicable diseases and the sustainable development goals [2,3]. In Delta State of Nigeria, concerted research has been ongoing on [4,5], especially including factors influencing diabetes manage- ment such as physical activities [6e8]. It has been established that intensive education is a valid option to improve patient self- management [9]. However, this method has yet to be tried in Nigeria and Delta State in particular. It is now generally agreed and no longer in dispute that regular physical activities is a necessary part of diabetes management [10]. Physical activities of daily living (ADL) includes all movement that increases energy use and may be simple tasks, unlike leisure ex- ercise that is scheduled and structured [11 , 12]. However, there are challenges in adoption of physical activities for blood glucose management. For instance, controlling blood glucose level still remain one of the challenges among athletes living with diabetes * Corresponding author. Prof Ezekiel Uba Nwose. Department of Public & Com- munity Health, Novena University, Ogume, Nigeria. E-mail address: enwose@csu.edu.au (E.U. Nwose). Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepage: www.elsevier.com/locate/dsx https://doi.org/10.1016/j.dsx.2019.05.033 1871-4021/© 2019 Published by Elsevier Ltd on behalf of Diabetes India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 13 (2019) 2266e2271