International Journal of Research in Medical Sciences | October 2019 | Vol 7 | Issue 10 Page 3844
International Journal of Research in Medical Sciences
Onyenekwe BM et al. Int J Res Med Sci. 2019 Oct;7(10):3844-3853
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Diabetes Mellitus in adult Nigerians: patients’ characteristics,
laboratory profile, practices and management outcome
Belonwu M. Onyenekwe*, Ekenechukwu E. Young, Chidinma B. Nwatu, Christian I. Okafor,
Chidiebere V. Ugwueze, Kingsley O. Onuekwusi
INTRODUCTION
Diabetes mellitus (DM) is one of the four growing
pandemic non-communicable diseases (NCD) ravaging
the modern world according to the WHO global report on
Diabetes.
1
The prevalence of the disease has been rising
globally especially in low and middle income countries
(LMIC). The 2016 estimate for the prevalence of diabetes
in Nigeria by the World Health Organization (WHO) was
4.3%.
2
Local studies estimate the prevalence to range
from 0.8% to 11% between rural and urban
populations.
3,4
The predominant type of DM in Nigeria is
Type 2 (T2DM), accounting for about 90%-95% of all
cases
.4,5
The WHO Assessment of the national response to
diabetes (Nigeria) in 2016 revealed that policies,
guidelines and monitoring were only partially
Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
Received: 08 August 2019
Revised: 08 September 2019
Accepted: 12 September 2019
*Correspondence:
Dr. Belonwu M. Onyenekwe,
E-mail: drmends@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Type 2 diabetes constitutes more than 90% of cases seen in Nigeria. Previous reports had shown that
patients were poorly controlled and failed to meet management target across a broad range of parameters. Objectives
of this study evaluated the characteristics and practices of patients attending the outpatient diabetes clinic. The study
also examined to what extent they achieved management goals and what practices by the patients impacted negatively
on treatment outcome.
Methods: This was a cross sectional descriptive study. All patients were eligible. Consecutive patients attending the
Diabetes Clinic were evaluated. Their demographic, behavioural, social, clinical and laboratory data were obtained.
Data analysis was done with SPSS V 21.
Results: There were 193 subjects, 78 males and 115 females aged 35-82(59.8± 9.1) years. T2DM was diagnosed in
93.4%. Hypertension was coexistent in 74%. Present or past foot ulcer was recorded in 11.9%. Only 37% of the
subjects had an exercise program, 35% did the daily foot exam, and 45% had ophthalmology consult. Skipping
medication was widespread (64%), mainly due to self-titration of medications (44%) and cost (23%). Fear of
hypoglycemia (83%) and hypotension (79%) was prevalent. Their body mass index was 18.2-41.2(27.6±4.8) kg/m2.
Subjects were prescribed a total of 2-14 medications (5.5±1.6). Metformin was the most commonly used glucose
lowering medication (88.6%), followed by sulfonylureas (64%) and insulin (27.5%). HbA1c ranged from 5.3-16;
9.0±2.4%(33-151; 75±2.7 mmol/mol).
Conclusion: Glycaemic control was poor in the study population. Intermittent medication to avoid hypoglycemia
played a major role. The patients lacked competence to manage their diabetes from day to day. Diabetes Self-
Management Education and Support (DSMES) and early use of insulin are recommended.
Keywords: Adherence, Competence, Control, Diabetes mellitus, Profile
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20194320