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Journal of Applied Sciences and Environmental Management
World Bank assisted National Agricultural Research Project (NARP) - University of Port Harcourt
ISSN: 1119-8362
Vol. 5, Num. 1, 2001, pp. 75-77
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Journal of Applied Sciences & Environmental Management,
Vol. 5, No. 1, June, 2001, pp. 75-77
Prevalence Of Diabetes Mellitus Among
Nigerians In Port Harcourt Correlates With
Socio-Economic Status
* NWAFOR, A ; OWHOJI, A
Department of Human Physiology, College of Health Sciences,
University of Port Harcourt, P. M. B. 5323, Port Harcourt, Nigeria.
* Corresponding author
Code Number: ja01011
ABSTRACT
Random blood glucose analysis by the use of the Trinders method was carried out to determine the prevalence of diabetes mellitus among Nigerians in Port Harcourt. The study population
were randomly selected and classified into two socio-economic status as high
or low based on affluent diet, occupation, income and access to medical care.
The mean blood glucose concentration for the high socio-economic group staff of
the oil industries was 7.42 ±0.25mmol/L and significantly higher (P < 0.001) than
that for the low socio-economic class - the non- oil industrial workers,
5.33±0.45mmol/L. The prevalence of diabetes was found to be as high as 23.4%
among the high socio-economic group and 16% among the low socio-economic
group. Undiagonised diabetes occurred in 18.9% of the population studied
and were not aware of their diabetic problem. Diabetic awareness programmes
are to be promoted with acion to identify people with diabetes early enough
with the arm of providing appropriate medical treatment. @ JASEM
High blood glucose, more specifically, diabetes mellitus
is a major health problem (WHO, 1998). Diabetes, clinically is a non communicable
disorder but diabetics as a group are at increased risk of disease states
such as heart diseases, blindness, nerve disorders, kidney diseases, gangrene etc
(Adetuyibi, 1976, Alberti et al 1975, Hamstem and Steiner 1994, Amos et al
1997, Edward and Raffaele 1996). The exact cause(s) of diabetic induced
complications are not fully understood, the underlying factor that appears
to make those with diabetes more prone to many health problems is prolonged
and frequent elevation of blood sugar. The prevalence of diabetes, in the
developed countries is well established.(Alhasmi et al 1995, Rewers and Hamman,
1995, WHO 1994). The world Health Organisation stated in 1998 that a 122%
rise in the number of adults with diabetes is projected by 2005, to reach
300 million adults worldwide (WHO, 1998).
The literature relating to the prevalence of diabetes in Nigeria is scarce.
In so far diabetes is a well known major public health problem worldwide,
there is therefore the growing tendency that every effort should be directed
towards actively looking for the prevalence of diabetes in the Nigeria population.
Of interest is the general impression that the prevalence of diabetes among Nigeria population
in Port Harcourt is as high as and perhaps comparable with that of the Western
Countries because of the urbanization and industrialization of Port Harcourt and
the Westernisation of lifestyle of the populace. The aim and the objective
of this study therefore was to investigate and compare the prevalence of
diabetes among different socio-economic groups in Port Harcourt from which
the norm for Nigerians may merge and to ascertain whether or not those with
high blood glucose are aware of their diabetic problem.
MATERIALS AND METHODS
Subjects for this study were randomly selected from staff of an oil company
(Agip) Port Harcourt, staff and students of College of Education. Port Harcourt and
the University of Port Harcourt Teaching Hospital. Respondents were ages
between 17 and 60 years. The oil company workers have access to a better
dietary habits, health conditions, improved education and income and were
classified as high socio-economic class. The staff and students of the College of Education and
University Teaching Hospitals, Port Harcourt on the other hand were classified
as low socio-economic group based on the aforementioned criteria. None
of the subjects were found to be hypertensive (defined as blood pressure > 140/90
mmHg).
The glucose oxidase (Trinders) method (Lett and Turner, 1975, Kannel an
McGee (1979 Barham and Trinder, 1972) were employed for the study. Venous
blood were obtained with a minimum of stasis into a clean disposable plastic
syringe and then transferred into a universal bottle containing anticoagulant
potassium fluroxide. After mixing, the blood samples were then centrifuged
at 3000 rpm for 5 minutes plasma was collected and kept at 370c
ready for use. Prior to use, the plasma was treated with glucose oxidase
reagent and colour developed within 15 minutes. The colour that developed
was measured colour metrically at 480nm. Statistical analysis of the data
were done using comparison of proportions and paired - tests. A p-valve
less than 0.05 was calculated statistically significant
RESULTS
Out of 403 subjects, 141 (35%) were staff of Agip oil company and 262 (65%)
were students and staff of the College of Education and University of Port
Harcourt Teaching Hospital. The mean blood glucose concentration level of
the staff of the oil company was 7.45±2.25 mmol/1 and was significantly higher
(P < 0.001) than that for the non oil company workers 5.33±0.48 mmol/1.This
represents a difference of 68.2%.
There were 64 (45.4%) diabetics (53 or 37.6% males and 11 or 7.8% females)
from a total 141 employee of the oil company studied (Table 1). Most of the
employee of the oil company were males (male: female ratio 6.1:1). Thirty
of the 53 (37.6%) diabetic males were known diabetics receiving medical treatment. All
the diabetic subjects have been in the employment of Agip company for more
than 10 years and moreso, non presented a family history of diabetes. The
duration of diabetes was less than 6 years and all the patients were non-insulin
dependent diabetes (NIDDM).Forty two diabetes (20 or 7.6% males and 22 or
8.4% females) from a total of 262 non oil industrial worker were employed
in the study (Table 2). The male: female ratio was 1:1.5.
There were 33/141 (23%) and 42/262 (16%) undiagnosed diabetes among the
oil company staff and non oil company works respectively. The prevalence
of diabetes was significantly increased (P<0.001) among the oil company
workers than was for the non-oil company workers. The mean blood glucose
concentration for the non-diabetics 77/141 (55%) among the staff of the oil
firm and for the non-oil company workers 220/262 (84%) were similar (Tables
1 and 2). There were 76/403 (18.9%) undiagnosed diabetes in the population
and were not aware of their diabetic problem. subjects in the high socio-economic
class and 5.33 ±0.45mmol/L for the 262 subjects.
TABLE 1: Blood Glucose Concentration Of 141 Staff Of An Oil Company
In Port Harcourt (Mean ± Sd)
Sex/Characteristics
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Number (%)
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Blood glucose concentration (mmol/L)
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Male: non-diabetes diabetes
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65 (45%)
53 (37.6%)
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5.12 ± 0.65
10.55 ± 2.14
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Females: non-diabetes diabetes
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12 (8.5%)
11 (7.8%)
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4.85 ± 0.86
9.8 ± 1.16
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TABLE 2. Blood Glucose Concentration Of Non-
Oil Company Workers In Port Harcourt (Mean ± Sd)
Sex/Characteristics
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Number (%)
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Blood glucose concentration (mmol/L)
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Male :non-diabetes diabetes
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85 (32.4%)
20 (7.63%)
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5.19 ± 0.38
7.73 ± 1.04
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Females: non-diabetes diabetes
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135 (51.5%)
22 (8.4%)
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4.63 ± 0.75
8.26 ± 1.08
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DISCUSSION
Diabetes mellitus is a major public health problem (who, 1998). Published
information on the prevalence for Nigeria is scarce. This perhaps might be
a reflection that diabetes features relatively low among the health care
needs of the country. In the present study the random blood glucose concentration
was found to be 7.45±0.25 mmol/L for the 141 in the low socio-economic status.
The normal plasma glucose concentration varies only slightly throughout the
day and the random blood glucose cut-off point for the diagnosis of diabetes
range from 2.5 to 7.3 mmol/L. The only rise that occurs in found after a
meal but even then there is rarely a rise of more than 0.6 to 0.8 mmol/L
(Superstein, 1975, WHO 1985).
The high prevalence of diabetes among the oil company workers compared to
those in the non-oil industrial sectors suggests that Nigerians are prone to
high rates of diabetes. Thrifty genotypes hypothesis (Lakhdar, 2000, Gill,
1996) provides attractive proposition to explain the explosive emergence
of diabetes among the oil industrial workers. The hypothesis states that the population affected with high
rates of diabetes may have genes that promoted fat deposition during periods of over
- nutrition, which represented a survival advantage in times of deprivation
(Lakhdar 2000). The prevalence of diabetes varies considerably around the world (Humphrey
et al 1995). The high prevalence of diabetes among the oil industrial workers
might be associated with affluent dieta high fat consumption and the corresponding
reduced complex carbohydrate intake and a sedentary life style (Elmugarner et
al 1995).
Inspite of the small size, the present study also demonstrated that undiagonised diabetes
occurred in 18.9% of the population studied and were not aware of
their diabetic problem. Reports in the literature indicated that rates
of undiagonised diabetes population can be high as 45 to 56% in Saudi Arabia (Al-Nuaim,
1997), 40-56% in Egypt (Hermen et al 1995) and 30 to 40% in Bahrain
(Al-Mahroos and Mekeigue 1998). Thus diabetic awareness programmes is to
be promoted with action to identify people with diabetes early
enough with the arm of providing appropriate treatment regimens.
REFERENCES
-
Adetuyibi A 1976 Diabetes in Nigeria. African
review of long term complications. Trop Geog. Med 28: 155-168.
-
Alberti A. K. Dornhorst A and Rowe, As 1975 Metabolic rhythms diabetes. Isr. J.
Med. Sci. 11:571
-
Alhasmi MAF, Alswallem A, Wasy A. S 1995. Prevalence
of Diabetes mellitus in Saudi Arabia. Saudi Med. J. 16:
294 299.
-
AlMahroos F, Mekeigue P. M. 1998 High prevalence of
diabetes in Bahrainis. Associations with ethnicity and raised plasma cholesterol. Diabetes
care 21: 936-942.
-
Al-Nuaim A. R. 1997 Prevalence of glucose intolerance
in urban and rural communities in Saudi Arabia. Diabet Med. 14:
595 - 602.
-
Barham D, Trinder P. 1972. An improved colour reagent
for the determination of blood glucose by oxidase system. Analyst 97: 142-145
-
Edward SH, Raffaele N. 1996 Diabetes Mellitus. In. Zieglar E. Filler
L J (eds). Present knowledge in Nutrition. ILSI Press, Washington, D.
C.
-
Elmugarner I. T, Zayat ASA, Hossain M. M. 1995 Diabetes,
obesity and hypertension in urban and rural people of Bedouin origin in the United Arab Emirates. J.
Trop Med. Hyg 98: 407 415.
-
Gill G. 1996 Diabetes an increasing problem in the Middle
East. International Diabetes digest 7: 1.
-
Humphrey ARG, Zimmet PZ, Hamman R. F. 1995 The epidomology of
diabetes mellitus. In the diabetes Annual Marshall S. M., Home P.
D, Rizza R. (ed). Amsterdam, Elsevier pp 1- 31.
-
Hamsten A, Steiner G. 1994 Non-insulin dependant diabetes mellitus
and atherosclerosis, a hypoprotein perspective. (editorial) J.
intern Med. Suppl. 736: 1 3.
-
Herman W. H, Ali M. A. 1995 Engelhau Diabetes mellitus
in Egypt, risk factors and prevalence. Diabet med 12, 1126 1131
-
Kennel W B and McGee D L 1979 Diabetes and cardiovascular disease. The Framngham
study JAMA 241: 2035 38.
-
Lakhdar A. An epidemic of diabetes in the Arab world. International diabetes digest
10(3): 66, 2000.
-
Lett, J. A. & Turner K 1975 Evaluation of Trinders glucose
oxidase methods for measuring glucose in serum and urine. Clin.
Chem 21: 1754.
-
Rewers M, Hamman R. F. 1995 Risk factors for non-insulin dependent diabetes. In: Harris MI, Cowie cc, Stern
MP (eds). Office, Washington De, USA.
-
Superstein, MD 1975 The glucose tolerance test. A pitfall in
the diagnosis of diabetes mellitus. Adv. Intern. Med. 20: 297 302.
-
WHO expert Committee 1985. Diabetes mellitus. WHO technical report series 727. Geneva
-
World Health Organisation 1994. Prevention of diabetes mellitus. Report of WHO study group Tech.
Rep. Ser. No (144) WHO Geneva.
-
WHO Press Release1998. WHO/63 14TH Sept.
-
World Health Organisation 1985. Diabetes mellitus Report of a WHO study Group Tech. Rep. Ser. ;
727.
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