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PREVALENCE OF RISK FACTORS FOR TYPE 2 DIABETES MELLITUS AMONG ADULTS

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Topic Description

CHAPTER ONE

INTRODUCTION

Background   to the Study  

Diabetes mellitus is a complex metabolic disorder that affects both males and females. This chronic disease occurs due to the inability of the body to effectively produce insulin or use the insulin it produces. It usually manifests as hyperglycemia or high levels of glucose in the blood. (World Health Organization, 2013). It has been estimated that 80% of people with diabetes live in low- and middle-income countries and the greatest number of people with diabetes are between 20 to 79 years of age (IDF, 2013) Diabetes mellitus (DM) is a global clinical and family health problem.

There are three major types of diabetestype 1 diabetestype 2 diabetes, and gestational diabetes. All types of diabetes mellitus have something in common. Normally, the body breaks down the sugars and carbohydrates into a special sugar called glucose. Glucose fuels the cells in the body. But the cells need insulin, a hormone, in the bloodstream in order to take in the glucose and use it for energy (WHO, 2013).

The impact of diabetes mellitus as a global epidemic has recently been recognized   by the United Nations (UN).Thus a United Nation resolution passed in 2007 has set aside the 14th of November every year as world diabetes day. According to International Diabetes Federation ( 2013) the number of people with type 2 diabetes mellitus is increasing in every country. The increasing burden of type 2 diabetes mellitus (T2DM) is gaining a worldwide attention as an important risk factor for premature death from non communicable disease in families (Ginte, 2012). It is a multi-dimensional medical condition that requires significant participation of patients and members of family in the process of care  and impacts on every facets of quality of life of the affected persons and their families and places huge burden on personal, family and national economies (Uloko, 2012).

The prevalence of Type 2 Diabetes Mellitus has been reported to vary between different populations. Research studies have demonstrated that T2DM is relentlessly increasing worldwide affecting economically affluent nations and is gradually creeping and afflicting developing countries IDF(2013). The global burden of DM in 2013 by International Diabetic Federation was estimated at 382 million with predicted rise to 592 million in 2035 compared to world prevalence of 366 million in 2011 and predicted increase to 540 million in 2035 with predilection for developing countries (IDF,2013).

In sub-Saharan Africa, T2DM constitutes an important clinical and public health problem and affected 19 million people with predicted rise to 41.5 million by 2035 (IDF,2013). In a systematic review of prevalence of T2DM in sub- Saharan Africa from 1999-2011, the reported prevalence ranged from 1% in rural Uganda to 12% in urban Kenya (Hall, 2011). In Northern Africa, systematic review of prevalence of T2DM reported prevalence range of 2.6% in rural Sudan to 20.0% in urban Egypt (Bos & Agyemang, 2013).

In Nigeria, available data suggest that diabetes is emerging as a major health problem. The Nigeria national prevalence reported in 1997 by an expert committee set up by the Federal Ministry of Health (FMOH) was 2.2 %, with  a current 2.4% prevalence estimate, this  means  that minimum of six million Nigerians have diabetes (IDF,2008). The disease affects many people under the age of 64 years in Africa as compared to the developed world where it affects many people over the age of 64 years. More than 90% cases   in Nigeria are Type 2 diabetes and this is the predominant type of diabetes all over the world. About 20-30% of type 2 patients present for the first-time with complications and this impact negatively on the morbidity and the mortality (IDF, 2013)

Type 2 diabetes is a common condition and a serious global health problem. In most countries the disease has increased alongside with rapid cultural and social changes: ageing populations, increasing urbanization. Rapid increase in both the prevalence and incidence of type 2 diabetes has occurred globally with significant increase, in societies in economic transition (WHO, 2005). A 3 year follow up study in Denmark on the risk factors of type 2 diabetes shows that, the most important known non-modifiable risk factors are ageing, heredity (Chan, Malik, Jia, Kadowaki, Yajnik , Yoon , et al. 2009). Another study in Denmark on the risk factors of type 2 diabetes also shows that, the most important modifiable risk factors are obesity, dietary factors, physical inactivity, smoking, and alcohol consumption (Rasmussen , Glümer, Sandbaek , Lauritzen  & Borch-Johnsen ,2008).  It has also been observed that prevalence of overweight and obesity, prime risk factors for type 2 DM, is increasing. A large number of studies have shown that an increase in the prevalence of obesity is followed by a similar rise in the prevalence of type 2 DM and that obesity is responsible for more than 80% of all cases of type 2 DM.(Ogden, Carroll , Curtiz, McDowell , Tabak& Flegal, 2006).

The increase in type 2 diabetes mellitus in Africa has been attributable in part to sedentary lifestyle, behavioral habits, physical inactivity, low intake of fruits and vegetables, high intake of animal fat and protein, and lifestyle changes. (Dahiru , Jibo,  Hassan & Mande,2008).The increase in type 2 diabetes mellitus in Africa has been attributable in part to urbanization and urban residence  (Dahiru , Jibo,  Hassan , Mande.2008) The prevalence and risk factors of adult Diabetes  shows Age, social class, and Ethnicity was significantly associated with type 2 Diabetes. This shows the association of each risk factor with adult diabetes in Nigeria. Diabetes was more frequent in people aged 50 years and social class, Subjects in the highest socioeconomic class showed significantly higher prevalence of type 2 diabetes when compared with the others, Diabetes was more prevalent in the Ibibio and Hausa_/Fulani subjects than the other ethnic groups ADA(2008) The prevalence and risk factors of type 2 Diabetes in Nigeria study also shows, Physical inactivity, family history of diabetes, Alcohol intake was significantly associated with type 2 Diabetes. Subjects who drank more than 21 units of alcohol per week were more likely to have diabetes than those who drank moderately. Physical activity has been identified as an integral part in primary prevention of type 2 DM in high risk people and in secondary prevention of associated complications in people already diagnosed with diabetes. Physical activity contribute to improve insulin sensitivity, decrease blood glucose and blood pressure level, weight loss, reduce triglycerides and cholesterol, increase muscle tone, improve circulation, stress relief and well being feelings ADA(2008).

Since most risk factor for type 2 diabetes are modifiable early identification of at-risk individuals and appropriate lifestyle intervention would help in preventing or postponing the onset of type 2 diabetes mellitus. Hence this study is to   assess prevalence of risk factors for type 2  diabetes among adults in Kakpi community in Agaie local Government area of Niger State.

Statement of Problem

Diabetes mellitus (DM) has been described as a killer disease in so many situations. It is now ranked among one of the most common non-communicable diseases in the world. It falls within 4th–5th leading cause of death in most developed countries and it is epidemic in many developing and newly industrialized countries (Hill, 2009). The number of people with Type 2 diabetes is growing rapidly worldwide. This rise is associated with economic development, ageing populations, increasing urbanization, dietary changes, reduced physical activity, and changes in other lifestyle patterns (IDF, 2013). With urbanization, the people in rural communities have now adopted unhealthy lifestyle like constant eating of processed foods( snacks, fried rice) and increased consumption of assorted drinks with refined sugar especially during festivities such as wedding and naming ceremonies, village meetings etc. One may asked whether these people in rural communities know the implication of this unhealthy lifestyle pattern. In addition, do these people actually know the risk factors for Type 2 diabetes mellitus and those at risk of this condition? Answer to these questions prompted the researcher to investigate the Prevalence of risk factors for Type 2 diabetes among adult in kakpi community in Agaie local Government area of Niger State.

Purpose of the Study

The main purpose of this study is to investigate the prevalence of risk factors for Type 2 diabetes mellitus in Kakpi community in Agaie Local Government Area of Niger state.

Objectives of the Study

The specific objectives of the study are to:

  • Determine   prevalence of overweight, a risk factor for type 2 diabetes mellitus among the study group.
  • Assess the prevalence of hypertension, a risk factor Type 2 diabetes mellitus among study group.
  • Determine the prevalence of physical inactivity, a risk factor for Type 2 diabetes mellitus among the study group.
  • Evaluate Socio demographic risk factor, of Type 2 diabetes mellitus prevalence among the study group.

 

Research Questions

  • What is the prevalence of overweight, a risk factor for type 2 diabetes mellitus among study group?
  • What is the prevalence of hypertension a risk factor for type 2 diabetes mellitus among study group?
  • What is    the prevalence of physical inactivity a risk factor for Type 2 diabetes mellitus among study group?
  • What is Socio demographic risk factor of Type 2 diabetes mellitus prevalence among study group?

Hypothesis

Socio demographic profile of respondents will not significantly influence prevalence of risk factors for type 2 diabetes mellitus.

Significance of the Study       

Findings from this study will provide information to health personnel on the prevalence of risk factor for Type 2 diabetes mellitus.  Understanding the risk factors of Type 2 Diabetes mellitus and the people affected, is important to allow rational planning of health program or measures such as nutrition education, lifestyle modification and allocation of resources. Findings from this study will also provide information to policy   makers on the burden of the disease in this area, and to make necessary plan to reduce the burden. Moreover, the finding will serve as reference for further research on this topic.

Scope of the Study 

This study is delimited to determining the prevalence of risk factor for Type 2 diabetes among adult males and females in Kakpi community.

Operational Definition of Term

  • Prevalence of Risk Factor: Refers to the presence of one or more of the risk factors that may increase the probability of developing type 2 diabetes mellitus which include overweight or obesity, smoking, age, physical inactivity, occupation, family history alcohol, hypertension and eating habit.
  • Type 2 Diabetes Mellitus: Is a metabolic disorder that results due to either a deficiency of insulin secretion or combination of insulin resistance and inadequate insulin secretion. The classic symptoms are polyuria, (frequent urination) polydipsia (excess thirst) weight loss, sometimes with polyphagia (constant hunger).
  • Adult: is an individual male or female that is 18 years and above.

Overweight: it is an increased body weight in relation to height, when compared to some standard of acceptab

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