PREVALENCE AND ASSOCIATED FACTORS OF PRE-DIABETES AND DIABETES MELLITUS TYPE 2 AMONG PUBLIC SERVICE WORKERS IN ONDO STATE, NIGERIA

Abstract

Background : Paucity of epidemiological data on diabetes mellitus among public service workers, considered as at-risk population, may undermine the government efforts toward addressing the scourge of non-communicable diseases in Nigeria. In addressing t his health promotion gaps, we embarked on a “screen and link” intervention programme to determine the prevalence of pre-diabetes and diabetes mellitus type 2 (T2DM), and examined the associated factors of dysglycaemia (pre-diabetes and diabetes) in Ondo State, Nigeria. Methods : The screen and link intervention programme drew 4844 public service workers across 47 ministries, departments and agencies of the state. The World Health Organisation Structured Questionnaire for Stepwise surveillance was utilized to obtain relevant items of socio-demography, medical history and lifestyle behaviour. Height, weight and blood pressure were measured according to standard procedure. Glycaemia was measured using ACCUTREND R test strips for capillary blood glucose (fasting state). Pre-diabetes and diabetes were defined as fasting blood glucose 100 – 125 mg/dl and greater than or equal to 126 mg/dl, respectively. All participants with dysglycaemia were linked to care. We performed univariate and multivariate model analyses to determine the associated factors of dysglycaemia. P<0.05 and 95% confidence interval were considered statistically significant. Results : Overall, 2299 men and 2529 women participated in the study. The mean age of the participants was 40.4 years (SD = 9.7). The majority had at least secondary education (86.3%), married (76.6%), and middle level staff (53.2%). The prevalence of pre-diabetes and T2DM was 11.7% (n=563) and 5.3% (n=254) respectively, with slight increase of pre-diabetes among women (12.5% versus 10.8%). In univariate analysis, the following factors were associated with pre-diabetes/diabetes; aging (p<0.0001), marital status (p<0.0001), level of education (p=0.008), BMI (p<0.0001), systolic blood pressure (<0.0001) and diastolic blood pressure (<0.0001). A positive linear association existed between diabetes and increasing age, body mass index, diastolic blood pressure and systolic blood pressure. In multivariate model analysis, after adjusting for confounding factors, only hypertension (OR=2.16 95%CI = 1.62 – 2.91) and BMI (OR=0.47, 95%CI = 0.34 – 0.66) were the independent and significant predictors of dysglycaemia. Conclusion : Our findings suggested that diabetes was higher than the national average of 4.83%. The overlap of cardiometabolic syndrome of hypertension and overweight/obesity with pre-diabetes and diabetes was evident in the study population. A well-implemented workplace policy on non-communicable diseases in Ondo State will contribute significantly towards addressing the sustainable development goal agenda of Nigeria.