Risk Factors of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Resource-Constrained Setting of a Primary Care Clinic in Eastern Nigeria

Abstract

Background: As the case detection of pre-diabetes(PD) increases worldwide, screening for its risk factors which overlap with those of type 2 diabetes mellitus(DM) is an important primary care challenge that is often neglected especially in under-resourced setting. Aim: This study was designed to determine the prevalence and risk factors of pre-diabetes among adult Nigerians with essential hypertension in a resource-constrained setting of a primary care clinic in Eastern Nigeria. Materials and Methods: A cross-sectional study carried out on 320 consecutive adult Nigerians with essential hypertension who were screened for PD and 106 of them who had PD and met the inclusion criteria were age and sex matched with 106 non-hypertensive and non-diabetic control. Demographic and some risk factors of PD were obtained using a pretested, structured and interviewer-administered questionnaire. Pre-diabetes was defined as fasting plasma glucose of 100-125 mg/dL and /or plasma glucose level of 140-199 mg/dL two hours after a 75g oral glucose load. Results: One hundred and six (33.1%) out of the 320 hypertensive patients screened had PD. Obesity (P=0.001), positive family history of DM (P=0.001) and inadequate physical activity (P=0.001) were significantly associated with PD. The most significant predictor of PD was obesity(OR=12.50(2.38-34.48), P=0.001).The obese patients were twelve and half times more likely to have PD compared to their non-obese counterparts. Conclusion: There was high prevalence of PD in adult hypertensive study population. Obesity, family history of DM and inadequate physical activity were proximate independent risk factors. The presence of these risk factors should therefore provide guide for screening adult Nigerians with essential hypertension for PD in primary care.