Type 2 diabetes mellitus risk assessment among doctors in Ondo state.

Introduction: Diabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State. Methods: This was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant. Results: One hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13-26.33; p = <0.001); BMI ≥25kg/m2 (AOR:11.41; CI:4.14-31.45; p = <0.001); family history of DM (AOR:9.93; CI:3.25-30.39; p = <0.001); abdominal obesity (AOR:6.66; CI:2.08-21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable (AOR:3.11;CI:1.03:9.37: p = 0.04). Conclusion: There was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.

Diabetes-related knowledge, attitude, and practice among outpatients of a tertiary hospital in North-western Nigeria.

Introduction: One of the challenges facing the management of diabetes is the misconception and inadequate knowledge about the disease. We assessed the level of diabetes-related knowledge, attitude, and practice (KAP) among patients with diabetes in North-western Nigeria. Materials and Methods: This was a hospital-based cross-sectional study. A total of 400 participants were recruited. A KAP questionnaire was used to assess the KAP of the patients. Glycated hemoglobin was used to measure the level of glucose control of the study participants. Results: The mean age of the patients was 51 years, majority being females 233 (58.3%). The mean knowledge score was 6.2 ± 3.1 points (out of 15), average attitude score was 2.5 ± 1.5 points (out of 5), and the mean practice score was 2.1 ± 1.3 points (out of 6). The level of KAP was found to be directly related to glycemic control (P < 0.01). The level of education (odds ratio [OR]: 5.0 and 95% confidence interval [CI]: 0.196-0.452) and monthly income (OR: 4.4 and 95% CI: 0.123-0.326) were found to be independent predictors of diabetes-related KAP. Conclusion: The study has demonstrated poor diabetes-related KAP. The patient's level of education and income plays a major role in the management of diabetes.

RésuméIntroduction: L'un des défis auxquels est confrontée la gestion du diabète est l'idée fausse et les connaissances insuffisantes sur la maladie. Nous avons évalué le niveau de connaissances, d'attitudes et de pratiques liées au diabète chez les patients atteints de diabète dans le nord-ouest du Nigéria. Matériel et méthodes: Il s'agissait d'une étude transversale en milieu hospitalier. Au total, 400 participants ont été recrutés. Un questionnaire CAP a été utilisé pour évaluer le KAP des patients. L'hémoglobine glyquée a été utilisée pour mesurer le niveau de contrôle du glucose des participants à l'étude. Résultats: L'âge moyen des patients était de 51 ans, la majorité étant des femmes 233 (58,3%). Le score de connaissance moyen était de 6,2 ± 3,1 points (horssur 15), le score d'attitude moyen était de 2,5 ± 1,5 points (sur 5) et le score moyen de pratique était de 2,1 ± 1,3 points (sur 6). Le niveau de KAP s'est avérée être directement liée au contrôle glycémique (P <0,01). Le niveau d'éducation (odds ratio [OR]: 5,0 et intervalle de confiance à 95% [IC]: 0,196 à 0,452) et le revenu mensuel (OR: 4,4 et IC à 95%: 0,123 à 0,326) se sont avérés être des prédicteurs indépendants de la KAP liée au diabète. Conclusion: L'étude a démontré une faible CAP liée au diabète. Le niveau d'éducation et le revenu du patient jouent un rôle majeur dans la gestion du diabète.

Type 2 diabetes mellitus risk assessment among doctors in Ondo state

Introduction: Diabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State. Methods: This was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant. Results: One hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13-26.33; p = <0.001 ) ; BMI ≥25kg/m2 (AOR:11.41; CI:4.14-31.45; p = <0.001) ; family history of DM (AOR:9.93; CI:3.25-30.39; p = <0.001) ; abdominal obesity (AOR:6.66; CI:2.08-21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable(AOR:3.11;CI:1.03:9.37: p = 0.04) Conclusion: There was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.

Cost of Illness of Diabetic Foot Ulcer in a Resource Limited Setting: A Study from Northwestern Nigeria.

INTRODUCTION: Diabetic foot ulcer is a major complication of diabetes with a high economic cost of managing. Data from resource limited setting will bring to light how patients in these localities suffer financially in addition to poverty and lack of health insurance. This study estimated cost of illness among patients with diabetic foot ulcer in northwestern Nigeria. METHODS: It was a hospital based cross-sectional study. Questionnaire was used to take the bio data and medical history. Direct medical, direct non-medical and indirect cost were estimated. RESULT: Majority of the patients were males with the mean age of 59.3 ± 15.1 yrs. About 60% of the patients earn less than $100 monthly. The total cost of illness of diabetic foot ulcer was estimated at $140,735.56 (median = $1381.55[IQR 1002.42-]). Direct cost of illness was $107,797.06 (median = $1023.27[IQR 773.93-1568]), while the indirect cost was $32,938.49 (median = $209.90[IQR 128.74-357.08]). Out of pocket payment accounted for 90% of the payment. CONCLUSION: The cost of diabetic foot ulcer is very exorbitant and the patients affected are mostly poor, unemployed and the breadwinners of their families.

Metabolic syndrome among HIV infected patients: A comparative cross sectional study in northwestern Nigeria.

INTRODUCTION: The increasing availability of antiretroviral drugs has made HIV-positive patients to live longer, and conditions that are associated with longevity such as metabolic syndrome and other cardiovascular related conditions have become relevant in them. This is less well studied among African populations. Therefore the study aimed at estimating and comparing the prevalence of and associated risk factors for the metabolic syndrome (MS) among African HIV infected patients. METHOD: In this comparative cross-sectional study, we analyzed the data of 300 participants matched for age and gender who satisfied the inclusion criteria with half of the subjects on HAART, while the other half was HAART naïve. The MS was diagnosed using ATP-III criteria. RESULTS: The mean age of the patients was 34.8±9.9years. The majority of the patients were females 64%. The prevalence of MS among HAART-exposed patients was found to be 19.3%, while it was 5.3% among HAART naïve patients (p=0.001). Raised triglyceride and elevated blood pressure were the criteria with the highest occurrence among HAART-exposed, 82.8% for each. Advanced age, longer duration of HIV diagnosis and HAART exposure, increased BMI, weight gain after HAART exposure, exposure to PIs and increased mean CD4 cell count were found to be significantly associated with MS (p<0.05). However, only age (OR 4.3, 95% CI 1.6-11.8, p=0.005) and BMI (OR 4.2, 95% CI 1.5-11.9, p=0.007) were found to be independently associated with the development of MS. CONCLUSION: Exposure to HAART particularly protease inhibitor based regimen increases the risk of MS among HIV-infected patients.