Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria

Gabriel Uche Pascal Iloh; Ndubueze Richard Uchenna

doi:doi:10.11648/j.ejpm.20140201.11

| Peer-Reviewed

Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria

Gabriel Uche Pascal Iloh, Ndubueze Richard Uchenna

Published in European Journal of Preventive Medicine (Volume 2, Issue 1)

Received: 25 December 2013 Published: 20 February 2014

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A cross-sectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched with 320 non-hypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. 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. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern. The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.

Published in	European Journal of Preventive Medicine (Volume 2, Issue 1)
DOI	10.11648/j.ejpm.20140201.11
Page(s)	1-8
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Adult Hypertension, Nigeria, Pre-Diabetes, Primary Care Clinic

References

[1]	Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of Diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27:1047-1053.
[2]	Kearney PM, Whelton M, Reynolds K. Global burden of hypertension- analysis of worldwide data. Lancet 2005; 365: 217-223.
[3]	Unwin N, Setel P, Rashid S, Mugusi F, Mbanya JC, Kitange H, et al. Non-communicable diseases in sub-Saharan Africa: where do they feature in the health research agenda? Bull World Health Organ 2001; 79: 947-953.
[4]	Familoni OB. Hypertension-how much do our patients know? Africa Health 2002; 24: 13.
[5]	Ayodele OE, Alebiosu CO, Salako BL, Awoden OG, Adigun A. Target organ damage and associated clinical conditions among Nigerians with treated hypertension. Cardiovasc J South Afr 2005; 16: 89-93.
[6]	Ramlo-Halsted BA, Edelman SV. The natural history of type 2 diabetes: Implications for clinical practice. Prim Care 1999; 26: 771-789
[7]	Ogbu I. S, Neboh C. I. The prevalence of Prediabetes among hypertensive patients in Enugu, Southeast Nigeria. Niger Med J 2009: 50: 14-17.
[8]	Shyam SG, Mohammed AA, Kamlesh B, Kalyan KD. Prevalence of pre-hypertension and associated cardiovascular risk profiles among prediabetic Omani adults. BMC Public Health 2008; 8: 108.
[9]	Tuomilehto J, Lindstron J, Eriksson JG, Valla TT, Hamalainen H, Illane-Parikka P et al. Prevention of type 2 DM by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-1350.
[10]	Robinson SJ, Gordon SA, Russell JW, Feldman EL. Micro-vascular complications of impaired glucose tolerance. Diabetes 2003; 52: 2867-2873.
[11]	Iloh GUP, Uchenna NR, Obiegbu NP. Risk factors of pre-diabetes among adult Nigerians with essential hypertension in a resource-constrained setting of a primary care clinic in eastern Nigeria. American Journal of Health Research 2013; 1: 56-64.
[12]	Harris MI, Eastman RC. Early detection of undiagnosed Diabetes mellitus: a US perspective. Diabetes Metab Res Rev 2000; 16: 230-236.
[13]	Leiter L.A., Barr A., Belanger A, Labin S, Ross A, Tidesley H D. et al, Diabetes screening in Canada, (DIASCAN), study. Prevalence of undiagnosed diabetes and glucose intolerance in family physician offices. Diabetes Care 2001; 24: 1038-1043.
[14]	Rolka DR, Burrows NR, Li Y, Geiss LS. Self-reported prediabetes and risk-reduction activities-US-2006. JAMA 2009; 301: 591-593.
[15]	Shobha SR, Philips S, Tamara M. Impaired glucose tolerance and impaired fasting glucose. Am Fam Physician 2004; 69: 1961-1968, 1971-1972.
[16]	Lorna ET, Ushma DU, Shadi C, Renu G, Diana KB, Charon G et al. Prevalence and control of diabetes and impaired fasting glucose in New York City. Diabetes Care 2009; 32: 57-62.
[17]	Shuqian L, Wenyu W, Xiaoguang Y, Elisa T, Jian Z, Yuna H et al. Prevalence of diabetes and impaired fasting glucose in Chinese adults, China National Nutrition and Health survey 2002. Prev Chronic Dis 2011; 8(1).
[18]	Shrestha UK, Singh DL, Bhattarai MD. The prevalence of hypertension and diabetes defined by fasting and 2 hour plasma glucose criteria in urban Nepal. Diabetes Medicine 2006; 23: 1130-1135.
[19]	Kuller LH, Veletgas P, Barzilay J, Beauchamp NJ, ‘O’ leary DH, Savage PJ. Diabetes mellitus: subclinical cardiovascular disease and risk of incident mortality. Arterioscer Thromb Vasc Biol 2000; 20: 823-829.
[20]	The DECODE study: Group for the European Diabetes Epidemiology. Glucose tolerance and cardiovascular mortality: comparison of fasting and two hour diagnostic criteria. Arch Intern Med 2001; 161: 397-405.
[21]	Cynthia C, Harvey K, Bonita E, Falkner BE. The utility of fasting glucose for detection of prediabetes. Metabolism 2006; 55: 434-438.
[22]	Gerstein H, Yusuf S, Bosch J, Pogue J, Sheridan P, Dinccag N, et al "Effect of rosigiltazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial". Lancet 2006 ; 368: 1096-1105.
[23]	Riddell M, Fowles J. How to treat prediabetes with exercise effectively. Clinical practice guide Diabetes 2010; 10-20.
[24]	Dawson B, Trapp RG. Basic and Clinical Biostatistics, 4th edition, New York: Lange Medical Books & McGraw-Hill 2004; p 145-146.
[25]	Iloh GUP, Amadi AN, Nwankwo BO. Obesity in adult Nigerians: a study of its prevalence and common primary co-morbidities in a semi-urban Mission General Hospital in South-Eastern Nigeria. Niger J Med 2010; 19: 459-466.
[26]	Onwubere B, Kadiri S. Guidelines for the management of hypertension in Nigeria. Nigerian Hypertension Society. Enugu, Ezu Books Limited 2005.p. 1-40
[27]	Iloh GUP, Amadi AN, Nwankwo BO, Ugwu VC. Obesity in adult Nigerians: A study of its pattern and common primary co-morbidities in a rural Mission General Hospital in Imo state, south-eastern Nigeria. Niger J Clin Pract 2011; 14: 212-8.
[28]	Essien OE, Peters EJ, Udoh AE, Ekott JU, Odigwe CO. Prevalence and pattern of abnormal glucose tolerance in adult Nigerians with primary hypertension. Niger J Med 2007; 16: 50-56
[29]	Govindarajan G, Sowers JR, Stump C. Hypertension and Diabetes Mellitus. European Cardiology 2006; 2: 1-7.
[30]	Chen K, High L. Prevalence of impaired fasting glucose and type 2 diabetes mellitus in Penghu Islets, Taiwan: evidence of a rapidly emerging epidemic. Diab Res Clin Pract 2009; 44: 59-69.
[31]	Mills JD, Grant PJ. Insulin resistance homeostasis factors and cardiovascular risk. Br J Diabetes Vasc Dis 2000; 2: 19-26.
[32]	Akintude AA. Epidemiological and conventional cardiovascular risk factors among hypertensive subjects with normal and impaired fasting glucose. S Afr Med J 2010; 100: 594-597.
[33]	Iloh GUP, Ikwudinma AO Abdominal obesity in adult Nigerian Africans: prevalence and co- occurrence with cardio-metabolic risk factors in a resource poor setting of a rural hospital in Eastern Nigeria. American Journal of Health Research 2013; 1: 73-80.
[34]	Azuamah YC, Amadi AN, Amadi COA, Esenwah EC, Azuamah EC, Iloh GUP. Co-occurrence of diabetes mellitus and hypertension in some rural communities of southeast Nigeria. International Journal of Advanced Medical Sciences and Applied Research 2011, 11: 30-41.
[35]	WHO. Global strategy on diet, physical activity and health. Bulletins of the WHO 2006; 5: 16-8.
[36]	Iloh GUP, Amadi AN, Ikwudinma AO, Njoku PU. Prevalence and family biosocial predictors of abdominal obesity among adult Nigerian Africans in a resource constrained setting of a rural hospital in Eastern Nigeria. European Journal of Preventive Medicine 2013; 1: 70 -78.
[37]	Iloh GUP, Chuku A, Obiegbu NP, Ofoedu JN, Ikwudinma AO. Frequency of cardiovascular risk factors in adult Nigerians with family history of non-communicable cardiovascular disease in a primary care clinic of a tertiary hospital in a resource-constrained environment of Eastern Nigeria. American Journal of Health Research 2013; 1: 17-25.
[38]	Iloh GUP, Ikwudinma AO, Obiegbu NP. Obesity and Its Cardio-metabolic Co-morbidities Among Adult Nigerians in a Primary Care Clinic of a Tertiary Hospital in South-Eastern Nigeria. J Fam Med Primary Care 2013; 2: 20-26.

Cite This Article

Plain Text BibTeX RIS

APA Style

Gabriel Uche Pascal Iloh, Ndubueze Richard Uchenna. (2014). Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. European Journal of Preventive Medicine, 2(1), 1-8. https://doi.org/10.11648/j.ejpm.20140201.11

Copy | Download

ACS Style

Gabriel Uche Pascal Iloh; Ndubueze Richard Uchenna. Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. Eur. J. Prev. Med. 2014, 2(1), 1-8. doi: 10.11648/j.ejpm.20140201.11

Copy | Download

AMA Style

Gabriel Uche Pascal Iloh, Ndubueze Richard Uchenna. Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. Eur J Prev Med. 2014;2(1):1-8. doi: 10.11648/j.ejpm.20140201.11

Copy | Download

@article{10.11648/j.ejpm.20140201.11,
  author = {Gabriel Uche Pascal Iloh and Ndubueze Richard Uchenna},
  title = {Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria},
  journal = {European Journal of Preventive Medicine},
  volume = {2},
  number = {1},
  pages = {1-8},
  doi = {10.11648/j.ejpm.20140201.11},
  url = {https://doi.org/10.11648/j.ejpm.20140201.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20140201.11},
  abstract = {Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A cross-sectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched  with 320 non-hypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. 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. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern.  The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.},
 year = {2014}
}

Copy | Download

TY  - JOUR
T1  - Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria
AU  - Gabriel Uche Pascal Iloh
AU  - Ndubueze Richard Uchenna
Y1  - 2014/02/20
PY  - 2014
N1  - https://doi.org/10.11648/j.ejpm.20140201.11
DO  - 10.11648/j.ejpm.20140201.11
T2  - European Journal of Preventive Medicine
JF  - European Journal of Preventive Medicine
JO  - European Journal of Preventive Medicine
SP  - 1
EP  - 8
PB  - Science Publishing Group
SN  - 2330-8230
UR  - https://doi.org/10.11648/j.ejpm.20140201.11
AB  - Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A cross-sectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched  with 320 non-hypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. 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. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern.  The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.
VL  - 2
IS  - 1
ER  -

Copy | Download

Author Information

Gabriel Uche Pascal Iloh

Department of Family Medicine, Federal Medical Centre, Umuahia, Abia state, Nigeria
Ndubueze Richard Uchenna

Department of Family Medicine, Federal Medical Centre, Owerri, Imo state, Nigeria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Gabriel Uche Pascal Iloh, Ndubueze Richard Uchenna. (2014). Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. European Journal of Preventive Medicine, 2(1), 1-8. https://doi.org/10.11648/j.ejpm.20140201.11

Copy | Download

ACS Style

Gabriel Uche Pascal Iloh; Ndubueze Richard Uchenna. Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. Eur. J. Prev. Med. 2014, 2(1), 1-8. doi: 10.11648/j.ejpm.20140201.11

Copy | Download

AMA Style

Gabriel Uche Pascal Iloh, Ndubueze Richard Uchenna. Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. Eur J Prev Med. 2014;2(1):1-8. doi: 10.11648/j.ejpm.20140201.11

Copy | Download

@article{10.11648/j.ejpm.20140201.11,
  author = {Gabriel Uche Pascal Iloh and Ndubueze Richard Uchenna},
  title = {Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria},
  journal = {European Journal of Preventive Medicine},
  volume = {2},
  number = {1},
  pages = {1-8},
  doi = {10.11648/j.ejpm.20140201.11},
  url = {https://doi.org/10.11648/j.ejpm.20140201.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20140201.11},
  abstract = {Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A cross-sectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched  with 320 non-hypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. 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. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern.  The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.},
 year = {2014}
}

Copy | Download

TY  - JOUR
T1  - Magnitude of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria
AU  - Gabriel Uche Pascal Iloh
AU  - Ndubueze Richard Uchenna
Y1  - 2014/02/20
PY  - 2014
N1  - https://doi.org/10.11648/j.ejpm.20140201.11
DO  - 10.11648/j.ejpm.20140201.11
T2  - European Journal of Preventive Medicine
JF  - European Journal of Preventive Medicine
JO  - European Journal of Preventive Medicine
SP  - 1
EP  - 8
PB  - Science Publishing Group
SN  - 2330-8230
UR  - https://doi.org/10.11648/j.ejpm.20140201.11
AB  - Background: Hypertension co-existing with Diabetes mellitus is increasing globally. However, current evidence has demonstrated the existence of a prolonged, intermediate phase of diabetes termed pre-diabetes in hypertensive patients. Aim: This study was designed to determine the magnitude of pre-diabetes among adult Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in South-eastern, Nigeria. Materials and Methods: A cross-sectional analytic study carried out on 320 adult hypertensive Nigerians who were age and sex matched  with 320 non-hypertensive, non-diabetic control group at the primary care clinic of a tertiary hospital in South-eastern Nigeria. These patients were screened for pre-diabetes. 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. Hypertension was defined as systolic and/or diastolic blood pressures ≥140/90 mmHg or documented use of antihypertensive medications in a previously diagnosed person with hypertension. Results: The prevalence of pre-diabetes was significantly higher in hypertensive patients (33.1%) than control (16.2%) (p= 0.001) with impaired fasting glycaemia ((29.4%) being the more common pattern.  The mean fasting plasma glucose of the hypertensive patients (122.4mg/dL±1.7)) was significantly higher than that of the control (91.8mg/dL±2.4) (p=0.000). Similarly, the mean two hours oral glucose load of the hypertensive patients (183.4mg/dL±1.6) was significantly higher than that of the control (161.8mg/dL±1.9)(p=0.001). Conclusion: This study has shown the existence of pre-diabetes among the hypertensive patients with impaired fasting glycaemia being the more common pattern. Screening adult Nigerians with essential hypertension for pre-diabetes should constitute clinical targets for intervention in primary care clinic.
VL  - 2
IS  - 1
ER  -

Copy | Download