Diabetes and related diseases in Nigeria: Need for improved primary care in rural communities

Background: The political commitments necessary to tackle the growing burden of diabetes mellitus (DM) and related NCDs have increased in recent years in Nigeria. This has resulted in the development of national policy and strategic objectives by the Federal Ministry of Health for the prevention and control of NCDs in Nigeria. This paper aims at highlighting a framework for integrating Diabetes and other related NCDs into primary health care.Materials and Methods: Data identification methods included internet search (using search engines and online databases) and in the libraries. Sources of information include international, regional, national and local healthcare policies and regulations. Peer-reviewed academic and research papers were identified.Results and Discussion: Prevention and care are both essential components in the control of diseases such as DM and hypertension, and a large evidence base is available on cost-effective interventions for prevention and control. However, ways of implementing these interventions and incorporating them into policies and practice in Nigeria remains a challenge. The delivery of care in such scenario will require the development of case management model(s), containing a core set of evidence-based diagnostics, essential medicines, behaviour change interventions and supporting tools for service performance monitoring.Conclusion: DM, including related NCDs are increasing in prevalence in Nigeria, and their complications pose an immense public health burden. There is a need for our health decision-makers at all levels to develop strategies and interventions to halt the growing trend and burden of diabetes through effective primary care, especially in rural communities of Nigeria.Keywords: Diabetes, Non-Communicable Diseases (NCDs), Primary Care, Rura

Connecting peptide (c-peptide) and the duration of diabetes mellitus amongst patients, at the Federal Medical Centre (FMC), Owerri, southeast, Nigeria

Objective: C-peptide is derived from proinsulin and it is secreted in equimolar concentration with insulin. Plasma C-peptide is more stable than insulin and it provides an indirect measure of insulin secretory reserve and beta cell function. To determine relationship between C-peptide and duration of diabetes mellitus, age, body mass index, systolic blood pressure and diastolic blood pressure.Methods: This is a cross-sectional study of type 2 diabetes mellitus patients attending Endocrine Clinic. Information such as age, sex, height, weight, blood pressure and duration of diabetes were obtained. Blood samples were taken for fasting serum C-peptide. Data was analysed using SPSS version 16.Results: Out of the 46 subjects recruited 23 (50%) were females and 23 (50%) were males. The mean age was 55.63 ± 14.7 years. Mean duration of diabetes for both sexes was 8 years with a range of 1 to 32 years. The mean BMI was 26.87 ± 5.00 kg/m2for males and 30.09 ± 4.32 Kg/m2 for females. The mean fasting serum C-peptide was 2.16 ± 1.41 ng/ml and there was no significant difference between males and females. There is statistically significant inverse correlation between C-peptide and duration of diabetes (r= -0.356, p= 0.015). Conversely there is a direct relationship between C-peptide and BMI (r=0.307, p=0.038).Conclusion: Increasing duration of diabetes is associated with decreasing level of C-peptide and decreased beta cell secretory reserv