Prevalence of type 2 diabetes mellitus in Southern Cross River: a cross-sectional observational survey

  • Akaninyene OtuEmail author
  • Margaret Akpan
  • Emmanuel Effa
  • Victor Umoh
  • Ofem Enang
Original Article


The International Diabetes Federation estimates that 1.6 million (1 in 53) Nigerian adults have diabetes mellitus while 60.7% (949,900) of Nigerian adults with diabetes are undiagnosed. In spite of these worrying projections, current nationwide data on diabetes prevalence to aid policy formulation in Nigeria is non-existent. This was a cross-sectional observational study that recruited 1200 adults residing in the Southern Cross River State. Glucometers were used to measure the fasting capillary glucose of participants, and those with readings ≥ 7 mmol/l were asked to come back the following day for another fasting blood glucose check for confirmation. Those who had two fasting blood glucose readings consistently ≥ 7 mmol/l were classed as having diabetes mellitus and referred to the nearest hospital for further evaluation and management. Blood pressure and waist circumference were also measured. There were 683 (56.9%) females and the mean age of the participants was 41.3 ± 15.3. Using body mass index (BMI), 159 (13.3%) participants were found to be obese. The prevalence of diabetes mellitus among the tested participants was 6.9%. Univariate analysis was carried out to identify associations with diabetes among the participants. Statistically significant associations were identified between blood pressure > 140/90 mmHg (p = 0.013), local government area (p = 0.001), level of education (p = 0.002), and diabetes. The diabetes mellitus prevalence of 6.9% in this community is much higher than internationally reported estimates for Nigeria and makes a compelling case for further epidemiological studies on diabetes in Nigeria and prioritisation of this disease by health policy makers.


Diabetes mellitus Cross River Nigeria Fasting glucose 



We are grateful to the Health Research and Ethics Committee (HREC) of the Cross River State Ministry of Health for providing us with the funds and logistics support required to make this study a reality. We acknowledge the untiring efforts of Dr. Comfort Ekanem of the HREC who worked to ensure that this research project succeeded. We appreciate the commitment of the staff of all the health centres we recruited participants from. We are indebted to the staff of the Department of Internal Medicine, University of Calabar, for their support and encouragement throughout this process.


This work was supported by the Cross River State Ministry of Health.

Compliance with ethical standards

Ethical approval was obtained from the Health Research Ethics Committee (HREC) of the Cross River State Ministry of Health. The permission of the various village heads was sought prior to commencement of the recruitment process. The research team explained the purpose of the study to each of the participants while guaranteeing them absolute confidentiality and the right to either accept or refuse the interview/tests. Written informed consent was obtained from each of the participants.


  1. 1.
    International Diabetes Federation (IDF). IDF Diabetes Atlas. 7th ed. 2015. Accessed 12th August 2017.
  2. 2.
    Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: the past, present and future. World J Diabetes. 2014;5(6):905–11. Scholar
  3. 3.
    World Health Organization. Global Report on Diabetes. 2016. Accessed 12th August 2017.
  4. 4.
    Ekelund U, Hennings S, Brage S, Hennings S, Emms Wareham SJ. Physical activity energy expenditure predicts progression towards the metabolic syndrome independently of aerobics fitness in middle aged healthy Caucasians. The Medical Research Council Ely Study. Diabetes Care. 2006;28:1195–200.CrossRefGoogle Scholar
  5. 5.
    Aguocha BU, Ukpabi JO, Onyeonoro UU, Njoku P, Ukegbu AU. Pattern of diabetic mortality in a tertiary health facility in south-eastern Nigeria. African Journal of Diabetes Medicine. 2013;21(1):14–6.Google Scholar
  6. 6.
    Dahiru T, Aliyu AA, Shehu AU. A review of population-based studies on diabetes mellitus in Nigeria. Sub-Saharan Afr J Med. 2016;3:59–64.CrossRefGoogle Scholar
  7. 7.
    Akinkugbe OO, Akinyanju OO. Final report. National survey on non-communicable diseases in Nigeria. Lagos: Federal Ministry of Health; 1997. p. 64–90.Google Scholar
  8. 8.
    Enang OE, Otu AA, Essien OE, Okpara H, Fasanmade OA, Ohwovoriole AE, et al. Prevalence of dysglycemia in Calabar: a cross-sectional observational study among residents of Calabar, Nigeria. BMJ Open Diabetes Res Care. 2014;2(1):e000032. Scholar
  9. 9.
    Enang O. The fattening rooms of Calabar—a breeding ground for diabesity. Diabetes Voice. 2009;54:40–1.Google Scholar
  10. 10.
    Ansa VO, Anah MU, Ndifon WO. Soft drink consumption and overweight/obesity among Nigerian adolescents. CVD Prevention Control. 2008;3(4):191–6. Scholar
  11. 11.
    Federal Republic of Nigeria. Provisional results of the main findings of 2006 census. Official Gazette. No. 4. Vol. 94. Government notice No. 3. Lagos. Federal Republic of Nigeria, 2007: B52.Google Scholar
  12. 12.
    Nyenwe EA, Odia OJ, Ihekwaba AE, Ojule A, Babatunde S. Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria. Diabetes Res Clinical Pract. 2003;62(3):177–85. Scholar
  13. 13.
    Nwafor A, Owhoji A. Prevalence of diabetes mellitus among Nigerians in Port Harcourt correlates with socioeconomic status. J Appl Sci Environ Mgmt. 2001;5:75–7.Google Scholar
  14. 14.
    Ekpenyong CE, Akpan UP, Ibu JO, Nyebuk DE. Gender and age specific prevalence and associated risk factors of type 2 diabetes mellitus in Uyo metropolis, South Eastern Nigeria. Diabetol Croat. 2012:41–1.Google Scholar
  15. 15.
    Oguoma VM, Nwose EU, Skinner TC, Digban KA, Onyia IC, Richards RS. Prevalence of cardiovascular disease risk factors among a Nigerian adult population: relationship with income level and accessibility to CVD risk screening. BMC Public Health. 2015;15(1):397. Scholar
  16. 16.
    Nwatu CB, Ofoegbu EN, Unachukwu CN, Young EE, Okafor CI, Okoli CE. Prevalence of prediabetes and associated risk factors in a rural Nigerian community. Int J Diab Dev Ctries. 2015;2015:1–7.Google Scholar
  17. 17.
    Beran D, Yudkin JS. Diabetes care in sub-Saharan Africa. Lancet. 2006;368(9548):1689–95. Scholar
  18. 18.
    Gezawa ID, Puepet FH, Mubi BM, Uloko AE, Bakki B, Talle MA, et al. Socio-demographic and anthropometric risk factors for type 2 diabetes mellitus in Maiduguri North Eastern Nigeria. Sahel Med J. 2015;18(5):1–7. Scholar
  19. 19.
    Tagruum YO, Okoh EO, Inalegwu E, Banwat ME, Zoakah AI. Non-communicable diseases: prevalence and risk factors among adults in a rural community in Plateau State, Nigeria. Int J Biomedical Res. 2015;6(4):228–34. Scholar
  20. 20.
    Oluyombo R, Olamoyegun MA, Olaifa O, Iwuala SO, Babatunde OA. Cardiovascular risk factors in semi-urban communities in southwest Nigeria: patterns and prevalence. J Epidemiol Glob Health. 2015;5(2):167–74. Scholar
  21. 21.
    Oladapo OO, Falase AO, Salako L, Sodiq O, Shoyinka K, Adedapo K. A prevalence of cardiometabolic risk factors among a rural Yoruba south-western Nigerian population: a population based survey. Cardiovasc J Afr. 2010;21(1):26–31.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Alebiosu OC, Familoni OB, Ogunsemi OO, Raimi TH, Balogun WO, Odusan O. Community based diabetes risk assessment in Ogun State, Nigeria World Diabetes Foundation project 08-321. Indian J Endocrinol Metab. 2013;17(4):653–8. Scholar
  23. 23.
    Maiyaki MB, Garbati MA. The burden of non-communicable diseases in Nigeria; in the context of globalization. Ann Afr Med. 2014;13(1):1–10. Scholar
  24. 24.
    Afolabi WAO, Oyawoye OO, Sanni SA, Onabanjo OO. Proximate and cholesterol composition of selected fast foods sold in Nigeria. Nigerian Food Journal. 2013;13(1):70–6.CrossRefGoogle Scholar
  25. 25.
    Rodbard HW, Blonde L, Braithwaite SS, Brett EM, Cobin RH, Handelsman Y. American Association of Clinical Endocrinologists guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007;13(Suppl 1):1–68. Scholar
  26. 26.
    World Health Organization. WHO global infobase. Accessed 12 August 2017.
  27. 27.
    Brink PJ. The fattening room in Nigeria. West J Nurs Res. 1989;11(6):655–6. Scholar
  28. 28.
    Brink PJ. The fattening room among the Annang of Nigeria. Med Anthropol. 1989;12(1):131–43. Scholar
  29. 29.
    American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35(1):S11–63.Google Scholar
  30. 30.
    FB H, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345:790–7.CrossRefGoogle Scholar

Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  • Akaninyene Otu
    • 1
    • 2
    Email author
  • Margaret Akpan
    • 3
  • Emmanuel Effa
    • 1
  • Victor Umoh
    • 4
  • Ofem Enang
    • 1
  1. 1.Department of Internal MedicineUniversity of CalabarCalabarNigeria
  2. 2.National Aspergillosis CentreUniversity Hospital of South ManchesterWythenshawe, ManchesterUK
  3. 3.Department of NursingUniversity of CalabarCalabarNigeria
  4. 4.Department of MedicineUniversity of UyoUyoNigeria

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