Skip to main content


Log in

Pre-diabetes and it’s predictors in Abia State, Eastern Nigeria

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript


Background and objectives

The prevalence of diabetes mellitus (DM) is rising in sub-Saharan Africa, including Nigeria. A previous study in Abia State, Nigeria, showed a high prevalence of diabetes, with no significant difference in urban and rural communities. This study aimed at investigating the prevalence and risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), which represent reversible and preventable early signs of DM.

Subjects, materials, and methods

A cross-sectional comparative study of 2800 adult residents of Abia State, comprising equal number of urban and rural respondents. Interviewer-administered semi-structured questionnaires were used for data collection. Fasting blood glucose was performed for all the respondents, while oral glucose tolerance test (OGTT) was done for 2424 respondents, comprising 1117 urban residents and 1307 rural residents. Data was analyzed using SPSS version 20.


Mean age of the respondents was 48.54 ± 13.24 years: rural = 54.23 ± 14.26 years and urban = 42.85 ± 13.24 years, p < 0.001. Male to female ratio was 1:2.5 (p < 0.001). Pre-diabetes (IFG and IGT) was observed in 6.3% of the respondents, comprising 3.9% in urban and 8.7% in rural residents, p < 0.001. The prevalence of IFG and IGT was 4.7% and 12%, respectively, p < 0.001. Independent predictors of pre-diabetes included abnormal waist circumference (WC), hypertension, and daily intake of fruits and vegetables in the urban area, while in the rural area, they included hypertension and abnormal WC.


The prevalence of pre-diabetes is high in Abia State, with a higher burden among rural residents. Hypertension and abnormal WC are significant predictors of pre-diabetes in Abia State. Daily consumption of fruits/vegetables in processed forms may be associated with an increased risk of pre-diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others


  1. Knowler WC, Barrett-Conner E, Fowler SE, Hammon RF, Lachin JM, Walker EA, et al. The diabetes prevention program research group: reduction in the incidence of type 2 iabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  CAS  Google Scholar 

  2. Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijav V. Indian diabetes prevention programme (IDPP): the indian diabetes prevention programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49:289–97.

    Article  CAS  Google Scholar 

  3. Okpechi IG, Chukwuonye II, Tiffin N, Madukwe OO, Onyeonoro UU, Umeizudike al. Blood pressure gradients and cardiovascular risk factors in urban and rural populations in Abia State South Eastern Nigeria using the WHO STEPwise approach. PLoS ONE 8: e73403.

  4. Dirk LC, Henrik F, David LM, Beatrice K, Inge T, Michael KB, et al. Prevalence of glucose intolerance and associated risk factors in rural and urban populations of different ethnic groups in Kenya. Diabetes Res Clin Pract. 2009;84:303–10.

    Article  Google Scholar 

  5. International Diabetes Federation: IDF diabetes atlas.7th ed, Brussels, Belgium: International Diabetes Federation, 2015. Accessed on 20 Mar 2016

  6. Data obtained from the official portal of Abia State Government, Nigeria. 2016. Available at Accessed 13 Oct 2016

  7. Sundar Rao PSS, Richard J. Introduction to biostatistics and research methods simplified. 5th ed: PHI Learning Private Limited.2012

  8. WHO STEP wise approach to surveillance- Instrument v.3.1 5–16

  9. National Heart, Lung and blood institute. US department of health and human services. Accessed 13th June,2015

  10. Ejike CE, Uka NK, Nwachukwu S. Diabetes and pre diabetes and correlates with measures of obesity. Afr J Biochem Res. 2015;9:55–60.

    Article  Google Scholar 

  11. Enang OE, Otu AA, Essien OE, Okpara H, Fasanmade OE, Ohwovoriole AE, et al. Prevalence of dysglycaemia in Calabar. A cross sectional observational study among residents of Calabar, Nigeria. Epidemiology/Health service research. BMJ open diab Res care. 2014;2:e000032.

    Article  CAS  Google Scholar 

  12. Nwatu CB, Ofoegbu EN, Unachukwu CN, Young EE, Okafor CI, Okoli CE. Prevalence of pre-diabetes and associated risk factors in a rural Nigerian community. Int J Diabetes Dev Ctries. 2013;36(2).

  13. Mezie-Okoye MM. Diabetes in older adults: experience from a rural community in south-east Nigeria. African J Diabetes Med. 2013;21:45–8.

    Google Scholar 

  14. Nyenwe EA, Odia OJ, Ihekwaba AE, Babatunde S. Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria. Diabetes Res Clin Pract. 2003;62:177–85.

    Article  Google Scholar 

  15. Sabir AA, Isezuo SA, Ohwovoriole AE. Dysglycaemia and its risk factors in an urban Fulani population of Northern Nigeria. West Afr J Med. 2011;30:325–30.

    CAS  PubMed  Google Scholar 

  16. Sabir A, Ohwovoriole A, Isezuo S, Fasanmade O, Abubakar S, Iwuala S. Type 2 diabetes mellitus and its risk factors among the rural Fulanis of northern Nigeria. Ann Afr Med. 2013;12:217–22.

    Article  Google Scholar 

  17. Chiwanga FS, Njelekela MA, Diamond MB, Banjunirwe F, Guwatudde D, Nankya-Mutyoba J et al. Urban and rural prevalence of diabetes and pre-diabetes and risk factors associated with diabetes in Tanzania and Uganda. Glob Health Action. 2016; 9:

  18. Thorpe LE, Upadhyay UD, Chamany S, Garg R, Mandel-Ricci J, Kellerman S, et al. Prevalence and control of diabetes and impaired fasting glucose in New York city. Diabetes Care. 2009;32:57–62.

    Article  Google Scholar 

  19. Reaven GM. Pathophysiology of insulin resistance in human disease. Physiol Rev. 1995;75:473–86.

    Article  CAS  Google Scholar 

  20. Azevedo M, Alla S. Diabetes in sub-saharan Africa: Kenya, Mali, Mozambique, Nigeria, South Africa and Zambia. Int J Diabetes Dev Ctries. 2008;28:101–8.

    Article  Google Scholar 

  21. Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R et al. Impaired fasting glucose and impaired glucose tolerance: Implications for care. IN: Diabetes care. American Diabetes Association ;2007. Page 753–759,

  22. Shaw JE, Zimmet PZ, de Courten M, Dowse GK, Chitson P, Gareeboo H, et al. Impaired fasting glucose or impaired glucose tolerance: what best predicts future diabetes in Mauritius? Diabetes Care. 1999;22:399–402.

    Article  CAS  Google Scholar 

  23. Stern MP, Williams K, Haffner SM. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med. 2000;136:575–81.

    Article  Google Scholar 

  24. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004;28:S2–9.

    Article  Google Scholar 

  25. Goldstein J, Jacoby E, del Aguila R, Lopez A. Poverty is a predictor of non-communicable disease among adults in Peruvian cities. Prev Med. 2005;41:800–6.

    Article  Google Scholar 

  26. Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C. High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008;31:893–8.

    Article  Google Scholar 

  27. Alberts M, Urdal P, Steyn K, Stensvold I, Tverdal A, Nel JH, et al. Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa. Eur J Cardiovasc Prev Rehabil. 2005;12:347–54.

    Article  Google Scholar 

  28. Zhao M, Lin H, Yuan Y, Wang F, Xi Yang, Wen LM, et al. Prevalence of pre-diabetes and its associated risk factors in rural areas of Ningbo, China. Int J Environ Res Public Health. 2016;13:808–12.

    Article  Google Scholar 

  29. Kweku M, Nyavor P, Bani F, Axame WK, Owusu R, Takramah W, et al. Prevalence and awareness of type 2 diabetes among urban and rural traders in Holwe municipality, Ghana. Int J Clinical Case. 2017;1:64–77.

    Google Scholar 

  30. Y. Wu, D. Zhang*, X. Jiang, W. Jiang Fruit and vegetable consumption and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies. Nutrition, Metabolism & Cardiovascular Diseases 2015; 25:140-147

  31. Holt EM, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, et al. Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc. 2009;109:414–21.

    Article  CAS  Google Scholar 

  32. Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 2010;341. c4229. Published 2010 Aug 18. doi:

  33. Ceriellona. Oxidative stress and glycaemic regulation. Metabolism 2000; 49:27–29

  34. Bazzano LA, Li TY, Joshipura KJ, Hu FB. Intake of fruits, vegetables and fruit juices and risk of diabetes in women. Diabetes care. 2008;31:1311–7.

    Article  CAS  Google Scholar 

  35. Wu-Qing H, Ying Lu, Ming Xu, Huang Jing, Yi-Xiang Su, Zhang Cai-Xia. Excessive fruit consumption during the second trimester is associated with increased likelihood of gestational diabetes mellitus: a prospective study. Sci Rep. 2017;7:43620.

    Article  Google Scholar 

  36. Richard JJ, Mark SS, Yuri S, Takahiko N, Daniel IF, Duke-Hee K, et al. Potential role of sugar(fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney diseases and cardiovascular disease. Am J Clin Nutr. 2007;86:899–906.

    Google Scholar 

  37. Hodge AM, Dowse GK, Collinqs VR, Zimmet PZ. Abnormal glucose tolerance and alcohol consumption in three populations at high risk of non-insulin-dependent diabetes mellitus. Am J Epidemiol. 1993;137:178–89.

    Article  CAS  Google Scholar 

  38. Wannamethee SG, Shaper AG, Perry IJ, Alberti KG. Alcohol consumption and the incidence of type 2 diabetes. J Epidemiol Community Health. 2002;56:542–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Blessing Chinenye Ubani.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ubani, B.C., Young, E., Ekrikpo, U.E. et al. Pre-diabetes and it’s predictors in Abia State, Eastern Nigeria. Int J Diabetes Dev Ctries 42, 443–450 (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: