The Prevalence of Diabetic Mellitus Among Elderly People
CHAPTER ONE
Objectives of the Study
To determine the Prevalence of diabetic mellitus among elderly people. Specifically, the study aims:
- To determine the prevalence of Diabetes mellitus among among adults aged 50 years and over inKano Municipal Local Government.
- To assess the socioeconomic risk factors of diabetes among adults aged 50 years and over in Kano Municipal Local Government.
- To assess the behavioural risk factors of diabetes among adults aged 50 years and over in Kano Municipal Local Government
- Research questions
- What is the prevalence of Diabetes mellitus among among adults aged 50 years and over inKano Municipal Local Government.?
- What are the socioeconomic risk factors of diabetes among adults aged 50 years and over in Kano Municipal Local Government?
- What are the behavioural risk factors of diabetes among adults aged 50 years and over in Kano Municipal Local Government?
CHAPTER TWO
LITERATURE REVIEW
Definition of Diabetes mellitus
Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin (Sukha and Rubin, 2007). Deficiency in insulin production by the pancreas or inability of the insulin produced to bind effectively to its receptor on the cell surface results to chronic hyperglycemia and the attendant metabolic disregulation may be associated with secondary damage in multiple organ systems, especially the .kidneys, eyes, nerves, and blood vessels (Virella et al., 2003). Insulin has several functions in the human body. In the liver insulin increases the storage of glucose as glycogen. This involves the insertion of additional GLUT2 glucose transport molecules in cell plasma membranes.
In the muscle, insulin stimulates glycogen and protein synthesis. Glucose transport into muscle cells is facilitated by insertion of additional GLUT4 transport molecules into cell plasma membrane. In adipose tissue, insulin facilitates triglyceride storage by activating plasma lipoprotein lipase, increasing glucose transport into cells via GLUT4 transporters and reducing intracellular lipolysis (Jagessar et al., 2015). The primary symptoms are hyperglycemia and glucosuria, polyuria, polydipsia and polyphagia, sudden weight loss, ketonuria and ketonemia in acute episodes which results from inability to regulate glucose metabolism (Brownlee, 2001). In the later stage of diabetes, lipid metabolism is affected and is seen as hyperlipidemia and hypercholesterolemia, a risk factor in atherosclerosis (Ross, 1999; Schwartz, 2006; WHO, 2006). Insulin deficiency may arise in various ways such as destruction of β-cells of the pancreas, an organ responsible for the production of insulin (Leslie et al., 2008) and although the exact cause of the disease is uncertain, genetic and secondary predisposing factors contribute to the onset of the disease (Shafee et al., 2008). Any other abnormality in the glucose metabolism pathway may result in hyperglycemia.
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
In this chapter, we would describe how the study was carried out.
Research design
Research design is a detailed outline of how an investigation took place. It entails how data is collected, the data collection tools used and the mode of analyzing data collected (Cooper & Schindler (2006). This study used a descriptive research design. Gill and Johnson (2002) state that a descriptive design looks at particular characteristics of a specific population of subjects, at a particular point in time or at different times for comparative purposes. The choice of a survey design for this study was deemed appropriate as Mugenda and Mugenda (2003) attest that it enables the researcher to determine the nature of prevailing conditions without manipulating the subjects.
We conducted a cross sectional study based on data collected in an on-going longitudinal Study of Ageing and Adult Health (SAGE) Wave 1 from 2017 to 2018 in Nigeria.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered.
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATIONS
Conclusions
This study set out to investigate the Prevalence of diabetic mellitus among elderly people aged 50 plus years and the demographic, socioeconomic, health behaviour and anthropometric risk factors of diabetes in older adults in Nigeria. The overall prevalence was 3.95%, with no statistically significant differences by sex. Old age and education were associated with higher risk of diabetes among men while low and moderate levels of physical activity and obesity were associated with higher risk of diabetes among women.
The prevalence of diabetes among old adults in Nigeria was within the range of the prevalence of diabetes in the general population of Nigeria of between 3.8 and 6.3% (Okorie, 2014). However, the prevalence rate was lower in comparison to Ghana, South Africa and Kenya, which could be due to differences in population size, exposures to risk factors and study designs (Essien, 2013).
In conclusion, our study provides evidence on the prevalence of diabetes in Nigeria and its associated risk factors among older adults. The prevalence of diabetes among old adults in Nigeria was 3.95%. Old age, higher education, low level of physical activity and obesity were associated with higher risk of diabetes in the general population. Gender differences exist in the risk factors of diabetes with old age and higher education being the risk factors among males and obesity and physical inactivity as risk factors among females. Hence, there is need to enhance the existing prevention programmes with emphasis on social determinants of diabetes, sustained physical activities and good nutritional practices starting at an early age to reduce the level of exposure and subsequently to decrease the prevalence of diabetes at old age.
Recommendation
- It is recommended that the Federal government and state government to give priority to diabetes disease by providing free insulin and oral glycemic drugs to diabetes patients.
- It is recommended that the Federal government and state and local government to prioritize diabetes care by ensuring all patients subscribe to NHIS and to cover management costs of diabetes, both for outpatient and in-patient services through NHIS. This is because of the many comorbidities associated with diabetes and thereby reducing the economic burden of a diabetic patient and also improve HRQoL and reduce DALYs.
- It is recommended that state government to prioritize resource allocation for diabetes management so as to reduce the economic burden suffered by diabetes patients.
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