Diabetes, hand and/or foot ulcers: a cross-sectional hospital-based study in Port Harcourt, Nigeria.

OBJECTIVE: The study aimed to establish the prevalence of diabetes mellitus and the pattern of diabetic hand and foot ulcers in hospitalized adult patients in a teaching hospital in Port Harcourt, Nigeria. RESEARCH DESIGN AND METHODS: All medical admission at the University of Port Harcourt Teaching Hospital between January 2000 and April 2001 were included in this cross-sectional study. Diabetes mellitus was diagnosed based on a fasting venous plasma glucose >or=7.0 mmol/l or a 2-h post-prandial venous plasma glucose level of >or=11.1 mmol/L using the glucose oxidase method. Data was processed for the 60 diabetic patients with limb ulcers excluding ulcers from major trauma. RESULTS: The prevalence of diabetes mellitus was 38.1% (95% CI=34.8-41.4) among medical in-patients; while hand and foot ulcer was 19.1% among diabetic patients. The left lower limb ranked highest in ulcer involvement (32/60); hand ulcers were found in 5 cases (8.3%). Twenty (33.3%) of the patients had a previous limb ulcer. In 31 patients (51.7%) the ulcers evolved spontaneously without an identifiable cause (p-value=0.00). By Wagner's Grading System, Grade III lesions ranked highest (21/64). CONCLUSIONS: A high prevalence of hand and foot ulcers was confirmed among patients with diabetics, which are common indications for hospitalization, and usually associated with long hospital stay with adverse outcomes including amputation and death. Diabetes education needs to be stepped-up, with emphasis on foot care and early presentation to hospital in the event of limb ulceration.

Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria.

OBJECTIVES: This study aimed to assess the prevalence rates of type 2 diabetes and to determine potential associated risk factors of the disease in Port Harcourt, Nigeria. RESEARCH DESIGN AND METHODS: Five hundred and two (502) subjects aged above 40 years, obtained by a two-stage cluster sampling technique participated in this survey. Casual (random) plasma glucose estimations were done for all subjects after relevant personal data were obtained. Subjects with casual plasma glucose (CPG) > or =7.0 mmol/l had oral glucose tolerance tests (OGTT) done. Fasting and 2 h post glucose load blood samples were analyzed for plasma glucose levels. RESULTS: Thirty-four (34) subjects had diabetes, giving a crude prevalence rate of 6.8% (CI=4.6-9.0%), and standardized rate of 7.9%. The crude prevalence rates were 7.7 and 5.7% for males and females, respectively. Of the 34 diabetic subjects seen, 14 (41.2%) of them were not previously known to have diabetes; 83.7% of these were asymptomatic. Body mass index (BMI) > or = 25 kg/m2 and WHR > or = 0.85, family history of diabetes, physical inactivity, heavy consumption of alcohol, older age as well as high social status and Hausa-Fulani or Ibibio origin were associated with significantly higher prevalence of type 2 diabetes. CONCLUSION: The prevalence of type 2 diabetes in Port Harcourt is relatively high. Changing lifestyle associated with industrialization may explain this. A significant proportion of the diabetic subjects are asymptomatic and undiagnosed. The risk factors as shown in our study clearly emphasize the point that type 2 diabetes is to a large extent a preventable disease.