Pattern, Trend and Predictors of Adult-Onset Type 1 Diabetes in Uyo, Nigeria

C. Amadi, O. Ayoade, S. Onung, S. Essien, Anietie A. Etuk, C. J. Okafor
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Abstract

Background: Unlike what obtains in childhood-onset type 1 diabetes, there remains a paucity of data on adult-onset type 1 diabetes in Nigeria. Hence, the current study aimed to determine the general characteristics of adult-onset type 1 diabetes among subjects (aged ≥18 years) presenting at the University of Uyo Teaching Hospital (UUTH) in Akwa Ibom State, South-south Nigeria. Methods: A 5-year (2014–2018) retrospective records review of subjects with type 1 diabetes was undertaken, using hospital medical records retrieved from the Department of Health Information Management of UUTH. Diagnosed adult cases of type 1 diabetes were meticulously identified and the relevant data at the point of initial diagnosis were acquired on a specially designed data acquisition template. Results: A total of 47,357 medical cases were identified of which 362 adults were diagnosed with type I diabetes (mean age 33.12 ± 4.40, range 20–51 years) and the females (n = 204; 56.4%) predominated among those diagnosed. The overall, male gender, and female gender prevalence was 7.4/1,000 (95% confidence interval [CI]: 6.89–7.98), 3.3/1,000 (95% CI: 2.52–4.08), and 4.3/1,000 (95% CI: 3.61–4.99), respectively. The females exhibited the highest trough, peak, annual, and overall prevalence during the study period. The female gender (OR: 2.334; 95% CI: 1.407–3.478; p = 0.010), age ≤30 years (OR: 1.976; 95% CI: 0.875–3.211; p < 0.001), urban-dwelling (OR: 3.243; 95% CI: 2.3407.780; <0.001), diabetes family history (OR: 1.365; 95% CI: 0.678–2.010; p = 0.033), and the rainy season (OR: 1.129; 95% CI: 0.401–1.910; p < 0.001) were independent predictors among the overall adult type 1 diabetics. On gender-segregated analyses, age ≤30 years, urban-dwelling, diabetes family history, and the rainy season remained independent predictors among the male and female adult type 1 diabetics (p < 0.05). Conclusion: The study demonstrated a high burden of type 1 diabetes among adult residents of Uyo, Akwa Ibom State, South-South Nigeria. The predictors of adult type 1 diabetes, identified in the present study, are valuable epidemiologic evidence for the design of type 1 diabetes-targeted preventive programs by various concerned stakeholders.
尼日利亚尤约地区成人发病1型糖尿病的模式、趋势和预测因素
背景:与儿童期发病的1型糖尿病不同,尼日利亚成人发病的1型糖尿病数据仍然缺乏。因此,本研究旨在确定在尼日利亚南南阿克瓦伊博姆州Uyo大学教学医院(UUTH)就诊的成人发病1型糖尿病患者(年龄≥18岁)的一般特征。方法:使用从UUTH卫生信息管理处检索的医院病历,对1型糖尿病患者进行5年(2014-2018年)回顾性记录分析。对诊断为1型糖尿病的成人病例进行仔细识别,并在专门设计的数据采集模板上获取初始诊断时的相关数据。结果:共发现病例47,357例,其中成人362例(平均年龄33.12±4.40岁,年龄范围20 ~ 51岁),女性204例;(56.4%)在确诊者中占主导地位。总体、男性和女性患病率分别为7.4/ 1000(95%可信区间[CI]: 6.89-7.98)、3.3/ 1000 (95% CI: 2.52-4.08)和4.3/ 1000 (95% CI: 3.61-4.99)。研究期间,女性的患病率以波谷、波峰、年患病率和总体患病率最高。女性(OR: 2.334;95% ci: 1.407-3.478;p = 0.010),年龄≤30岁(OR: 1.976;95% ci: 0.875-3.211;p < 0.001),居住在城市(OR: 3.243;95% ci: 2.3407.780;<0.001),糖尿病家族史(OR: 1.365;95% ci: 0.678-2.010;p = 0.033),雨季(OR: 1.129;95% ci: 0.401-1.910;P < 0.001)是成人1型糖尿病患者的独立预测因子。在性别分离分析中,年龄≤30岁、居住城市、糖尿病家族史和雨季仍然是男性和女性成年1型糖尿病患者的独立预测因素(p < 0.05)。结论:该研究表明,尼日利亚南南阿夸伊博姆州Uyo的成年居民患1型糖尿病的负担较高。本研究确定的成人1型糖尿病的预测因子,为各利益相关方设计针对1型糖尿病的预防方案提供了有价值的流行病学证据。
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