Nigeria, with a population of 158 million people, is the most populous country in Africa and accounts for one sixth of Africa’s population. Approximately 50% of Nigerians are urban dwellers and the country has a cultural diversity and 398 documented ethnic groups [World population prospects, 2012]. Health care delivery as in most developing countries of the world is at best sub-optimal and this may be responsible for the dismal health indicator statistics such as reduced life expectancy at birth and increased maternal mortality. Health care provision in Nigeria is …show more content…
Of the four classes of Diabetes Mellitus, three types are frequently recognized in our setting and these are type 1 Diabetes Mellitus (T1DM), type 2 diabetes mellitus (T2DM) and gestational diabetes. Of the three types of Diabetes Mellitus, type 2 diabetes mellitus (T2DM) is the commonly documented form of diabetes mellitus (DM) and in most endocrine clinics, it accounts for about 90%-95% of all cases of diabetes mellitus (DM). The prevalence of type 1 diabetes mellitus (T1DM) is not known but there are sketchy reports from various endocrine centers and documented prevalence rates which are all hospital based range from 0.1/1000 to 3.1/1000[Sahel Med J.2013]. It is pertinent to note that in our setting, clinical criteria are often used to classify patients with DM into type 1 and T2DM. These criteria include a cut off age of thirty years and insulin requirements or usage since diagnosis. For T2DM additional clinical criteria for diagnosis include history of usage of oral hypoglycemic agents or usage of combination of insulin and the oral hypoglycemic …show more content…
The use of glycosylated hemoglobin test in the diagnosis of DM was recommended by the WHO in 2011 and a level of ≥ 6.5% (≥ 48 mmol/mol) was taken as a cut-off for diagnosing type 2 diabetes in adults [WHO, 2011]. Using HbA1c for diagnosis requires the International Federation of Clinical Chemistry standardised assays for its measurement to ensure the results produced using different assays are equivalent and reliable [Mustafa S A, 2010]. In Nigeria, glycated haemoglobin levels are more often than not determined by point-of-care tests which are not standardized for use in diagnosing