S.O. Martins, O.F. Folasire and A.E. Irabor
Department of Family Medicine, University College Hospital, Ibadan, Nigeria
Introduction: Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes mellitus. Inadequate moderate-intensity physical activity, amidst other risk factors, is a well-documented risk factor for prediabetes. Hospital administrative staff can be particularly vulnerable to prediabetes because of the greater number of hours spent in a sitting or sedentary position during administrative duties. The aim of this study was to find the prevalence of prediabetes and to determine its predictors among administrative staff of a tertiary health centre in southwestern Nigeria.
Methods: This was a descriptive cross-sectional study carried out among 300 administrative staff of the University College Hospital, Ibadan over a period of three months. Data was collected using a semi-structured questionnaire that was adapted from the generic WHO-STEPs instrument approach to surveillance of chronic non-communicable diseases risk factors. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17. Descriptive analyses were performed to estimate the prevalence of prediabetes while the independent predictors of prediabetes were investigated using multinomial logistic regression model. The level of statistical significance was set at p < 0.05.
Results: The mean age of participants was 51.2 ± 5.3 years. There were 164 (54.7%) males and 136 (45.3%) females that participated in the study. The prevalence of prediabetes was 22.3%. Based on the final multivariable multinomial model, the independent predictors of prediabetes included; male sex (OR= 1.24; 95% CI= 1.082 - 2.460), positive family history of diabetes mellitus (OR= 1.57; 95% CI= 1.088 – 2.611), alcohol intake (OR= 1.13; 95% CI= 0.688 – 1.543) and inadequate moderate-intensity physical activity (OR= 1.49; 95% CI= 1.027 – 2.936).
Conclusion: There was a high prevalence of prediabetes among the administrative staff of University College Hospital, Ibadan. Regular screening of hospital employees for prediabetes is highly recommended. Work-place exercise should be advocated to improve moderate-intensity physical activity among hospital employees.
Keywords: Prediabetes, Administrative staff, Hospital employees, University College Hospital.
Prediabetes, an intermediate stage between normal glucose tolerance (NGT) and overt type 2 diabetes mellitus, is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes mellitus.1,2 As such, it represents two groups of individuals, those with impaired glucose tolerance (IGT) and/or those with impaired fasting glucose (IFG).1,3 According to the American Diabetes Association,4 prediabetes is diagnosed as a fasting blood glucose of 100 to 125 mg/dl (5.6 to 6.9 mmol/L) known as IFG; a blood glucose of 140 to 199 mg/dl (7.8 to 11.0 mmol/L) two hours after an oral glucose tolerance test (OGTT) known as IGT or HbA1c level of 5.7% to 6.4%. Prediabetes is largely asymptomatic and it is therefore mostly detected on routine screening in apparently healthy individuals.3,5 Three tests are used for the screening of prediabetes; a fasting blood glucose (FBG) level, a two-hour OGTT and measuring of HbA1c levels. Though, the OGTT is a specific indicator of diabetes risk and is considered to be the gold standard for detection of prediabetes.3
According to the Centers for Disease Control and Prevention (CDC),1 prediabetes has been noted to have a higher prevalence figures than diabetes mellitus among populations. For instance, prediabetes was called “America’s largest healthcare epidemic” in year 2011 as approximately 79 million adults in the United States had prediabetes.1 This number was more than three times the number of adults (approximately 26 million) with frank diabetes mellitus in the United States that same year.1 Few studies have shown a high prevalence of prediabetes among hospital employees in a similar fashion as noted in the general population. In a study to determine the prevalence of prediabetes in healthcare professionals, Rongies et. al6 found 15.7% of their study participants had prediabetes. In another survey among medical staff of a hospital in Kuwait, AlRandi et. al7 found that out of the 51 participants with high Finnish diabetes risk assessment scores, 26 (51.0%) had prediabetes.
Inadequate moderate-intensity physical activity, amidst other risk factors, is a well-documented risk factor for prediabetes.8–10 The World Health Organization (WHO) had recommended that; adults aged 18–64 years should do at least 150 minutes of moderateintensity physical activity throughout the week.2 Arguably, hospital administrative staff can be particularly vulnerable to chronic medical conditions like diabetes mellitus because of the greater number of hours spent in a sitting or sedentary position during administrative duties while making out time for exercises might be extremely difficult. Uninterrupted sitting at workplaces for lengthy hours has also been linked with high postprandial glucose and insulin levels which may lead to prediabetes.11
Studies have shown that hospital employees, despite their proximity to healthcare system, have a low level of health seeking behaviour including regular screening for chronic medical conditions like diabetes mellitus.12– 15 A huge knowledge gap exists as there is no local study on the prevalence and predictors of prediabetes among hospital administrative staff in Nigeria. The specific objectives of this study were to find the prevalence and predictors of prediabetes and to determine its predictors among administrative staff of a tertiary health centre in southwestern Nigeria. The findings of this study will be important for implementing routine screening for prediabetes among hospital employees and for informing public health policy decisions on lifestyle interventions to prevent the progression of prediabetes to type 2 diabetes mellitus.