Assessing The Knowledge, Attitude And Practice (KAP) of Prediabetes Management Among Healthcare Providers in Four Tertiary Hospitals In Nigeria: An Observational-Based Cross-Sectional Study

Dr. Kenneth Ogar Inaku, Dr. Ifeyinwa Dorothy Nnakenyi, Dr. Lucius Chidebere Imohc, Dr. Akeem Oyeyemi Lawal, Dr. Emin Johnson Emine, Dr. Abdulazis Saleh Longwap, Dr. Abdulazis Saleh Longwap


Introduction: An estimated 6.3 million Nigerians were reported to have prediabetes in 2015 placing Nigeria in the 9th position in world ranking. This number is projected to become 12.9 million by 2040. One way of reversing this trend is early identification of individuals at risk. This study was carried out to assess the knowledge, attitudes and practice of health care providers toward prediabetes diagnosis and management. Methods: This was an observational-based cross-sectional study involving the use of self administered questionnaire to doctors from the departments of internal medicine, paediatrics, obstetrics and gynaecology, family medicine and others. Results: In all, 358 questionnaires out of 410 were selected. All 10 risk factors for prediabetes were correctly identified by 82/358 (22.9%) participants with 300/358 (83.8%) able to identify at least 5 risk factors. Laboratory reference interval of 5.6 – 6.9 mmol/L for diagnosing prediabetes using fasting plasma glucose were correctly identified by 70/358 (19.6%) (lower value) and 14.5% (upper value) respectively. American Diabetes Association guidelines for prediabetes screening was the most familiar to 272(76.0%) respondents even though 144/358(40.2%) do not consider prediabetes as a condition that requires specific management. Over half 186/358(52%) of respondents agreed that metformin use can reduce the risk of diabetes in individuals with prediabetes but only 6/358(1.7%) have ever discussed starting metformin with their patients. Conclusion: There is need to educate medical doctors about risk factors for prediabetes and its management to curb the rising diabetes epidemic in Nigeria.


Prediabetes, Prevention, Risk factors, Fasting plasma glucose, Lifestyle modification

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Tabak GA, Herder C, Rathmann W, Brunner EJ, Kivimaki M. Prediabetes : A high-risk state for developing diabetes. Lancet 2012;379(9833):2279–2290.

World Health Organization, International Diabetes Federation. Definition and diagnosis of Diabetes Mellitus and intermediate hyperglycaemia: Report of a WHO/IDF consultation. In 2006.

American Diabetes Association. Standards of Medical Care in Diabetes 2017. Diabetes Care 2017;40(Suppl. 1):S75–87.

Diabetes Federation International. DIABETES. IDF Diabetes Atlas. 2015;7th Edition.

Jaja T, Oduwole AO, Fetuga B. Prevalence of prediabetes in secondary school students in Port Harcourt, Nigeria. African J Diabetes Med 2015;23(1):11–14.

Nwatu CB, Ofoegbu EN, Unachukwu CN, Young EE, Okafor CI, Okoli CE. Prevalence of prediabetes and associated risk factors in a rural Nigerian community. Int J Diabetes Dev Ctries 2016;36(2):197–203.

Forouhi NG, Luan J Hennings S, Wareham NJ. Incidence of Type 2 diabetes in England and its association with baseline impaired fasting glucose: the Ely study 1990-2000. Diabetes Met. 2007;24:200–207.

Nathan DM, Davidson MB, Defronzo RA, HeineRJ, Henry RR, Pratley R, et al. Impaired fasting glucose tolerance: implication for care. Diabetes Care 2007;30:753–759.

Jellinger PS. What you need to know about prediabetes. “Power of Prevention”. Am Coll End 2009;1:9.

Ogedengbe SO, Ezeani IU. Profile of metabolic abnormalities seen in patients with type 2 diabetes mellitus and their first degree relatives with metabolic syndrome seen in Benin City , Edo state Nigeria. Journal of Diabetes and Metabolic Disorders 2014;13(1):1–9.

Gong Q, Zhang P, Wang J, Gregg EW, Li H, Zhang B E. Changes in mortality in people with IGT before and after the onset of diabetes during the 23-year follow-up of the Da Qing Diabetes Prevention Study. Diabetes Care 2016;39(9):1550–1555.

Knowler WC, Fowler SC Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, et al. Ten-year follow-up of diabetes incidence and weight loss in the in the Diabetes Prevention Programs Outcome Study. Lancet 2009;374:1677–1684.

Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijav V. The Indian Diabetes Prevention Program shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006;49:289–297.

Tuomilehto J, Lindstrom J, Erksson JG, Valle TT, Hammalainen H, Itanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–50.

Centers for Disease Control and Prevention (CDC). National Diabetes Prevention Program. National Diabetes Prevention Program website Updated 2016. Accessed 23 Sept 2017.

Tseng E, Greer RC, O'Rourke P, Yeh H, McGuire MM, Clark JM, et al. Survey of primary care providers’ knowledge of screening for, diagnosing and managing prediabetes. J Gen Intern Med. Publ online 20 July 2017. 2017;

Macaulay S, Dunger DB, Norris SA. Gestational Diabetes in Africa: A Systematic Review. PLOS ONE 2014; 9(6) e97871

Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care 2018; 31:1668-9.

Duran A, Saenz S, Torrej’O MJ, et al. Introduction of IADPSG criteria for screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: The St. Carlos Gestational Diabetes Study. Diabetes Care 2014; 37:2442-50.

Ejike CECC, Uka NK, Nwanchukwu SO. Diabetes and prediabetes in adult Nigerians: Prevalence, and correlations of blood glucose concentrations with measures of obesity. African Journal of Biochemistry Research 2015; 9(3):55-60.

Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barrtte-Connor E. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with gestational diabetes: The Diabetes Prevention Program Outcome Study 10-year follow-up. J. Clin Endocrinol Met 2015;jc20143761.

Lindstrom J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson. J, et al. The

Finnish Diabetes Prevention Study (DPS). Diabetes Care 2003; 26(12):3230–3236.

Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, et al. Pharmacological and lifestyle intervention to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 2007; 334:299. PMID: 17237299.

Karve A, Hayward RA. Prevalence, diagnosis, and treatment of impaired fasting glucose and impaired glucose tolerance in nondiabetic US adults. Diabetes Care 2010; 33(11):2355-2359.

Uzochukwu BSC, Ughasoro MD, Etiaba E, Okwuosa C, Envuladu E, Onwujekwe OE. Healthcare financing in Nigeria: Implications for achieving universal health coverage. Niger J Clin Prac 2015; 18(4);437-444.

Unwin N, Whiting D, Roglic G. Social determinants of diabetes and challenges of prevention. Lancet 2010;375:2204-2205.

White M. Population approaches to prevention of type 2 diabetes. PloS Medicine. 2016; 13(7):e1002080.doi:10.1371/journal.pmed.1002080.

Adam J, Tyrrell R, Adamson AJ, White M. Effect of restriction on Television food advertising to children exposed to advertisements for less healthy food: Repeat cross-sectional study. PloSONE. 2012; 7:e31578.doi:10.1371/jouenal.pone.

He FJ, Pombo-Rodrigues S, MacGregor GA. Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality. BMJ Open. 2014;4(4).



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