High Glucose Abnormalities and Its Risk Factors in Adult Patients Attending Outpatient Clinics in Banjul, the Gambia

Background: By virtue of its potency as a risk factor and prognostic importance, the presence of an abnormal glucose tolerance in a patient deserves serious attention and makes its diagnosis a priority. Objective: To determine the prevalence of previously undiagnosed diabetes mellitus (PUDM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among patients attending clinics in Banjul, The Gambia and determine the risk factors associated with these states of abnormal glucose tolerance. Design: Cross-sectional study. Setting: Outpatient clinics of Royal Edward Francis Small Teaching Hospital and Medical Research Council Laboratories in Banjul. Methods: Two hundred and eight consecutive patients with hypertension on treatment and 108 non-hypertensive patients aged over 25years were enrolled. A questionnaire was filled and anthropometric measurements were taken. The standard oral glucose tolerance test (OGTT) was done. The WHO glucometabolic criteria was used in classifying the participants as normal OGTT, PUDM, IFG and IGT. Results: The mean (±SD) of blood glucose at 0min (FBG) was 5.7 (± 2.4) mmol/l while the mean (± SD) blood glucose at 120min (2HBG) was 7.7 (±2.2) mmol/l. Eighty percent had FBG of < 6.1mmol/l, 10% had FBG ≥6.1 - < 7.0mmol/l while another 10% had ≥ 7.0mmol/l. Sixty percent of participants had 2HBG < 7.8mmol/L, 32% had ≥ 7.8 - < 11.1 mmol/l and the remaining 8% ≥ 11.1mmol/l. Fifty-three percent had a normal OGTT, 4% had IFG, 29% had IGT and 15% had PUDM from the OGTT using the WHO criteria. PUDM and IGT were associated with hypertension but IFG was not associated with any of the risk factors. Conclusion: The prevalence of PUDM, IFG and IGT in patients attending clinics in Banjul was high. The major risk factor for PUDM and IGT was hypertension.