THE ROLE OF DIET IN THE ASSOCIATED RISK FOR NON-INSULIN DEPENDENT ON DIABETES MELLITUS (NIDDM) IN BORNO STATE OF NIGERIA

Abstract

Diabetes Mellitus, especially Non-Insulin Dependent Diabetes Mellitus (NIDDM), has recently incurred epidemiologic investigation due to the many cases seen and the surmounting problems associated with its management. A case-control study of 100, 40-82 years old, male and female indigenes of Borno state was used to determine the foods in the dietary pattern of the people that could predispose to NIDDM. The subject were first interviewed in Hausa or Kanuri, using a structured questionnaire, screened and classified as cases or controls according to World Health Organization (1985) criteria using fasting and/or 2-hour post oral 75-g glucose load plasma glucose level, Twelve of the subject were classified as cases and eighty-eight were controls. The questionnaire sought information on demographic, anthropometric, dietary and other health related variables that are common among NIDDM patients. Dietary factors. Past and present, were assessed by semi-quantitative food frequency and 24-hour diet recall methods. The energy and nutrient content of the diet recall of the subjects, and the percentage contribution to energy by the calorigenic nutrients were assessed from a compiled nutrient data base of the foods consumed by people in Borno state. The comparison of risk for NIDDM associated with various factors among cases and controls was measured by ‘odds ratio’ (OR). Dichotomous logistic regression analysis was used to determine the risk for NIDDM associated with dietary factors while controlling for other variables commonly associated with NIDDM patients. The processes involved in data collection, and in determining the role of diet in the associated risk for NIDDM are fully documented. The results show a prevalence of 12% for NIDDM among the group. Wainanrogo-a fried cassava dough, Fish, and Beverage groups with odds ratios of 6.3 (95% confidence interval, CI: 1.47-28, p <0.01), 5.0 (95% CI: 1.04-21, 86, p<0.01), and 5.0 (95% CI: 0.97-48, 84, p<0.05), respectively, were dietary risk factors for NIDDM. Crude odds ratio indicates that 45-54 years age-group, and rural dwellers are at risk for NIDDM, with increasing risk for older females or those with a body mass index (BMI)<25. Logistics regression of dietary factors, age, sex, BMI, waist-hip ratio (WHR), place of abode of subjects, with the energy or caloigenic nutrients implicated at risk factors for NIDDM, found Wainan Rogo as the most risk factor for NIDDM. The results show that some foods have significant associated risk with NIDDM, avoidance of which may help protect people with similar dietary pattern from having NIDDM and thereby prevent the spread of the disease to such epidemic proportions currently observed for the Pima Idians and African-Americans.