CAUSES AND MANAGEMENT OF DIABETES AMONG ADULT AGE OF 35-70 YEARS

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TOPIC: CAUSES AND MANAGEMENT OF DIABETES AMONG ADULT AGE OF 35-70 YEARS

ABSTRACT
This study investigates the causes and management of diabetes among adults aged 35–70 years at Lagos State University Teaching Hospital (LASUTH). The research was designed to identify the primary causes of diabetes in this age group, assess the current diabetes management practices, evaluate the level of patient compliance with these management strategies, and determine the factors influencing compliance. The study adopted a descriptive research design and employed a structured questionnaire for data collection. A total of 78 adults diagnosed with diabetes were surveyed, and the data were analyzed using frequency counts and percentages. The findings revealed that the leading causes of diabetes among the participants were poor dietary habits, physical inactivity, and stress, coupled with a genetic predisposition. In terms of management practices, respondents generally adhered to prescribed pharmacological treatments, but compliance with lifestyle modifications such as diet and exercise was lower. The study also identified that while many participants were consistent with medication adherence, factors such as financial constraints, lack of time, and cultural beliefs hindered adherence to recommended lifestyle changes. The research highlights the importance of comprehensive diabetes care that addresses not only medical treatment but also lifestyle interventions and socio-economic challenges. It is recommended that healthcare providers focus on patient education, address the socio-economic barriers to diabetes management, and involve family members in care strategies. The study further suggests the need for more targeted healthcare policies and support systems to improve diabetes management outcomes in Nigeria.
 
CHAPTER ONE
INTRODUCTION (Preview)
 1.1 Background to the Study
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to defects in insulin secretion, action, or both (Bellary et al., 2021). Globally, the prevalence of diabetes has reached alarming rates, with significant implications for public health, particularly among adults aged 35–70 years. This age group is especially vulnerable due to factors such as aging, sedentary lifestyles, and poor dietary habits (Galindo et al., 2023). The World Health Organization (WHO) has emphasized the growing burden of diabetes, particularly in low- and middle-income countries, where healthcare systems often face challenges in effectively managing the disease (Afaya et al., 2020). In sub-Saharan Africa, the diabetes epidemic has resulted in increased morbidity and mortality, making it a priority area for research and intervention.
Several studies have identified the underlying causes of diabetes among adults, which include genetic predisposition, obesity, physical inactivity, and dietary patterns (Azeez et al., 2021). Moreover, socioeconomic factors such as income levels, education, and access to healthcare contribute to the disease's prevalence (Bossman et al., 2021). For instance, Bossman et al. (2020) highlighted that a lack of awareness and inadequate healthcare infrastructure exacerbate diabetes complications in many African countries. Similarly, lifestyle transitions, including urbanization and dietary westernization, have been strongly linked to the increasing rates of diabetes, particularly in urban centers (Christensen et al., 2023). These findings underscore the multifactorial nature of diabetes and the need for comprehensive management strategies.
Management of diabetes requires an integrated approach encompassing medical, lifestyle, and educational interventions (Ekpo et al., 2020). Pharmacological treatments, including insulin and oral hypoglycemic agents, remain the cornerstone of diabetes care. However, recent evidence suggests that lifestyle modifications, such as dietary regulation and increased physical activity, significantly improve glycemic control (Fajinmi et al., 2022). Public health campaigns emphasizing preventive measures have also proven effective in mitigating the disease burden (Falola et al., 2023). Nonetheless, the lack of adherence to management protocols remains a critical barrier to achieving optimal outcomes.
In Nigeria, the prevalence of diabetes among adults has surged in recent decades, fueled by urbanization and changing lifestyles (Chika-Igwenyi et al., 2023). Azeez et al. (2021) identified cultural and economic factors as significant determinants of diabetes management in the Nigerian context. Despite advancements in medical treatments, the healthcare system faces challenges in addressing the high demand for diabetes care, particularly in tertiary institutions such as the Lagos State University Teaching Hospital (LASUTH). As one of the leading healthcare facilities in Nigeria, LASUTH provides specialized care for diabetes patients, serving as a critical case study for understanding the dynamics of diabetes management in urban settings. This study focuses on the causes and management of diabetes among adults aged 35–70 years at LASUTH. 
1.2 Statement of the Problem
Diabetes mellitus (DM) is a pervasive health issue affecting millions globally, with its prevalence steadily rising among adults aged 35–70 years. Althiugh there has been advancements in medical science, the effective management of diabetes remains a significant challenge, particularly in low- and middle-income countries like Nigeria. The problem is multifaceted, with causes ranging from genetic predisposition and lifestyle factors to socio-economic determinants such as limited access to quality healthcare and health education. Studies, including those by Azeez et al. (2021) and Bellary et al. (2021), have demonstrated that urbanization and dietary changes significantly contribute to the disease's prevalence. However, in Nigeria, the lack of structured healthcare systems, inadequate awareness programs, and poor adherence to management protocols exacerbate the burden(Christensen et al. 2023). At LASUTH, where patient volume is high, these challenges are further compounded by insufficient resources and limited healthcare personnel, creating gaps in diabetes care and management.
Moreover, despite the availability of treatment options such as pharmacological agents and lifestyle modifications, many patients experience suboptimal outcomes due to barriers such as cultural beliefs, financial constraints, and non-compliance with prescribed regimens. The absence of robust data on the specific causes and management practices within LASUTH further limits the development of effective, evidence-based strategies. This study seeks to address these critical gaps by exploring the causes and management of diabetes among adults aged 35–70 years at LASUTH.
1.3 Objectives Of The Study
The study generally focuses on the causes and management of diabetes among adults aged 35–70 years at LASUTH. The study will specifically assess the objectives below:
1. Analyze the causes of diabetes among adults aged 35–70 years at LASUTH.
2. Assess the management practices of diabetes among adults aged 35–70 years at LASUTH.
3. Evaluate the level of compliance with diabetes management measures among adults aged 35–70 years at LASUTH.
4. Identify the factors influencing the compliance with diabetes management measures among adults aged 35–70 years at LASUTH.
OTHER PARTS OF CHAPTER ONE INCLUDE
1.4 Research Questions
1.5 Scope of the Study
1.6 Significance of the Study
1.7 Definition of Terms
CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of diabetes mellitus, classification of diabetes mellitus, diabetes in the elderly, management of diabetes mellitus among the elderly, etc. The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Literature Gap
 
CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted descriptive research design
Population of the Study: The target population for this study consists of 97 adults aged 35 to 70 years who are receiving treatment for diabetes at LASUTH.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 78 participants.
Sampling Technique: The study employed a simple random sampling technique to select the individual respondents.
Research Instrument: The study utilized a questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies, percentages, means, and standard deviations to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistic, such as logistic regression, were used for further analysis
THIS CHAPTER ALSO COVERED
Validity of the Instrument
Reliability of the Instrument
Ethical Consideration
CHAPTER FOUR
DATA ANALYSIS AND PRESENTATION (Preview)
MAJOR FINDINGS:
The findings of the study are summarized as follows, in line with the sequence of the research questions analyzed:
i. The study found that the causes of diabetes among adults aged 35–70 years at LASUTH are largely attributable to family history, excessive thirst, comorbid chronic conditions, sedentary lifestyle, poor dietary habits, obesity, stress, and prior prediabetes diagnosis. This is evidenced by the majority of respondents affirming each of these factors, with family history recording the highest proportion (76.9%), followed by excessive thirst and obesity (70.5% each), stress (66.7%), sedentary lifestyle (64.1%), poor dietary habits (61.5%), other chronic conditions (57.7%), and prior prediabetes diagnosis (51.3%).
ii. The study found that the management practices of diabetes among adults aged 35–70 years at LASUTH are generally favourable, as evidenced by the high proportion of respondents who reported being on medication (87.2%), regularly visiting the diabetes clinic (76.9%), monitoring blood sugar levels (70.5%), exercising regularly (66.7%), following a prescribed diet plan (64.1%), and receiving diabetes education or counseling (57.7%).
iii. The study found that the level of compliance with diabetes management measures among adults aged 35–70 years at LASUTH is relatively high, as evidenced by the majority of respondents indicating that they always attend scheduled medical appointments (74.4%), take their prescribed medication (70.5%), check their blood sugar levels as advised (66.7%), follow their prescribed diet (64.1%), and adhere strictly to their exercise plan (64.1%). However, 38.5% of respondents reported sometimes experiencing challenges in adhering to their diabetes management plan.
iv. The study found that fear of complications (70.5%) and family support (64.1%) are the strongest factors positively influencing compliance with diabetes management measures among adults aged 35–70 years at LASUTH, while stress (51.3%) and financial constraints (44.9%) were identified as notable barriers. Time constraints (38.5%), lack of access to healthcare professionals (28.2%), cultural beliefs (25.6%), and difficulty understanding medical advice (23.1%) were reported as comparatively less prevalent but still relevant challenges to compliance. 
THIS CHAPTER ALSO COVERED
4.1 Demographic Analysis
4.2 Analysis of Research Questions
4.3 Test of Hypothesis
4.4 Discussion of Findings
CHAPTER FIVE
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS 
5.1 Summary of the Study
5.2 Conclusions
5.3 Limitation of the Study
5.4 Recommendation
5.5 Suggestion for Further Findings
References
APPENDIX

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