Prevalence and determinants of type 2 diabetes mellitus among adults in rural communities of Rivers State, Nigeria

Abstract

Background: Type 2 diabetes mellitus (T2DM) is increasingly recognized in rural populations, yet data on prevalence and determinants in rural communities in Rivers State, Nigeria, remain limited. Understanding these factors is essential for planning targeted interventions. This study determined the prevalence and independent determinants of T2DM among adults. Methods: A community-based cross-sectional study was conducted between March and September 2025 among 602 adults aged ≥18 years in nine rural communities across three rural Local Government Areas. Multistage probability sampling selected households and one eligible adult per household. Data on sociodemographic characteristics, lifestyle behaviours, and family history were collected using a pretested WHO STEPwise questionnaire. Anthropometry, blood pressure, and fasting blood glucose were measured using standard protocols. Internal consistency was assessed using Cronbach’s alpha. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed. Model diagnostics included multicollinearity assessment, Hosmer-Lemeshow goodness-of-fit, and receiver operating characteristic curve analysis. Results: Prevalence of T2DM was 9.3%, with 41.1% previously undiagnosed. Age ≥45 years (AOR=3.12; 95% CI: 1.68–5.78), obesity (AOR=2.84; 95% CI: 1.49-5.42), physical inactivity (AOR=2.17; 95% CI: 1.16-4.05), hypertension (AOR=2.63; 95% CI: 1.38-5.02), and family history of diabetes (AOR=3.41; 95% CI: 1.72-6.78) were independently associated with T2DM. The model demonstrated good fit (Hosmer-Lemeshow p=0.64) and discrimination (ROC=0.78). Conclusions: T2DM is prevalent in rural communities of Rivers State, with undiagnosed cases common. Modifiable and non-modifiable factors predict T2DM, supporting screening and lifestyle interventions.