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.

Laboratory testing plays a critical role in healthcare delivery with test results used for disease screening, diagnosis, treatment progress and prognosis. Some tests are performed outside the laboratory by non-laboratory trained individuals using Point of Care Testing (POCT) devices. We aimed to evaluate the knowledge, factors that may affect results generated, quality control practices and the importance of POCT regulation on the overall testing process. This is a prospective study which 70 POCT devices operators / users gave their consent at the University of Calabar Teaching Hospital. Pretested questionnaires were used as the tool for evaluation. The respondents were 70 in number including medical doctors (51.4%) and Nurses (45.7%). The most commonly used POCT devices included glucose meters (91.4%), urine testing strips (65.7%) and haemoglobin meters (25.7%). Other devices in use were bilirubin meters (5.7%) and cholesterol meters (1.4%). About half (56%) of respondents understood the test reaction principles of their devices. Accident and Emergency department had the highest use (37.1%). Quality control practices were undertaken by 24.3% of respondents. Majority (65%) of operators used their devices for monitoring the progression of illness. Opinion on the regulation of use of POCT was supported by most respondents. Periodically validating and calibrating POCT devices within the hospital by the central laboratory will go a long way to ensure uniform testing and improve result quality.

Objectives: Dysglycemia is a common metabolic alteration during pregnancy with adverse effects on both mother and fetus. This is related to the fact that pregnancy is associated with insulin resistance which is a harbinger for hyperglycemia. This study was carried out to find out the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Calabar area using International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic values. Material and Methods: This was a prospective, observational, cross-sectional study among pregnant women attending antenatal care in four health facilities in Calabar and adjoining areas conducted from September 2018 to August 2019. All consenting pregnant women were given 75 g glucose in 250–300 mL of water after 8–10 h overnight fast, without regard to the presence or absence of GDM risk factors. GDM diagnosis was made if any of the following glucose values were met or exceeded: (1) Fasting >92 mg/dl, (2) 1 h post-glucose load >180 mg/ dl, and (3) 2 h post-glucose load >153 mg/dl. Data were analyzed using IBM Statistical Package for the Social Sciences version 20.0 and results were presented using tables and a Venn diagram. Results: There were 345 pregnant women aged 18–50 (28.7 ± 6.3) years at 24–41 (29.6 ± 4.1) completed weeks of gestation. GDM was diagnosed in 48 (13.9%) women. Fasting plasma glucose cutoff diagnosed 81% while 37.5% and 50.0% met the diagnostic cutoff for 1 h and 2 h, respectively, and 15 (31.3%) women were positive for all three diagnostic cutoffs. Diabetes mellitus in a first-degree relative was the most common risk factor identified while hypertension in a first-degree relative and history of GDM was the least. Some 36.5% of women had no identifiable risk factors. Those who had positive fasting plasma glucose only (6.1%) were more than twice those diagnosed by 1 and 2 h only (2.6%) combined. The number of women with glucose values in the diabetic range was 6 (1.72%) but was classified as GDM since they were not previously known diabetics. Conclusion: This study has shown that the prevalence of GDM is 13.9% among women in Calabar and environs using the IADPSG criteria. Fasting plasma glucose can identify more than twice GDM patients than 1 and 2 h values combined. GDM still remains a major health issue among pregnant women hence there should be a national policy on routine screening for GDM with more studies being encouraged to determine the preferred glucose cutoff among Nigerians.

Introduction / Background: Diabetes mellitus is highly prevalent in both developed and developing countries today affecting about 429 million adults globally and is expected to rise by 147% to 629 million in 2045. Effective management of diabetes mellitus requires the periodic measurement of fasting plasma glucose. Self-monitoring blood glucose has been used to achieve this for over three decades now. This study, therefore, assesses the performance of three blood glucose meters used by patients with diabetes in our environment. Materials and Methods: This study adopted a comparative analytical prospective design that involved three of the frequently used glucose meters in our environment namely RUBY®, ONCALL®, and FINETEST®. Glucose calibrators of increasing concentrations from 40 mg/dL to 200 mg/dL were prepared from a freshly constituted 1800 mg/dl stock solution of glucose. Sera obtained from five patients were assayed along with control sera using a routine laboratory method (glucose oxidase [GOX]) for standardization and the three glucose meters simultaneously and the results were compared for statistical differences on Microsoft Excel using means and standard deviation. P ≤ 0.05 was set as a level of significance. Results: The mean glucose values of calibrators (120 ± 63.3) were statistically significantly different from the mean glucose values of the RUBY (139.6 ± 80.9), (P = 0.0118) and the ONCALL (188.8 ± 82.1), (P ≤ 0.0001) glucose meters, respectively. The percentage increase in blood glucose estimation by the RUBY and ONCALL devices was 115.8% and 157.3% respectively. The FINETEST glucose meter overestimated glucose by 232.0% higher than the laboratory GOX method even though there was no statistical significance (P = 0.062) between the two means. The percentage imprecision for the different glucose meters was: RUBY 9.5%, FINETEST 14.8%, and ONCALL 18.2%. Conclusion: Quality control should be used routinely in the use of point of care testing glucose measurements and devices should be sent to the central laboratory periodically for recalibration to avoid mismanagement of diabetic patients on hypoglycaemic drugs.