1.1 Introduction
Diabetes mellitus is defined as a chronic metabolic disorder marked by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both (American Diabetes Association, 2022). The condition affects the body's ability to utilize glucose efficiently, leading to elevated blood sugar levels that pose significant risks to long-term health. As a global public health burden, diabetes is associated with complications such as cardiovascular disease, kidney failure, neuropathy, impaired wound healing, and vision loss, all of which are major contributors to morbidity and mortality worldwide (World Health Organization, 2021).
The increasing prevalence of diabetes in developing countries, including Nigeria, has become a growing concern for healthcare providers and policymakers. Factors such as urbanization, sedentary lifestyles, genetic predispositions, and dietary transitions have contributed to the rising incidence of both Type 1 and Type 2 diabetes within the Nigerian population (Oputa & Chinenye, 2015). Effective monitoring of blood glucose levels is essential for preventing complications and improving the quality of life of diabetic patients. Regular assessment allows clinicians to evaluate treatment effectiveness, adjust medications, and provide necessary lifestyle recommendations.
This chapter introduces the research by reviewing the background that informed the study, identifying the issues that led to its formulation, and outlining the aim and objectives. It also explains the study's significance, defines its scope, presents the research questions and hypotheses, addresses the limitations, and clarifies important terms used throughout the work.
1.2 Background of Study
The evaluation of blood glucose levels has evolved significantly over the past century, shaped by advancements in medical science, laboratory technology, and the global understanding of diabetes mellitus. According to Ratner (2012), the history of glucose monitoring can be traced back to the mid-19th century when physicians first detected sugar in the urine of diabetic patients using rudimentary chemical tests. Although these early diagnostic methods were limited in accuracy, they laid the foundation for later developments in blood-based glucose evaluation (Ratner, 2012).
Diabetes mellitus has emerged as one of the most significant chronic diseases affecting populations globally. According to the World Health Organization (2021), diabetes is a major cause of premature mortality, reduced quality of life, and long-term complications that impact nearly every organ system of the body. The condition is characterized by persistent elevation of blood glucose levels, which, when uncontrolled, results in complications such as neuropathy, nephropathy, cardiovascular disease, and impaired wound healing. The growing burden of diabetes in low- and middle-income countries has intensified the need for effective glucose monitoring and evidence-based management strategies.
In Nigeria, the prevalence of diabetes continues to rise steadily. Oputa and Chinenye (2015) reported that lifestyle changes, urbanization, and demographic shifts have contributed significantly to the increased number of individuals diagnosed with the condition. These authors asserted that limited access to healthcare, inadequate awareness, and varying socio-economic conditions further complicate the ability of patients to manage their blood glucose levels effectively. Similarly, Uloko et al. (2018) stated that many diabetic patients in Nigeria present late to health facilities, often already experiencing severe complications due to prolonged periods of poor glucose regulation.
Blood glucose monitoring plays a central role in diabetes management, as it enables clinicians to evaluate treatment response, adjust therapy, and detect abnormal glucose fluctuations early. According to Ogbonna and Ezeani (2019), regular monitoring is essential for preventing acute and chronic complications and for improving overall patient outcomes. However, the authors affirmed that many patients in Nigeria still struggle with consistent monitoring due to economic constraints, limited access to glucometers, and inadequate diabetes education.
In clinical settings such as Eko Hospital, Lagos, the need for accurate evaluation of blood glucose among diabetic patients is particularly important. The hospital manages diverse patient categories, including both newly diagnosed and long-term diabetic individuals. Researchers such as Adejumo and Okunola (2020) contend that variations in patients' adherence to medication, diet, and lifestyle recommendations often result in inconsistent glucose levels, making it necessary for healthcare providers to continually assess and review treatment strategies. Furthermore, challenges related to patient counseling, healthcare workload, and differences in individual metabolic responses have been reported to influence glucose stability among patients receiving care in Nigerian hospitals. This study is set against the backdrop of evaluating blood glucose levels among diabetic patients attending healthcare facilities, with particular reference to Eko Hospital, Lagos.
1.3 Statement of Problems
Investigation revealed that diabetes mellitus is a chronic metabolic disorder characterized by persistent elevation of blood glucose, which is strongly associated with complications such as neuropathy, retinopathy, cardiovascular diseases, and kidney failure (World Health Organization, 2021). Although routine monitoring of blood glucose is essential for effective management, several patients continue to present with unstable or poorly controlled glucose levels upon hospital visits.
Furthermore, healthcare providers face challenges relating to workload, variations in diagnostic approaches, and limited time for individualized patient counseling, which is affecting the overall quality of glucose regulation among diabetic patients. In addition, many diabetic patients experience delays in recognizing symptoms of abnormal glucose levels, leading to late hospital visits and increased risk of complications (Igwe & Nwankwo, 2020). It is against this backdrop that this study seeks to evaluate blood glucose levels among diabetic patients at Eko Hospital, Lagos.
1.4 Aim and Objectives of Study
The aim of this study is to evaluate the blood glucose levels among diabetic patients at Eko Hospital, Lagos. The specific objectives of the study are as follows:
- To determine the pattern of blood glucose levels among diabetic patients at Eko Hospital.
- To identify factors influencing fluctuations in blood glucose levels.
- To assess the effectiveness of existing monitoring practices used in the hospital.
- To examine the relationship between patient adherence and blood glucose control.
- To provide recommendations for improving blood glucose management within the hospital.
1.5 Research Questions
Based on the objectives of this study, the following research questions will guide the investigation:
- What is the pattern of blood glucose levels among diabetic patients at Eko Hospital, Lagos?
- What factors influence fluctuations in blood glucose levels among these patients?
- How effective are the existing blood glucose monitoring practices used in the hospital?
- What is the relationship between patient adherence and blood glucose stability?
- What measures can improve blood glucose evaluation and management at Eko Hospital?
1.6 Research Hypothesis
Based on the stated objectives, the following hypothesis is formulated:
Hypothesis One
- H0: There is no significant relationship between patient adherence and blood glucose stability among diabetic patients at Eko Hospital, Lagos.
- H1: There is a significant relationship between patient adherence and blood glucose stability among diabetic patients at Eko Hospital, Lagos.
1.7 Significance of Study
The outcome of this research will guide healthcare practitioners by offering evidence-based information that will support better clinical decision-making. The research study will assist medical professionals in determining whether existing treatment plans, monitoring strategies, and lifestyle recommendations are achieving desired outcomes or will require adjustment.
Furthermore, the results will promote greater awareness of the importance of consistent glucose monitoring and will encourage individuals to adopt practices that will support stable blood glucose levels. In addition, the study will offer valuable information that will assist patients in understanding how their behavior and treatment adherence will affect their long-term health.
Lastly, researchers and scholars will benefit as the study will add to the growing body of literature on diabetes management in Nigeria. It will create opportunities for future studies and will serve as a reference point for comparisons with other healthcare settings and patient populations.
1.8 Scope of Study
This study focuses on the evaluation of blood glucose levels among diabetic patients receiving care at Eko Hospital, Lagos. The scope covers patient records, clinical assessments, monitoring procedures, and factors influencing glucose stability within the hospital's outpatient and inpatient diabetes management units. The study is confined to Eko Hospital due to its structured diabetes care program, availability of diagnostic equipment, and diverse patient population.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The study was conducted within a limited period, which affected the sample size and depth of analysis.
- Financial Constraint: The research was conducted within a tight budget, which restricted the number of organizations that could be included and the level of resources available for extensive data analysis.
- Delay from Respondents: Many participants were slow to respond to surveys and interview requests, resulting in gaps in the data and extended timelines. This delay impacted the ability to gather data from all targeted organizations, which could have provided more diverse insights into the internal control systems in place.
1.10 Definition of Terms
Blood Glucose:
Blood glucose refers to the concentration of sugar present in the bloodstream, which serves as the body's primary source of energy. According to the American Diabetes Association (2022), maintaining stable blood glucose is essential for normal metabolic functioning.
Glucose Monitoring:
Glucose monitoring refers to the process of measuring blood sugar levels to guide treatment decisions. Ogbonna and Ezeani (2019) affirmed that regular monitoring is crucial for effective diabetes management.
Diabetes Mellitus:
Diabetes mellitus is a chronic metabolic disorder characterized by prolonged high blood glucose levels resulting from inadequate insulin production or ineffective insulin use. World Health Organization (2021) stated that diabetes is one of the fastest-growing global health challenges.
Hyperglycemia:
Hyperglycemia describes a state in which blood glucose levels rise above normal. Ginsberg (2009) asserted that persistent hyperglycemia is associated with long-term complications such as nerve damage and cardiovascular disease.
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