Key result
Diabetes diagnosis rates are ~31% lower in young Nigerian women versus men across the care cascade.
Why the study?
Diabetes is a growing burden in Nigeria with limited population-level screening and diagnosis, and nationally representative indicators were lacking.
Cross-Sectional
Yes
Absolute Event Rate: 0.9% vs 1.3%
p-value: p=0.004
A nationally representative survey of younger Nigerian adults demonstrates major attrition at every step of the diabetes care cascade, highlighting an urgent need to expand opportunistic screening and improve medication access.
Background Diabetes is a growing noncommunicable disease (NCD) burden in Nigeria, yet population-level screening and diagnosis remain limited. The 2023–24 Nigeria Demographic and Health Survey (NDHS) provides the first nationally representative indicators describing blood sugar screening, diabetes diagnosis, and treatment uptake among adults. We aimed to construct a national diabetes care cascade using NDHS 2023–24 indicators among Nigerian adults aged 15–49, and to compare cascade outcomes across sociodemographic subgroups including sex, age, residence, region, wealth, and education. Methods We conducted a survey-weighted secondary analysis of NDHS 2023–24 individual-level microdata using IBM SPSS Statistics with the Complex Samples module, accounting for the complex sampling design of the NDHS. Key variables included: (1) ever had blood sugar measured, (2) ever diagnosed with diabetes, (3) prescribed medication among those ever diagnosed, and (4) currently taking diabetes medication among all diagnosed adults. All proportions are reported with 95% confidence intervals. Sex differences at each cascade step were formally tested using design-based logistic regression. Results Nationally, 18.6% (95% CI 17.8–19.4) of women and 17.6% (95% CI 16.6–18.6) of men had ever had their blood sugar measured. Diagnosis was extremely low in both sexes (0.9%, 95% CI 0.8–1.1 in women; 1.3%, 95% CI 1.1–1.6 in men). Among those ever diagnosed (women n = 356, men n = 146), 60.4% of women and 55.1% of men were prescribed medication, and 52.5% of women and 39.2% of men were currently taking medication. Sex differences were statistically significant for diagnosis ( p = 0.004) and for current medication use among diagnosed individuals ( p = 0.019), but not for screening ( p = 0.052) or for ever having been prescribed medication ( p = 0.394). Screening and diagnosis were markedly higher in urban areas, southern zones, wealthier households, and among the most educated. Conclusion Nigeria’s diabetes care cascade shows major losses at every stage among adults aged 15–49 years. Sociodemographic disparities in screening were steep and consistent. These findings, which do not capture older adults who bear a substantially higher diabetes burden, highlight the need to expand routine opportunistic screening and strengthen long-term diabetes care within primary healthcare.
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Nwankwo et al. (2026) conducted a cross-sectional in Diabetes. Female sex vs. Male sex was evaluated on Diabetes diagnosis (p=0.004). Among Nigerian adults aged 15-49, diabetes diagnosis was extremely low and differed significantly by sex (0.9% in women vs 1.3% in men, p=0.004), with major losses at every stage of the care cascade.
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