CHAPTER ONE:

INTRODUCTION

1.1 Background

Type 2 diabetes is associated with substantial increases in the risk of vascular morbidities, such as coronary heart disease and stroke as well as health complications ranging from kidney failure, limb loss and blindness. Alongside established lifestyle factors, such as smoking, adiposity, and diet. Alcohol consumption is also thought to play a role in the development of type 2 diabetes [1]. Alcohol has been consumed as part of rituals and religious occasions but also as a safe, nutritious, and healthy beverage, as it has antimicrobial properties and contains calories. However, alcohol is a toxic substance; it is not produced by the body and is poisonous in high concentrations [2]. DM is a life-threatening disease. Its global prevalence is on the rise. It is a major cause of blindness, heart attacks, kidney failure, stroke and lower limb amputation. T2DM can be prevented or delayed by a healthy diet, maintaining normal body weight, regular physical activity and avoiding alcohol. Type 2 Diabetes mellitus (T2DM), non-insulin-dependent Diabetes mellitus, or adult-onset diabetes, account for about 90% (285million people), and this number is projected to grow to 438 million by 2030 [3]. In 2010, the International Diabetes Federation estimated the global prevalence of Diabetes mellitus at 6·6 % in adults (age range 20–79 years). Diabetes is now one of the most common non-communicable diseases in the world and a major cause of premature illness and death in most countries. To prevent diabetic complications and premature mortality, patients are recommended to adopt a healthy lifestyle as part of their self-management strategy. Alcohol is equally seen to be a predisposing factor to obesity which brings about insulin resistance which is the main etiology of DM [4]. According to the International Diabetes Federation, 537 million adults have been clinically diagnosed with T2DM. Increased Alcohol intake has been shown to be positively correlated with in an increased incidence of T2DM. Heavy alcohol drinking causes diabetes by increasing caloric intake and obesity, which disrupts carbohydrate and glucose metabolism [5]. The majority studies revealed that moderate alcohol consumption was associated with decrease in the risk of diabetes, whereas high alcohol intake was associated with a higher risk [6,7]. Diabetes mellitus is further characterized by a chronic hyperglycemia occurring when the human organism cannot produce enough insulin and/or cannot use it properly [8]. Alcohol consumption can worsen diabetes-related medical complications, such as disturbances in fat metabolism, nerve damage, and eye disease [9]. DM and its complications are a major cause of morbidity and mortality in developing countries. Successful management of DM requires that we understand the beliefs, lifestyles, attitudes, family and social networks of the patients being treated [10]. Moreover, overweight adults are more likely to experience problems, including higher morbidity and mortality [11]. Chronic hyperglycemia of Diabetes mellitus is associated with continuing damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, lungs and blood vessels. Diabetes mellitus is an incurable life-long disease, involving multiple systems, and with devastating complications which end up in severe disability and death. Diabetes mellitus is associated with the ongoing malfunction of various organs and its complications are mainly a consequence of macro-vascular and micro-vascular damage [12]. Chronic use of alcohol is considered to be a potential risk factor for the incidence of type 2 Diabetes mellitus (T2DM), which causes insulin resistance and pancreatic β-cell dysfunction that is a prerequisite for the development of diabetes. Diabetes, especially T2DM, causes deregulation of various metabolic processes, which includes a defect in the insulin-mediated glucose function of adipocytes, and an impaired insulin action in the liver [13].

1.2. Problem statement

DM is associated with substantial increase in the risk of vascular morbidities such as stroke and it serves to be one of the most threatening communicable diseases. It also serves as a leading factor of death and serves as a predisposing factor to other diseases such as kidney problems, hypertension, blindness etc. However, it appears that alcohol is still consumed in much quantity despite its stated implications. Understanding the high risk of developing this disease will help reduce the rampancy of it. There is therefore, the need to provide effective measures and strategies in mitigating these risk factors. Despite all measures taken to reduce the occurrence of DM in alcohol consumers, it still serves as a threat to both the present and future population. This study therefore aims at investigating the occurrence and associated factors of Diabetes mellitus in alcohol consumers.

1.3. Rationale for study

Diabetes mellitus is a chronic metabolic disorder that affects millions of people worldwide. It is characterized by high blood sugar levels, which can lead to serious health complications if untreated. While diabetes can occur in anyone, regardless of gender or age it is more common in certain groups such as those with family history of diabetes, and obese individuals. The pancreas contains beta cells of the islets of Langerhans that produce insulin which converts extra glucose into glucagon for storage in the muscles. When affected by excessive alcohol consumption, these cells produce insufficient amounts of insulin thereby increasing the blood glucose concentrations in consumers of alcohol. These high concentrations lead to hyperglycemia and then Diabetes mellitus in due time if not controlled. Studies have equally shown that, heavy drinking can lead to insulin resistance, which is a key factor in the development of DM. Understanding the specific risk factors for diabetes among consumers of alcohol can help inform prevention and treatment strategies for this condition.

This study will provide valuable information on the prevalence and risk factors for DM among a large, diverse population of people who consume alcohol regularly. This study will equally provide valuable insights to mechanisms underlying the relationship between Alcohol consumption and diabetes.

1.4. Research questions

-What is the prevalence of diabetes mellitus in consumers of alcohol in Bambili locality?

1.5. Research hypothesis

Null hypothesis: Consumers of alcohol are not exposed to diabetes mellitus

Alternative hypothesis: Consumers of alcohol are exposed to diabetes mellitus

What are the associated factors of diabetes mellitus in consumers of alcohol in Bambili locality?

1.6. Objectives

1.6.1. Main objective

The main objective of this research is to determine the prevalence and associated factors of Diabetes mellitus in consumers of alcohol in Bambili locality.

1.6.2. Specific objectives

-To determine the prevalence of Diabetes mellitus in consumers of alcohol in Bambili locality

-To investigate the factors associated with Diabetes mellitus in alcohol consumers in Bambili locality.