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Effect of Community-Based Blood Sugar Screening on Prediabetes Detection among Adults in Nigeria

Abstract

Prediabetes has become an important public health concern among adults in Nigeria and is characterized by blood glucose levels that are higher than normal but below the diagnostic threshold for diabetes. Although individuals with prediabetes may not experience obvious symptoms, the condition is associated with an increased risk of developing type 2 diabetes and other metabolic and cardiovascular complications. Adults may be at increased risk because of overweight and obesity, physical inactivity, unhealthy dietary practices, family history of diabetes, advancing age, hypertension, and other lifestyle and metabolic factors. Prediabetes may remain undetected when adults do not undergo routine blood glucose assessment, resulting in missed opportunities for early lifestyle intervention and prevention of progression to diabetes. Community-based blood sugar screening provides an opportunity to identify adults with abnormal blood glucose levels through accessible screening activities conducted within communities, primary healthcare centres, outreach programmes, workplaces, markets, and other community platforms. Early detection of prediabetes may facilitate nutritional counselling, physical activity promotion, weight management, regular monitoring, and appropriate referral for further clinical assessment. However, inadequate screening coverage, limited availability of screening equipment, shortage of trained healthcare personnel, low awareness, financial barriers, and weak referral and follow-up systems may limit the effectiveness of community-based blood sugar screening programmes in Nigeria. Against this background, this study investigates the effect of community-based blood sugar screening on prediabetes detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and the Health Systems Framework. The Health Belief Model explains how adults' perceptions of susceptibility to prediabetes and diabetes, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in community-based blood sugar screening. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, and environmental factors on dietary practices, physical activity, healthcare-seeking behaviour, and access to preventive health services. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective community-based screening and chronic disease prevention programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based blood sugar screening may influence prediabetes detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, and eligible adults. Community-based blood sugar screening will be measured using indicators such as availability of screening services, screening coverage, frequency of community screening activities, accessibility of screening locations, number of adults screened, blood glucose testing, availability of trained healthcare personnel, screening equipment, diabetes and healthy lifestyle education, and referral arrangements. Prediabetes detection will be assessed using indicators such as abnormal blood glucose results within the prediabetes range according to the applicable diagnostic criteria, newly identified prediabetes cases, repeat or confirmatory testing where appropriate, referrals for further clinical assessment, and linkage to lifestyle modification, monitoring, or preventive healthcare services. Data will be collected using structured questionnaires, community screening registers, blood glucose testing records, healthcare facility records, referral registers, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, blood glucose findings, and patterns of prediabetes detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based blood sugar screening on prediabetes detection. Where appropriate, prediabetes detection rates before and after implementation of community-based screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based blood sugar screening has a significant positive effect on prediabetes detection among adults in Nigeria. Adults who participate in community-based blood sugar screening are expected to have a higher likelihood of having previously undetected prediabetes identified than adults without access to such services. Systematic blood glucose assessment may facilitate early identification of abnormal glucose levels and provide opportunities for nutritional counselling, physical activity promotion, weight management, health education, regular monitoring, and appropriate clinical referral. Bringing screening services closer to adults may reduce geographical, financial, and time-related barriers and encourage individuals who may not routinely visit healthcare facilities to participate in preventive health assessments. Early identification of prediabetes may also create an opportunity to implement lifestyle interventions aimed at reducing the likelihood of progression to type 2 diabetes. Conversely, inadequate screening coverage, limited testing equipment, shortage of trained healthcare personnel, low awareness, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based blood sugar screening. The study therefore expects accessible and well-organized community-based blood sugar screening to contribute significantly to improved detection and early management of prediabetes among adults in Nigeria. The study is expected to contribute to the literature on community-based blood sugar screening, prediabetes detection, diabetes prevention, adult health, non-communicable disease prevention, metabolic health, community health services, preventive healthcare, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, healthcare providers, community health workers, diabetes prevention programmes, development partners, and policymakers regarding strategies for improving early detection and prevention of prediabetes. The study will also provide evidence-based recommendations for expanding community-based blood sugar screening programmes, improving access to reliable blood glucose testing, strengthening community education on diabetes risk factors and healthy lifestyles, increasing availability of trained healthcare personnel and screening equipment, improving referral and follow-up systems, promoting healthy nutrition and physical activity, and integrating prediabetes screening into community-based non-communicable disease prevention programmes across Nigeria.

Keywords: Community-based blood sugar screening, prediabetes detection, adults, blood glucose screening, prediabetes, diabetes prevention, metabolic health, non-communicable disease prevention, community health services, preventive healthcare, Nigeria, public health.