This document outlines a study on the prevalence and associated factors of diabetes mellitus among adults in Burao General Hospital, Somaliland in 2021. The study will use a cross-sectional design to collect data from 384 adult patients using systematic random sampling. Variables like age, marital status, education level and income will be assessed for their association with diabetes prevalence. Data will be collected using questionnaires and blood sugar testing, then analyzed using SPSS. Results will be disseminated to relevant health organizations to inform diabetes prevention and treatment.

1. Prevalence and associated factors with Diabetes mellitus among adults in
Burao General Hospital 2021

2. • Student name
• Aweil duale mohomed
• Said elemi Ahmed
• abdikani mohomed Abdi Kareem
• sharmaarke Mohamud Ahmed

3. 1. Introduction
1.1 Background
• Diabetes mellitus is a clinical syndrome characterized by an increase in
plasma blood glucose (hyperglycemia). Diabetes has many causes but is
most commonly due to type 1 or type 2 diabetes. Type 1 diabetes is
caused by autoimmune destruction of insulin-producing cells (β cells) in
the pancreas, resulting in absolute insulin deficiency, whereas type 2
diabetes is characterized by resistance to the action of insulin and an
inability to produce sufficient insulin to overcome this ‘insulin
resistance’. Hyperglycemia results in both acute and long-term
problems. Acutely, high glucose and lack of insulin can result in marked
symptoms, metabolic decompensation and hospitalization. Chronic
hyperglycemia is responsible for diabetes-specific ‘microvascular’
complications affecting the eyes kidneys and feet (1)
•

4. • the incidence of diabetes has been raised intensively in many parts of the
world. Globally, an estimated 422 million adults are living with DM,
according to the latest 2016 data from the World Health Organization
(WHO). The number is projected to almost double by 2030. Increases in
the overall diabetes prevalence rates largely reflect an increase in risk
factors for type 2 DM, notably being overweight or obese. In 2010, 12.1
million people were estimated to be living with diabetes in Africa, and
this is projected to increase to 23.9 million by 2030. In Ethiopia, the
prevalence of diabetes was 3.5% in 2011, and the extrapolated
prevalence in 2013 was 4.36%. It is also known that a large number of
people remain undiagnosed, with an estimated number of undiagnosed
cases reported to be 1.39 million people in 2013. (2)

5. • According to the Somaliland there are many risk factors in diabetes
mellitus in the adults in Burao due to the lack good health facility in
Burao which is the second largest and populated town of Somaliland.
However, the prevalence of DM and its risk factors were not been
investigated in Somaliland especially in Burao city. Given this gap in the
literature and the increased burden of non-communicable diseases in the
country, hence the aim of the study was to examine the prevalence of
DM and associated risk factors among adults at Burao city, Somaliland
(5)
•

6. 1.2 Problems statement
• diabetes mellitus affects about 5.9%–14.0% of adults in low and middle-
income countries.10 between 3% and 19% of adults in the high-income
countries11-14 and 0% and 9.1% in low and middle-income African
countries are affected by diabetes15-21(4)
• Hyperglycemia results in both acute and long-term problems. Acutely,
high glucose and lack of insulin can result in marked symptoms,
metabolic decompensation and hospitalization. Chronic hyperglycemia
is responsible for diabetes-specific ‘microvascular’ complications
affecting the eyes, kidneys and feet. (1)

7. • Patients with type 1 diabetes present when progressive β-cell destruction
has crossed a threshold at which adequate insulin secretion and normal
blood glucose levels can no longer be sustained. Above a certain level,
high glucose levels may be toxic to the remaining β cells, so that
profound insulin deficiency rapidly ensues, causing the metabolic
sequelae (6)
• Hyperglycemia leads to glycosuria and dehydration, causing fatigue,
polyuria, nocturia, thirst and polydipsia, susceptibility to urinary and
genital tract infections, and later tachycardia and hypotension.
Unrestrained lipolysis and proteolysis result in weight loss (7)

8. justification of study
• The study will focus on analyzing the prevalence of diabetes mellitus
among adults living in burao general hozpital. Even through the study
will intended for academic purposes and it will confine to a single
district , the finding of the study can contribute profound knowledge and
evidence regarding the causes, effects and prevalence adults DM to
healthy related institutions to develop effective prevention and treatment
mechanisms /method .also the outcomes of the research may offer public
awareness and valuable information about the actual situation,
prevention mechanism and most appropriate treatment mechanism.
Moreover, academically, the study might produce empirical findings that
can be used as a base for other who want to make further investigation in
diabetes researchers

9. 2. Literature review
• The number of people with diabetes rose from 108 million in 1980 to
422 million in 2014. Prevalence has been rising more rapidly in low- and
middle-income countries than in high-income countries.
• The world prevalence of diabetes among adults (aged 20–79 years) will
be 6.4%, affecting 285 million adults, in 2010, and will increase to 7.7%,
and 439 million adults by 2030. Between 2010 and 2030, there will be a
69% increase in numbers of adults with diabetes in developing countries
and a 20% increase in developed countries. (8)
•

10. • 2.2 factors
• Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb
amputation.
• Regular physical activity reduces the risk of diabetes and raised blood glucose, and is an important
contributor to overall energy balance, weight control and obesity prevention – all risk exposures
linked to future diabetes prevalence (16). The global target of a 10% relative reduction in physical
inactivity is therefore strongly associated with the global target of halting the risk in diabetes.
However, the prevalence of physical inactivity globally is of increasing concern. In 2010, the latest
year for which data are available, just under a quarter of all adults aged over 18 years did not meet the
minimum recommendation for physical activity per week and were classified as insufficiently
physically active (16). In all WHO regions and across all country income groups women were less
active than men, with 27% of women and 20% of men classified as insufficiently physically active.
Physical inactivity is alarmingly common among adolescents, with 84% of girls and 78% of boys not
meeting minimum requirements for physical activity for this age. (8)

11. 3. Objectives
• 3.1 Major objective
• to assess prevalence and associated factors in Diabetes mellitus among
adults in Burao General Hospital 2021
•
• 3.2 Specific objectives
• To determine prevalence of diabetes mellitus among adults in burao
General hospital 2021
• To assess the associated factors of diabetic mellitus among adults in
burao general hospital 2021

12. 4. Methods and materials
• 4.1 study area
• Study will be conducted in Burao general hospital; B/G/H/ was
established in 1948 and located in center of Burao. It composed 8 wards.
one ward male medical, ward two male surgical, ward three female
surgical, ward four female medical. Ward five maternal wards, ward six
female medical ward, ward seven pediatric wards, ward eight
stabilization center. It has TB department, pharmacy and medical
laboratory area.
• 4.2 Study period
• The study period will conduct from 1 may up to 20 may 2022

13. • 4.3 study design
• An institutional based cross –section study will be used
• 4.4 population
• 4.4.1 Source of population
• All adults people at Burao general hospital
• 4.4.2 Study population
• All adult people attending at OPD at Burao general hospital
• 4.4.3 Selection criteria
• 4.4.3.1Inclusion criteria
• All adults people available in the OPD during data collection
• All adult people in the OPD who are willing to participate in the study
• 4.4.3.2Exclusion criteria
• Adult’s people who can’t participate due to illness

14. 4.5 Sample size determination
• The sample size is calculated using single population proportion formula
• Assumptions: with the assumptions of confidence interval =95%. Critical value
Z𝜎/2 = 1.96. degree of precision d =0.05 the proportion (P) = 50% got from previous
research about same with the study title done in the Ethiopia as this study concerning
prevalence diabetes mellitus in adult’s people.
• Where N= the required sample size
• Z 𝜎2 = the standardized normal distribution curve value for the 95% confidence
interval (1.96)
• P = the level of prevalence diabetes mellitus in adults’ people 50%
• D= degree of precision (the margin of error between the sample and population 5%)
= 0.05

15. •
•
•
•
•
• Hence, n = (1.96)2 (0.5) (0.5)
• (0.05)2
• N= (3.8416) (0.5) (0.5)
• N= (0.9604 / 0.0025)
• N= 384

16. • 4.6 Sampling technique
• Systematic random sampling method will use to select the participants of the study
• 4.7 Variables
• 4.7.1 Dependent variable:
• prevalence of diabetes mellitus
• 4.7.2 Independent variables
• Socio demographic level
• Age
• Marital status
• Educational status
• Income
• Occupation

17. • 4.9 Date collection procedure
• Structured questionnaire and glucometer to test the level of blood sugar
were used to collect the data from the participants in the study
• 4.10. Date Quality control
• Training will give to date collectors and pretesting of the questionnaire
will be done before the actual data collection of the study during date
collection period supervision shall performed, missing data was
regularly being checked and careful data will done
•

18. • 4.11. Data analysis
• Data will be termed and checked using SPSS version 21. Descriptive analysis (frequency distribution,
proportion and mean) were performed to summarize the characteristics of the study subjects,
diabetes and associated factors. Data will analyze and results will present in tables, graphs and texts.
• Ethical consideration
• Permission to carry out will obtained from Alpha university department of health science. Data is then
collected respecting the rights of the Burao general hospital and avoiding by writing names on study
tool. No names were used or indicated on the checklist. The process of research will a minefield of
ethical and legal issues, Consent from will obtained from the participants of the study and will ensure
confidentiality of the participants
• 4.13. Dissemination of the results
• The findings of the study will be presented at Alpha University, department of health science. It will
also be disseminated to the concerned bodies such as Togdheer regional health office and Somaliland
ministry of health. Efforts shall be made to will it published in reputable journal.
•