Project – Relationship Between Lifestyle Behaviours and Risk Factors of Diabetes Mellitus Among Civil Servants in Ikeja Local Government Area, Lagos State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Diabetes mellitus has become one of the most pressing global public health challenges due to its increasing prevalence, chronic nature, and significant contribution to morbidity, mortality, and healthcare costs. Diabetes mellitus is a metabolic disorder characterized by elevated blood glucose levels resulting from defects in insulin secretion, insulin action, or both. Persistent hyperglycaemia associated with uncontrolled diabetes can damage major body systems, particularly the cardiovascular system, kidneys, eyes, nerves, and blood vessels, leading to complications such as heart disease, kidney failure, blindness, and lower-limb amputation (World Health Organization [WHO], 2024).

The global burden of diabetes has increased substantially over recent decades. The World Health Organization reported that the number of adults living with diabetes increased from about 200 million in 1990 to approximately 830 million in 2022, with the greatest increase occurring in low- and middle-income countries where health systems often face challenges in prevention, early detection, and management (WHO, 2024). This increasing burden has been associated with population growth, ageing, urbanization, dietary changes, reduced physical activity, increasing obesity rates, and changing lifestyles.

Among the different types of diabetes, type 2 diabetes mellitus accounts for the majority of diabetes cases worldwide and is strongly associated with lifestyle-related factors. Unlike type 1 diabetes, which is mainly caused by autoimmune destruction of pancreatic beta cells, type 2 diabetes develops through complex interactions between genetic susceptibility, environmental exposure, and behavioural factors (American Diabetes Association [ADA], 2023). Lifestyle behaviours such as unhealthy diet, physical inactivity, excessive alcohol consumption, tobacco use, and obesity are recognized as major contributors to the development of type 2 diabetes (ADA, 2023).

Lifestyle behaviour refers to the patterns of actions, habits, and choices individuals make in their daily lives that influence health outcomes. These behaviours include dietary practices, physical activity, alcohol consumption, smoking habits, sleep patterns, stress management, and healthcare-seeking practices. Evidence indicates that healthy lifestyle modifications, including maintaining a healthy body weight, engaging in regular physical activity, consuming balanced diets, and avoiding tobacco use, can significantly reduce the risk of developing type 2 diabetes (WHO, 2024).

Dietary behaviour is one of the most important lifestyle determinants of diabetes risk. The increasing consumption of energy-dense foods, refined carbohydrates, processed foods, and sugar-sweetened beverages has contributed to rising levels of obesity and metabolic disorders globally. Poor dietary patterns may result in excessive calorie intake, increased body fat accumulation, insulin resistance, and impaired glucose regulation (Ley et al., 2014). In developing countries, including Nigeria, rapid urbanization has influenced traditional food practices, leading to greater dependence on processed foods and reduced consumption of fruits, vegetables, and fibre-rich diets.

Physical inactivity is another major lifestyle risk factor associated with diabetes mellitus. Regular physical activity improves insulin sensitivity, assists in maintaining healthy body weight, and reduces the likelihood of metabolic abnormalities. However, modern occupational and social environments have encouraged sedentary behaviours, including prolonged sitting, reduced workplace movement, and dependence on motorized transportation (WHO, 2022). Individuals engaged in office-based occupations may be particularly vulnerable because their daily activities often involve extended periods of sitting with limited opportunities for exercise.

The workplace environment significantly influences lifestyle behaviours and health outcomes. Civil servants, who often perform administrative and desk-based duties, may experience increased exposure to sedentary lifestyles, occupational stress, irregular eating patterns, and limited physical activity opportunities. Prolonged sedentary behaviour has been associated with increased risk of obesity, cardiovascular diseases, and type 2 diabetes (WHO, 2022). Therefore, government employees represent an important occupational group for assessing lifestyle behaviours associated with diabetes risk.

Occupational stress among civil servants may further contribute to unhealthy lifestyle patterns. Work-related stress can influence eating behaviours, sleep quality, physical activity levels, and coping mechanisms. Some individuals may respond to stress through emotional eating, reduced exercise participation, excessive alcohol intake, or other behaviours that increase metabolic risk. Chronic stress may also contribute to hormonal changes that affect glucose metabolism and insulin sensitivity (Kivimäki & Steptoe, 2018).

Obesity remains one of the strongest modifiable risk factors for type 2 diabetes. Excess accumulation of body fat, particularly abdominal obesity, contributes to insulin resistance and impaired glucose control. The increasing prevalence of overweight and obesity globally has occurred alongside the rise in diabetes cases, highlighting the close relationship between body weight, lifestyle behaviour, and metabolic health (WHO, 2024).

Nigeria is currently experiencing an increasing burden of diabetes mellitus due to demographic changes, urbanization, lifestyle transitions, and inadequate preventive practices. Although infectious diseases remain important public health concerns, non-communicable diseases such as diabetes are becoming increasingly significant. A systematic review and meta-analysis by Olamoyegun et al. (2024) found that diabetes prevalence in Nigeria has increased considerably, with important associated risk factors including obesity, increasing age, family history, unhealthy dietary habits, and physical inactivity.

Earlier evidence also demonstrated that diabetes prevalence varies across Nigerian regions and is associated with urban residence, unhealthy dietary patterns, obesity, and sedentary lifestyles. Uloko et al. (2018) reported that diabetes prevalence in Nigeria was influenced by factors such as physical inactivity, obesity, older age, and unhealthy lifestyle behaviours. These findings indicate that lifestyle modification remains a critical strategy for preventing diabetes among Nigerian adults.

Urbanization has significantly influenced lifestyle patterns in Nigeria. Urban residents increasingly experience changes in food consumption, transportation habits, occupational activities, and recreational behaviours. Lagos State, as Nigeria’s largest commercial and urban centre, represents an environment where these lifestyle transitions are highly evident. Increased availability of fast foods, sedentary employment structures, traffic-related inactivity, and demanding work schedules may contribute to increased exposure to diabetes risk factors.

Ikeja Local Government Area provides a suitable setting for assessing lifestyle behaviours and diabetes risk among civil servants because it serves as the administrative and economic centre of Lagos State. The area accommodates several government institutions, offices, and public sector workers whose occupational activities are largely sedentary. Civil servants within this environment may experience lifestyle challenges associated with office work, occupational pressure, and limited opportunities for maintaining healthy routines.

The consequences of diabetes among civil servants extend beyond individual health outcomes. Diabetes-related complications may contribute to increased healthcare expenditure, absenteeism, reduced productivity, early retirement, and decreased quality of life. Preventive workplace health programmes targeting lifestyle modification, regular screening, nutrition education, and physical activity promotion may reduce diabetes risk among government employees.

Despite increased awareness of diabetes, many adults remain unaware of their personal risk factors or fail to adopt preventive lifestyle behaviours. Some individuals continue to engage in unhealthy dietary practices, physical inactivity, and other behaviours that increase diabetes susceptibility. This situation highlights the importance of assessing lifestyle patterns and identifying specific risk factors within occupational populations.

Although previous studies have examined diabetes prevalence and risk factors among Nigerian adults, limited attention has been given specifically to civil servants in Ikeja Local Government Area, Lagos State. Understanding how lifestyle behaviours relate to diabetes risk factors among this population is necessary for developing targeted workplace interventions and strengthening diabetes prevention strategies.

Therefore, this study seeks to examine the relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area, Lagos State. The findings will provide evidence for promoting healthier workplace practices, improving diabetes awareness, and supporting preventive healthcare interventions among government employees.

1.2 Statement of the Problem

Diabetes mellitus has become an increasing public health challenge in Nigeria due to the growing influence of lifestyle-related risk factors, particularly among urban working populations. Although diabetes prevention and control strategies have improved globally, the disease continues to affect a large proportion of adults, with many cases remaining undiagnosed until complications occur. The increasing prevalence of diabetes has been linked to changing lifestyles characterized by unhealthy dietary habits, physical inactivity, obesity, prolonged sedentary behaviour, and other modifiable behavioural factors (World Health Organization [WHO], 2024).

The workplace environment has an important influence on the health behaviours of adults. Civil servants represent a population group that may be particularly exposed to diabetes risk factors because of the sedentary nature of many administrative jobs. Many government employees spend several hours daily sitting at desks, attending meetings, and performing computer-based tasks, resulting in reduced physical activity levels. Prolonged sedentary behaviour has been associated with increased risks of obesity, insulin resistance, cardiovascular diseases, and type 2 diabetes mellitus (WHO, 2022).

Furthermore, the increasing demands of modern employment may contribute to unhealthy lifestyle choices among civil servants. Work-related stress, long commuting hours, limited time for exercise, irregular meal patterns, and reliance on convenience foods may negatively influence health behaviours. Stress-related behaviours such as excessive food consumption, poor dietary choices, and inadequate sleep may increase susceptibility to metabolic disorders, including diabetes mellitus (Kivimäki & Steptoe, 2018).

Despite the known relationship between lifestyle behaviours and diabetes risk, many adults continue to engage in practices that increase their vulnerability to the disease. Poor dietary habits, including frequent consumption of processed foods, sugary drinks, and high-fat meals, remain common in urban settings. Similarly, low participation in physical activity has become increasingly prevalent due to occupational demands and lifestyle changes. These behaviours contribute to weight gain, obesity, and impaired glucose regulation, which are major pathways in the development of type 2 diabetes (Ley et al., 2014).

In Nigeria, the burden of diabetes is increasing alongside rapid urbanization and socioeconomic changes. Urban populations have experienced significant lifestyle transitions, including changes in food preferences, reduced physical activity, increased dependence on motorized transportation, and increased sedentary occupations. Studies have shown that Nigerian adults living in urban environments are increasingly exposed to diabetes risk factors associated with modern lifestyles (Uloko et al., 2018).

Although civil servants are generally considered a stable occupational group with regular access to healthcare information and services, many may still experience inadequate awareness of their personal diabetes risk factors and the importance of preventive lifestyle modifications. Some employees may not undergo regular screening for blood glucose levels, body mass index assessment, or cardiovascular risk evaluation. Consequently, individuals may remain unaware of developing metabolic abnormalities until complications arise.

Ikeja Local Government Area, Lagos State, provides an important context for examining the relationship between lifestyle behaviours and diabetes risk factors among civil servants. As an administrative and commercial centre, Ikeja accommodates a large number of government offices and public sector employees. The nature of work within these institutions is predominantly sedentary, and employees may face challenges associated with maintaining healthy dietary patterns, physical activity routines, and stress management practices.

Despite the growing concern about diabetes among Nigerian adults, there is limited evidence specifically examining how lifestyle behaviours relate to diabetes risk factors among civil servants in Ikeja Local Government Area. Most existing studies have focused on general adult populations, healthcare workers, or community-based samples, leaving insufficient information regarding government employees who may experience unique occupational health challenges.

The absence of adequate information on the lifestyle patterns and diabetes risk status of civil servants creates difficulties in developing targeted workplace health interventions. Without understanding the specific behaviours contributing to diabetes risk among this population, health promotion programmes may fail to address important occupational and behavioural determinants of the disease.

Therefore, there is a need to assess the relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area, Lagos State. This study will provide evidence regarding the influence of dietary practices, physical activity, body weight, and other lifestyle factors on diabetes risk and contribute to the development of effective workplace-based diabetes prevention strategies.

1.3 Aim of the Study

The aim of this study is to examine the relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area, Lagos State.

1.4 Objectives of the Study

The specific objectives of the study are to:

1. Assess the lifestyle behaviours of civil servants in Ikeja Local Government Area, Lagos State.
2. Determine the major risk factors associated with diabetes mellitus among civil servants in the study area.
3. Examine the relationship between dietary practices and diabetes risk factors among civil servants.
4. Assess the influence of physical activity patterns on diabetes risk among civil servants.
5. Determine the relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area.

1.5 Research Questions

The study will answer the following research questions:

1. What are the common lifestyle behaviours practiced by civil servants in Ikeja Local Government Area?
2. What are the major risk factors associated with diabetes mellitus among civil servants?
3. What relationship exists between dietary practices and diabetes risk factors among civil servants?
4. How does physical activity level influence diabetes risk among civil servants?
5. Is there a relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area?

1.6 Research Hypothesis

The following null hypothesis will be tested at a 0.05 level of significance:

H₀: There is no significant relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area, Lagos State.

1.7 Significance of the Study

This study will be significant to civil servants, government authorities, healthcare professionals, policymakers, researchers, and public health practitioners.

Civil Servants

The findings of this study will increase awareness among civil servants regarding the relationship between daily lifestyle behaviours and diabetes risk. Understanding the effects of dietary habits, physical inactivity, obesity, and other risk factors may encourage employees to adopt healthier lifestyles, undergo regular health screening, and engage in preventive practices.

Government Institutions and Employers

The findings will provide useful information for government agencies and employers regarding the health risks faced by civil servants. The evidence generated may support the development of workplace wellness programmes, including health education, physical activity initiatives, nutritional counselling, and routine diabetes screening.

Healthcare Professionals

Healthcare providers may benefit from the findings by gaining insight into the lifestyle-related factors contributing to diabetes risk among civil servants. The study may guide the development of targeted preventive interventions and health promotion strategies for working adults.

Policy Makers

The findings may assist policymakers in strengthening non-communicable disease prevention programmes within occupational settings. Evidence from this study may support policies promoting healthier workplace environments and improved access to preventive healthcare services.

Researchers and Academic Institutions

The study will contribute to existing knowledge on diabetes prevention, lifestyle behaviours, and occupational health in Nigeria. It will serve as a reference source for researchers interested in diabetes risk factors, workplace health promotion, and non-communicable disease prevention.

1.8 Scope of the Study

This study focuses on examining the relationship between lifestyle behaviours and risk factors of diabetes mellitus among civil servants in Ikeja Local Government Area, Lagos State.

The study will assess lifestyle behaviours including dietary practices, physical activity levels, alcohol consumption, smoking practices, stress management, and other health-related behaviours. It will also examine diabetes risk factors such as obesity, family history, age, sedentary behaviour, and lifestyle-related indicators.

The study population will consist of civil servants working within Ikeja Local Government Area. The study will not include private sector workers, unemployed individuals, students, or retirees.

1.9 Operational Definition of Terms

Diabetes Mellitus

A chronic metabolic disease characterized by elevated blood glucose levels resulting from impaired insulin production, insulin action, or both.

Lifestyle Behaviours

Daily habits and practices that influence health outcomes, including dietary habits, physical activity, smoking, alcohol consumption, sleep patterns, and stress management.

Risk Factors

Characteristics, behaviours, or conditions that increase the likelihood of developing diabetes mellitus.

Diabetes Risk Factors

Factors associated with increased likelihood of diabetes development, including obesity, physical inactivity, unhealthy diet, age, family history, and sedentary lifestyle.

Physical Activity

Any body movement produced by skeletal muscles that requires energy expenditure, including exercise, walking, and occupational activities.

Dietary Practices

Patterns of food consumption, including food choices, meal frequency, nutritional quality, and consumption of processed or sugary foods.

Civil Servants

Employees working within government ministries, departments, and agencies who provide administrative and public services.

Workplace Health Promotion

Organized activities and policies designed to improve employees’ health through education, prevention, and supportive workplace environments.

Ikeja Local Government Area

A local government area in Lagos State, Nigeria, serving as the geographical setting for this study.

Project – Relationship Between Lifestyle Behaviours and Risk Factors of Diabetes Mellitus Among Civil Servants in Ikeja Local Government Area, Lagos State