Diabetes Screening, Diagnosis, and Treatment Among Adults Aged 15–49 in Nigeria: A National Analysis of the 2023–2024 Nigeria Demographic and Health Survey (NDHS)

Abstract 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.