Abstract Body: Background:
Diabetes mellitus is a leading global cause of cardiovascular morbidity and mortality, with a rising burden in low- and middle-income countries. Although its prevalence is increasing in Nigeria, data on the burden and determinants of diabetes in riverine and semi-urban populations of the South-South region remain limited.

Objective:
To determine the prevalence and predictors of diabetes mellitus in a semi-urban riverine community in southern Nigeria.

Methods:
A descriptive cross-sectional study was conducted among 1,077 adults in Borokiri, Rivers State, over a two-week period in August 2024. Sociodemographic information, anthropometric indices, and blood glucose levels were collected using standardized procedures. Diabetes mellitus was determined based on fasting blood glucose ≥ 7.0 mmol/L (≥ 126 mg/dL) or a prior diagnosis of diabetes mellitus. Data were analyzed with SPSS version 26. Chi-square tests examined associations between glycemic status and independent variables such as family history of diabetes, age, obesity, and hypertension. Binary logistic regression identified significant predictors of diabetes mellitus.

Results:
A total of 1,077 adults participated in the study, with a mean age of 43.6 ± 15.4 years; 823 (76.4%) were female. The prevalence of diabetes mellitus was 7.8% (n = 84). Diabetes occurred more frequently in females (8.3%) than males (6.3%) (p = 0.308). 46.0% (496) were classified as obese using BMI, and abdominal obesity was 53.9% (n = 581) by WC and 51.8% (n = 558) by WHR. Diabetes was significantly associated with older age (p < 0.005), family history of diabetes (p < 0.005), hypertension (p < 0.005), and central obesity (p < 0.005). Independent predictors included older age (aOR = 3.59; 95% CI: 1.750–7.370; p < 0.005), family history of diabetes (aOR = 2.94; 95% CI: 1.603–5.395; p < 0.005), central obesity (aOR = 1.93; 95% CI: 1.144–3.255; p = 0.014), and hypertension (aOR = 3.64; 95% CI: 2.103–6.296; p < 0.005).

Conclusion:
Diabetes mellitus was observed in 7.8% of adults in this community, highlighting the need for culturally appropriate health education, lifestyle modification programs, and improved access to affordable diagnostic and treatment services. Strengthening community-based preventive strategies and integrating routine diabetes screening at the primary-care level are essential to address the growing cardiometabolic disease burden in resource-limited settings.