Compared to autotools, you'll notice that there's no well-established workflow for compile-time feature detection (which headers are installed etc) - the easiest option, if you're keeping the C code, might actually be to let autotools and friends do its job, compile the code to a static library and then import that.
If your project is small, using nim itself without extras might be enough - see for example https://github.com/arnetheduck/nim-sqlite3-abi which uses {.compile.} directives which ends up being a crude build system of its own.