The aim of the study was to give the first estimation of the prevalence of diabetes and impaired fasting glucose (IFG) in Ouagadougou and to investigate the factors which are associated with diabetes. During diabetes screening day, held in Ouagadougou in March 2011, all subjects over 20 years old (excluding pregnant women) who gave informed consent were included. Data were collected during face-to-face interviews. For diabetes, hypertension and body mass index (BMI), the participants were divided into categories according to the international standards. For statistical analyses chi-square test and binary logistic regression were used. Four hundred sixty seven subjects with the mean age of 39.1 years were included in the survey. Overall crude diabetes and IFG prevalence were 12.4% and 5.9%, respectively. The prevalence of unknown diabetes was 3.2%. In bivariate analysis, gender, age, hypertension and body mass index (BMI) were the factors associated with diabetes. In multivariate analysis, only gender (p = 0.008), age (P = 0.000) and BMI (p = 0.05) remained independently associated with diabetes. Adequate health care policies should be taken shortly. An important place must be reserved for the prevention of obesity. Therefore, primary prevention through lifestyle modifications may play a critical role in the control of diabetes.

[ABSTRACT]   Full text not available  [PDF]

Data for uptake of the recommended influenza and pneumococcal vaccination in patients with diabetes from developing countries are scarce. The aim of the study was to assess the uptake of influenza and pneumococcal vaccination in patients with diabetes. One thousand and five hundred patients with diabetes were approached; 1100 (685 female, age 5-90 years, median 50 years) consented for participation. Information regarding knowledge, beliefs and practices regarding vaccination was recorded by administering a predefined questionnaire. Only 99 (9%) and 97 (8.8%) of the 1100 patients had received influenza and pneumococcal vaccination respectively in the past 1-5 years. Vaccination rates were higher in males (15.9% versus 4.8% for influenza, p = 0.000 and 16.1% versus 4.5% ; p = 0.000 for Pneumococcus); and in those aged > 65 years (13.1% versus 7.96% , p = 0.017 for influenza; and 13.6% versus 7.6% , p = 0.012 for Pneumococcus). Reasons cited for non-participation included misperceptions about personal risk, vaccine efficacy and safety. Only 4 of the 28 physicians caring for the patients prescribed the vaccines regularly and the vaccination rates in their patients were significantly higher (p = 0.000). Poor vaccination rates in Northern Indian patients with diabetes call for intensive efforts to improve uptake.

[ABSTRACT]   Full text not available  [PDF]

The efficacy and safety of the newer analogue, detemir as the basal insulin is well established in patients with type 1 diabetes in developed countries. There are no reports on its usefulness in the Indian children with type 1 diabetes. Randomized, open label, controlled trial was conducted at Pediatric Diabetes Clinic (PDC) of a tertiary care hospital of North India. Out of 100 children with type 1 diabetes, 50 were randomized to receive insulin detemir while 50 were continued on Neutral Protamine Hagedorn (NPH) insulin. There was no significant difference in HbA1c levels, mean fasting blood glucose and mean blood glucose levels from baseline to the study endpoint between the 2 groups. Significantly more patients suffered at least one hypoglycemic episode in the NPH group as compared to detemir group. The mean monthly episodes (as well as mean total episodes) of all types of hypoglycemia were significantly less in detemir group at all-time points in the study. There was no significant change in body mass index within the 2 study groups as well as in comparison over the period of 6 months. The efficacy of insulin detemir on glycemic control was similar to insulin NPH. However, hypoglycemic events were significantly less with insulin detemir as compared to NPH insulin.

[ABSTRACT]   Full text not available  [PDF]

A 58 year old male patient with type 2 diabetes and systemic hypertension presented with complaints of severe pruritic lesions all over the body; sparing face, palms, soles and mucosae. After control of diabetes, the skin lesions started to heal. By 8 weeks, the lesions had completely healed leaving behind hyperpigmented new lesions and the size of the existing lesions increased whenever his blood glucose levels were high. The patient also had renal insufficiency and significant proteinuria. He also had coronary artery disease (CAD) and New York Heart Association (NYHA) Class IV cardiac failure. Patient responded well to topical anti-inflammatory salicylic acid. The case is of interest as with better glycemic control, the skin lesions healed, leaving behind hyperpigmented scars.

[ABSTRACT]   Full text not available  [PDF]

An imbalance in adipocytokines is reported in several diseases. The aim of the study was to assess the status of serum adipocytokines (notably leptin and adiponectin) in patients with type 2 diabetes presented with pre-metabolic or metabolic syndrome. This cross-sectional study was conducted in the Department of Pharmacology, College of Medicine in cooperation with department of Biology, College of Science at Al-Mustansiriya University in Baghdad, Iraq. A total of 78 patients with type 2 diabetes with pre-metabolic syndrome (n = 12) and metabolic syndrome (n = 66) of both genders were enrolled in the study. Data related to the components of metabolic syndrome including anthropometric measurements, blood pressure and fasting serum lipid profile were collected. Serum adiponectin and leptin were determined using the enzyme linked immunosorbent assay (ELISA). In patients with type 2 diabetes the levels of several components of metabolic syndrome were significantly higher than those with pre-metabolic syndrome. Although numerically higher levels of serum adiponectin and leptin levels were observed in subjects with metabolic syndrome (2.479 ± 0.321 pg/ml and 171.44 ± 29.57 pg/ml respectively) compared to pre-metabolic syndrome (2.096 ± 0.327 pg/ml and 148.23 ± 48.88 pg/ml respectively), the difference was not statistically significant. Multivariate analysis revealed non-significant correlation between serum levels of adipocytokines and all components of metabolic syndrome. Non-significant inverse correlations were observed between serum leptin and adiponectin in pre-metabolic (r = - 0.225) and metabolic (r = - 0.148) syndromes. Low serum adiponectin and leptin levels are associated with pre-metabolic syndrome compared to metabolic syndrome and these biomarkers are not good to discriminate between pre-metabolic and metabolic syndrome in patients with type 2 diabetes.

[ABSTRACT]   Full text not available  [PDF]

Metformin-associated lactic acidosis (MLA) is a rare but fatal complication. Data reveal that the incidence of MLA is less than 5.1 cases per 100,000 patient years with the mortality rate of 30-50%. The aim of the study was to determine the incidence of MLA in patients with diabetes admitted in our hospital and to identify the predisposing medical conditions, prognostic factors and outcome of these patients. We also compared our results with previously published data to identify specific features of MLA and formulate recommendations regarding our population. Retrospective analysis of all cases of lactic acidosis admitted in our hospital between 2006 and 2010 was done. Lactic acidosis (LA) was defined by serum pH < 7.35 and serum lactate ≥ 4 mmol/l. Eleven cases of MLA (4.35% of the total cases of acidosis) were observed. The average age was 71.0 ΁ 12.9 years. Mean dosage was 2000 mg/day. The cause was identified as an acute gastrointestinal event with dehydration and hypovolemia in 54.55% and decompensated heart failure was the second most frequent cause (18.18%); one patient had decompensated chronic obstructive pulmonary disease (COPD) with respiratory failure, one had a urinary tract infection and one patient had chronic kidney disease (CKD) stage 4/5. Average serum creatinine on admission was 456.65 μmol/l. Seven patients needed hemodialysis, one did not regain renal function and one patient died. The incidence of MLA is increasing due to increased Metformin prescription in the increasing population of patients with type 2 diabetes and associated co-morbidities. It is important to be aware of this complication, identify people at risk and manage the drug dosage or withhold it according to renal function and other co-morbidities. Because this complication is often precipitated by an acute event or decompensation of a chronic condition, it is essential to inform patients to stop their treatment in such situations.

[ABSTRACT]   Full text not available  [PDF]