Prevalence and associated factors of diabetic nephropathy at Tikur Anbessa Comprehensive Specialized University Hospital, Addis Ababa, Ethiopia

Introduction: Given the global prevalence of diabetes, diabetic nephropathy and its consequences are among the major causes of morbidity and mortality in diabetic populations. However, the prevalence and determinants of diabetic nephropathy in Ethiopia are little studied, and were the main objectives of this study. Methods: A cross-sectional study design was followed among 340 randomly selected diabetic patients attending the national diabetes referral clinics at the diabetes centre of Tikur Anbessa Specialized Hospital, Addis Ababa, using an interviewer-administered structured questionnaire. A total of 340 patients were involved, of whom 200 (59%) were females and 256 (75%) had type 2 diabetes mellitus. Urine and blood samples were drawn from the study population and the corresponding biochemical analyses were conducted at the Ethiopian Public Health Research Institute. Results: The mean age of the participants was 51.6 years (range 18–94 years). The median duration of their diabetes was 11 years (range 1–40 years). Forty-eight pecent of the patients were hypertensive. Only half of the hypertensive cases (53%) were using angiotensin-converting enzyme inhibitors, either alone or in combination with other antihypertensive medicines. Eighty-two percent of the participants had poorly controlled diabetes, with glycated haemoglobin >7%. None was using Sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide agonists. Some (109, 32%) of the participants were diagnosed with diabetic nephropathy in addition to reduced estimated glomerular filtration rate and albuminuria. Age, dyslipidaemia, educational status, presence of diabetic retinopathy, and elevated triglyceride levels were found to be significant predictors of the condition (P < 0.05). Conclusions: Diabetic nephropathy was present in nearly one-third of the diabetics in the study population. The management of diabetes with renoprotective agents, such as renin–angiotensin–aldosterone system inhibitors and SGLT2 inhibitors, are likely to be very important in this context

Clopidogrel-induced non-diabetic hypoglycemia reported from Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a case report

Abstract Background Recurrent episodes of hypoglycemia may be caused by several factors, including drugs, critical illnesses, hormonal deficiency, non-islet cell tumor endogenous hyperinsulinism, and accidental, surreptitious, or malicious hypoglycemia. Multiple drugs have been previously reported as causes of hypoglycemia, with moderate and low-quality evidence. However, Clopidogrel as a cause of non-diabetic hypoglycemia is rarely reported. Here we describe a single non-diabetic patient who experienced recurrent episodes of hypoglycemia after initiation of clopidogrel for clinical suspicion of acute coronary syndrome. Case presentation The patient, a 33-year-old Ethiopian male with documented hypertension on antihypertensive medication, has started receiving treatment for acute coronary syndrome after experiencing angina symptoms. He experienced hypoglycemia following the start of Clopidogrel, but it subsided once it was stopped. Currently, he has a follow-up at the cardiac clinic with a normal measurement of his serum blood glucose level. Conclusion Non-diabetic hypoglycemia is a rare illness characterized by low blood glucose levels in people who do not have diabetes. Patients with severe hypoglycemia may become unconscious or have seizures as a result of low blood sugar. Severe hypoglycemia is fatal and must be treated as soon as possible. Therefore, if non-diabetic hypoglycemia occurs, a thorough evaluation of the causes is essential, particularly any potential drug as a cause of hypoglycemia should be evaluated

A 14-year-old male patient with diagnosis of Prader–Willi syndrome in Ethiopia: a case report

Abstract Background Prader–Willi syndrome is a complex multisystem disorder due to the absent expression of paternally active genes in the Prader–Willi syndrome-critical region on chromosome 15 (15q11.2-q13). The main clinical features are hyperphagia (which frequently results in early-onset obesity), hypogonadism, developmental delays, typical behaviors (such as obsessive–compulsive tendencies, tantrums, perseveration, insistence on sameness, and rigidity), and distinctive facial features. In infants, the most prominent findings are hypotonia and feeding difficulties. Case presentation This paper highlights a case of a 14 year old male patient of an Ethiopian ethnicity with diagnosis of Prader–Willi syndrome, which is first report in Ethiopia. He presented with progressive excessive weight gain, insatiable appetite, clinical and laboratory features of hypogonadism, ophthalmological refractory error, and facial features of Prader–Willi syndrome, which was further confirmed by genetic analysis. He is currently on lifestyle intervention, testosterone replacement, and treatment for vitamin D deficiency. Conclusion Prader–Willi syndrome should be considered in a child who presents with progressive weight gain and other typical clinical features such as cognitive impairment, excessive insatiable eating, or hypothalamic hypogonadism. Early lifestyle intervention may help to reduce excessive weight gain. To our knowledge, this is the first case reported in Ethiopia