Characterization of lipid parameters in diabetes mellitus – a Nigerian report

<p>Abstract</p> <p>Background</p> <p>Diabetes mellitus (DM) is a disorder that is often associated with cardiovascular events and underlying lipid abnormalities. Cardiovascular complications are common causes of DM deaths in Nigeria yet dyslipidaemia is one aspect of DM that is underdiagnosed and undertreated in our patients. This report seeks to determine the prevalence and pattern of lipid abnormalities in Nigerians with types I and 2 DM.</p> <p>Methods</p> <p>A total of 600 patients with DM aged between 22 – 79 years were evaluated for lipid abnormalities. The anthropometric indices, glycosylated haemoglobin, pattern of DM treatment and co-morbidities were noted. Total cholesterol (TCHOL), triglyceride (TG), high density lipoproteins (HDL-C), low density lipoproteins cholesterol (LDL-C) levels and the atherogenic indices levels were documented. Test statistic used included student's t test and χ².</p> <p>Results</p> <p>Well over half (89%) of the study subjects had lipid abnormalities and there was no statistically significant difference in the proportions of subjects with type 1 and 2 DM with lipid abnormalities. Elevated LDL-C, TCHOL, TG and reduced HDL-C were noted in 74%, 42%, 13%, and 53% respectively of the study subjects. The commonly noted combined lipid abnormalities were elevated TG and reduced HDL-C. Hypertension, significant histories of smoking and alcohol ingestion were found to be potential determinants of the occurrence of dyslipidaemia. Age, sex, type of DM and anthropometric indices were found to be determinants of the the pattern of dyslipidaemia. Only a small proportion – (8%)-of the subjects with dyslipidaemia were on treatment for it.</p> <p>Conclusion</p> <p>Having defined the scope of dyslipidaemia in our patients and also highlighting its gross undertreatment, we hope that our data will help sensitize health care practitioners on screening for and treating dyslipidaemia. Elevated LDL-C and reduced HDL-C should be the primary targets of treatment in our patients with dyslipidaemia.</p

Dyslipidaemia as a risk factor in the occurrence of stroke in Nigeria: prevalence and patterns

Introduction: stroke is a major public health problem worldwide. Hypertension, diabetes mellitus, dyslipidaemia and smoking are some of the common modifiable risk factors in the occurrence of stroke. Therefore, this study was designed to assess the prevalence and patterns of dyslipidaemia among individuals with acute stroke. Methods: this is a retrospective descriptive cross-sectional study, carried out in the Departments of Medicine at the LAUTECH Teaching hospital, Ogbomoso and General Hospital, Orile-Agege, Lagos, South-West, Nigeria, over a 18-month period between September 2012 and February 2014. One hundred and six (106) patients with acute stroke confirmed with computed tomography (CT) brain scan were recruited. Clinical features, risk factors, lipid profiles and stroke patterns were identified. Results: mean age was significantly higher in ischaemiac stroke compared to haemorrhagic (64.08±10.87 Vs, 56.21±12.38years, p=0.001). There was slight male preponderance in both stroke types (1.3:1). Out of 106 patients, 65 (61.3%) had ischaemic stroke, 38 (35.8%) haemorrhagic and 3 (2.9%) with subarachnoid haemorrhage. Dyslipidaemia is the most frequent risk factor (85.9%), followed by hypertension (66.0%) and diabetes mellitus (15.1%). Dyslipidaemia was significantly higher in the ischaemic stroke compared to haemorrhagic. Reduced HDL-cholesterol is the most prevalent fraction of lipid abnormalities (74.5%). Conclusion: this study showed a significant association (85.9%) between dyslipidaemia and stroke. Our study showed low HDL-C as a potential risk factor for stroke. Hence, prevention of dyslipidaemia as well as other risk factors is the key to reducing the burden of stroke in our country.The Pan African Medical Journal 2016;2

In-patient morbidity and mortality patterns among patients with diabetes in Southwest Nigeria: A multicenter prospective study

Background: Diabetes is a disease of public concern with increasing hospital admissions and mortality in developing countries. Hence, we aimed to determine the patterns of in-hospital morbidity and mortality in patients admitted for diabetes. Methods: A prospective multicenter analysis of the causes of hospital admission and death among patients with type 2 diabetes who were admitted from diabetic clinic and emergency units over a 3-month period in selected tertiary hospitals in southwest, Nigeria was conducted. Data analysis was performed using the SPSS version 21.0. Results: A total of 341 patients with diabetes were admitted with a mean age of 59.6 ± 15.6 years and overall mortality of 14 deaths (4.4%). Almost three-fifths (59.5%) were previously known patients with diabetes with a mean duration of 52.44 ± 30.02 months. Two hundred and thirty-one (70.9%) patients were admitted through the emergency units and others through outpatient clinics. The duration of hospital stay ranged from 1 to 135 days, with a mean duration of 24.5 ± 14.7 days. The diabetes-related indications for admission were hyperglycemic crisis (diabetes ketoacidosis [DKA] and hyperglycemic hyperosmolar state [HHS]) (59.8%), diabetic foot ulcer [DFU], (11.7%), hypoglycemia (7.6%), and infections (7.3%). Among the diabetes-related diagnoses, 100%, 77.8%, 50.0%, 41.7%, and 28.3% of patients with chronic kidney disease, stroke, DFU, DKA, and HHS respectively stayed longer than 10 days on admission. Conclusion: Diabetes still contributes high cause of morbidity in our hospitals but with a reduced mortality compared to previously reported figure. Hence, continued emphasis on early diagnosis with improvements in diabetes care will help to improve diabetes outcomes