Role of free radicals in pathogenesis of diabetes nephropathy

Diabetes mellitus has assumed epidemic proportions in most parts of the world including the developing countries, and one of its ominous complications, diabetes nephropathy represent today the leading cause of endstage renal disease in the developed countries. However, the pathogenesis of diabetes nephropathy remains illusive, notwithstanding, free radicals seem to be the most favorable linkage between all the associated factors suggested. Consequently, free radicals, oxidative stress and antioxidants have become commonly used terms in modern discussions of renal disease mechanisms, making the kidney unique among other organs as the site in which a spectrum of seemingly unrelated diseases involves reactive oxygen species. Importantly, hyperglycaemia and its attendant metabolic syndromes, smoking and the use of xenobiotics have been shown to accelerate free radical generations and attenuate the antioxidant system creating oxidative stress. The management of diabetes nephropathy is extremely expensive and frustrating. Therefore, prevention is better. Sources of antioxidants, especially antioxidant vitamins are available and affordable in most environments. These may be adjunct to other ways of preventing the development of diabetic nephropathy. Reviews like this are necessary to stimulate stakeholders in management of diabetes mellitus and modern nephrologists. Key Words: Diabetes mellitus, nephropathy, free radicals, pathogenesis Annals of African Medicine Vol.3(2) 2004: 55-6

Characteristics of lipid profiles analysis in a public hospital practice in northeastern Nigeria.

Northeastern Nigeria is peculiar concerning lipid metabolism due to sizeable multiethnic population, common practice of consanguineous marriages, and high intake of animal fats (mai shanu). Therefore, rational requests and interpretation of results in the diagnosis of dyslipidaemia is very important in this part of the country. In spite of these seemingly obvious predisposing factors of dyslipidaemia, little, if any, report at all on hyperlipidaemia in this region has been documented. Objectives: This retrospective study intends to shed light on the characteristics of requests for lipid analysis, the subjects with hypercholesterolaemia and their lipid profile results when available. Methods: The clinical records of 328 (29.5%) out of 1110 patient requests received in the University of Maiduguri Teaching Hospital Laboratory with hypercholesterolaemia over a period of three years (1998-2000) were retrieved and analyzed. Results: There was a slight male preponderance 179(54.6%) over females 149(45.4%) with a ratio of 1.2:1. Hypercholesterolaemia in particular was poorly investigated as the primary cause was not sought in 40(12.2%) cases, 24(7.3%) discovered on routine checkup were not investigated further, and only 19(5.8%) of 176 cases with moderate to severe levels had lipid profile, of which 4(1.2%) alone had HDL-Cholesterol done together with total cholesterol at first request. Hypercholesterolaemia in this environment was most commonly associated with cardiovascular diseases and diabetes mellitus with or without hypertension. Factors such as alcohol intake, cigarette smoking and thiazide diuretic use were not significant causes of hypercholesterolaemia. Conclusion: Documentation/requests for lipid investigations were incomplete. The need for estimating both total cholesterol and HDL-Cholesterol on first request and their ratio determined alongside Body Mass Index (BMI) is emphasized as a standard routine especially in hypertension with or without diabetes mellitus, cerebrovascular diseases/stroke and obesity.&nbsp

Role of a diagnostic laboratory in the management of diabetes mellitus

To elucidate the role of a modern diagnostic laboratory in the management of diabetesmellitus Available literature on local and international studies on the role of the laboratory in the management of diabetesmellitus Preclinical diagnosis of diabetes mellitus, good monitoring of short, medium and long-term glycaemic control necessary to avoid diabetic complications in poor resource settings are now possible with modern diagnostic laboratories. Creating the required awareness on the roles of a diagnostic laboratory in the management of diabetesmellitus is needed now more than ever before in resource poor nations otherwise the success achieved by the developed world where diabetic patients become insulin independent after islet cell transplant with glucocorticoid free immunosuppression cannot be attained in the near future. Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.68-7

Oral Glucose Tolerance Test Revisted

Objective: The present review was undertaken to create the required utilization of oral glucose tolerance test in a developing country with a high prevalence of diabetes mellitus and its complications. Sources of data: This review is primarily based on available literature on local and international studies on oral glucose tolerance test Result: Pregnant and non- pregnant preparation; indications, contra indications and the diagnostic criteria for diabetes mellitus using oral glucose tolerance test was elucidated. Determinant for the usefulness or otherwise of oral glucose tolerance test for diagnosis of diabetes mellitus was also discussed Conclusion: Proper understanding of oral glucose tolerance test and teamwork of pathologist, physician, obstetrician, surgeon and pediatrician to face the challenges of diabetes mellitus and its unwanted complications is recommended Nigerian Journal of Clinical Practice Vol.6(1) 2003: 34-3

Anaemia in Patients with Diabetes Mellitus attending regular Diabetic Outpatient Clinic in Maiduguri, Nigeria

To investigate the occurrence of anaemia in diabetic patients that came for routine clinic visit in University of Maiduguri Teaching Hospital, Borno State. From August 2003 to February 2004, 53 patients that came for routine diabetic clinic visit had their fasting blood glucose, 2 hours post-prandial and haematocrit estimated as well as examining their peripheral blood film for morphological classification of anaemia. Twenty-one (39.6%) of the 53 patients were found to have anaemia, Sixteen (76.2%) had microcytic hypochromic anaemia and 5 (23.8%) had normocytic normochromic anaemia. Anaemia is commoner in males than females, and is seen in 13(50.0) of patients with good glycaemic control (Fasting blood glucose of less then 7.0mmol/L). Anaemia was seen in 3(75.0%) of the patients with documented chronic renal insufficiency. Anaemia is common in patients with diabetes mellitus. Since most patients with diabetes are rarely concerned about anaemia, they may not seek medical help unless their physician raises the suspicion. There is a need to suspect, investigate and treat anaemia in patients with diabetes presenting with non-specific complaints such as numbness and weakness. The services of dieticians should be employed for dietary counseling because some patients may omit important food items in their daily diet for fear of increasing their blood sugar level. KEY WORDS: Anaemia, diabetes mellitus. Nigerian Journal of Health and Biomedical Sciences Vol.4(1) 2005: 1-

Review Article: Dyslipidaemia, Lipid Oxidation, And Free Radicals In Diabetic Nephropathy: An Overview

Diabetes mellitus has assumed an epidemics proportion in most parts of the world including the developing countries, and one of its ominous complications, diabetic nephropathy represents today the leading cause of end-stage renal disease in USA, Europe, and Japan. However, there is a paucity of records of the magnitude in Africa and some parts of Asia. The pathophysiology of diabetic nephropathy can be viewed as a sequence of events evolving in a stepwise pattern starting with endothelial cell dysfunction (ECD) and end in end-stage renal failure ( Fig 1). Majority of diabetic associated metabolic syndromes, especially dyslipidaemia predispose to ECD, and therefore diabetic nephropathy. Diabetes mellitus is frequently associated with dyslipidaemia evidenced by high prevalence rate that range from 16%-40%, and chronically elevated level of plasma lipids, low-density lipoprotein in particular, leads to modification of structures, importantly through oxidative processes. Renal tissue particularly in diabetes milieu has been suggested to accelerate oxidation of lipids and lipoproteins. Lipids, particularly LDL oxidation are initiated by reactive oxygen species (ROS), but the rate of oxidation is usually suppressed in plasma by endogenous antioxidants. However, after ECD the lipid is sequested from the antioxidant milieu mainly in the glomerular wall intima and this accelerates its oxidation. The precise mechanism by which oxidized LDL promotes the development of ECD and diabetic nephropathy lesions remains to be elucidated. However, several lines of evidence suggest that oxidized LDL exerts many biological effects that may contribute to the initiation and progression of diabetic nephropathy. Therefore, oxidized lipids are a key early step in the pathogenesis of diabetic nephropathy. Importantly, trials of antioxidants in diseases where free radicals play an important role in their pathogenesis reveal satisfactory results,but results of trials of antioxidants in the management of chronic diabetic complications are inconclusive.Nonetheless, most, if not all, were instituted after a long-standing hyperlipidaemia and therefore oxidative stress, with already developed complications. This paper provides an overview on the involvement of oxidized lipids, lipoproteins and reactive oxygen species in initiation and progression of diabetic nephropathy. This will stimulate nephrologists to plan instituting the use of antioxidants as preventive measures at the diagnosis of the disease or even in those with impaired glucose tolerance. In addition, the use of lipid lowering agents in diabetics with hyperlipidaemia could become an additional cost-effective adjunct of the anti diabetic regimen. Highland Medical Research Journal Vol.2(1) 2004: 1-

Lipid profile in pre-dialysis chronic kidney disease patients attending university of Maiduguri Teaching Hospital, Maidurugi-Nigeria

No Abstract

Some trace elements and liver analytes in consumers of a local alcoholic beverage (Burukutu)

Aim: Trace elements, such as zinc and copper, have been reported to affect liver function. This study was therefore designed to determine the effect of “burukutu” (a local alcoholic beverage) on the serum levels of zinc and copper and to compare this with that of controls. Method: A total of 96 age-matched adult males made up 56 “burukutu” consumers, 20 refined alcohol consumers and 20 controls were recruited for the study. Serum zinc, copper, transaminases and total bilirubin were analysed. Results: These indicated that there was no significant difference (p>0.05) in serum zinc and copper between consumers of “burukutu” and the controls. However, there was a significant difference (

Effect of combined feeding of various doses of honey and black caraway oil on some biochemical and haematological parameters in normal healthy rats

Both Black caraway oil and Honey feeding have shown some favorable effects on some biochemical parameters experimentally and these substances have been use as medicinal remedies in treatment of various diseases. Objective: This study is design to determine the effect of combined feeding of various doses of Black caraway oil and honey on some biochemical and haematological parameters in normal healthy white albino rats Methods: Thirty albino rats of Wister strain were separated in groups and fed growers mesh. In addition, the tests groups were administered various doses of honey and black caraway oil either alone or in combination into the stomach directly, through gastric intubations. Group I served as normal control fed un only growers mesh and water, while groups II and III serve as black caraway oil and honey controls to which in addition to the growers mesh and water were also given 920mg and 1420mg of black caraway oil and honey and black caraway oil. Results: Both the Black caraway oil and honey controls showed some degree of hypoglycaemia and Hypocholesterolaemia with insignificant increase in plasta triglycerides and albumin. But no effect on the other parameters when compared with normal control. However, the combine back caraway oil combined and honey fed showed significant decrease in plasma total cholesterol and increase in serum glucose and triglycerides with insignificant decreased in total protein and albumin. No changed in UREA, sodium, potassium as well as no significant change in all the hematological parameters were noticed among the groups. Conclusion: The combined feedings have hypocholesterolaemic. hyperglycerdaemic effects with insignificant hypoproteinaemic effect. It has no the renal as well as haematological systems

Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non-adherent to diabetes care

CITATION: Booysen, B. L. & Schlemmer, A. C. 2015. Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non-adherent to diabetes care. South African Family Practice, 57(3):166-171, doi: 10.1080/20786190.2014.977027.The original publication is available at http://www.tandfonline.comBackground: Non-adherence to diabetes care is a concern at Bishop Lavis Community Health Centre (BLCHC) as it results in many diabetes complications that could have been avoided. The aim was to explore the reasons for people with diabetes in the Bishop Lavis area being non-adherent to diabetes care. Methods: A qualitative study was undertaken. Focus groups and in-depth interviews were conducted with patients who had uncontrolled blood sugar and non-compliance. The framework method was used to analyse the data. Results: The main findings in this study were that the following had a negative impact on compliance with diabetes care: (1) poor knowledge of diabetes mellitus; (2) drug treatment barriers such as shift work and not knowing the importance of taking medication regularly; (3) lifestyle adjustment barriers: dietary barriers and lack of exercise; (4) staff and clinic visit problems, for example over-burdened public health-care facilities; and (5) poor support structures including support from family, the community and financially as well as poor infrastructure. Conclusion: The main findings in this study were consistent with many of the previous studies done on adherence, i.e. patient barriers, disease and drug-regime barriers and doctor–patient relationship barriers. However, in this poverty-stricken area these participants also face other constraints that influence their compliance behaviour. These include (1) over-burdened public health care facilities, (2) insufficient education, (3) poor support structures, (4) infrastructure that is not wheelchair-friendly, (5) unsafe communities, (6) low income and unemployment.http://www.tandfonline.com/doi/full/10.1080/20786190.2014.977027Publisher's versionAuthors retain copyrigh