Prevalence of the metabolic syndrome among patients with type 2 diabetes mellitus in urban North-Central Nigeria.

Background: In most people with glucose intolerance or type 2 diabetes mellitus (DM), there is a multiple set of risk factors that commonly appear together forming what is now known as the ‘Metabolic Syndrome’ (MS). This ‘clustering’ of metabolic abnormalities that occur in the same individual appear to confer substantial additional cardiovascular risk. There has been no report on the MS among patients with type 2 DM in urban North-central Nigeria. Objective: The objective of this study was to determine the prevalence of the MS among urban North-central Nigerians with type 2 DM and to describe the frequency of the syndrome’s components. Methods: Six hundred and thirty four (634) patients with type 2 diabetes attending the out-patient clinic of the Diabetes Screening and Care Centre, Jos, Nigeria were screened for the MS. A brief history was obtained and their anthropometric indices and blood pressure were measured. Fasting venous plasma samples were analyzed for lipids. Early morning spot urine samples were obtained for estimation of microalbuminuria using the Bayer DCA 2000® machine. The diagnosis of MS was made based on the new International Diabetes Federation (IDF) definition. Results: Of the 634 patients enrolled with mean (standard deviation/SD) age 54.2(9.1) years, 56% were females. The prevalence of MS was 63.6% (74.5% in males and 54.9% in females,

Predictors of lower extremity amputation among patients with diabetic foot ulcer in a tertiary health facility in north central Nigeria

INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers.METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined.RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation.CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.KEY WORDS: Amputation, Neuropathy, Osteomyeliti

Hyperuricaemia in obese Type 2 diabetics in Jos, north central Nigeria

Introduction: Uric acid is a metabolite from the breakdown of purines. Elevated serum levels (hyperuricaemia) is known to have an association with cardiovascular risk factors that are often seen in obesity, such as hypertension, dyslipidaemia and glucose intolerance. This study will attempt to give an insight into this association among individuals with Type 2 Diabetes mellitus.Methodology: 100 patients with Type 2 diabetes visiting a private health facility in Jos, North Central Nigeria participated in this study. The data obtained for analysis from each participant were anthropometric indices ( body mass index, waist circumference) and laboratory parameters ( serum lipids and uric acid).Results: 64% of participants were males. 79% of the population were obese and 45% had hyperuricaemia. The proportion of females with obesity (94,4%) was significantly greater than that for males (70.3%) but there was no significant difference between the proportion of males and females with hyperuricaemia. Serum uric acid showed significant positive correlation with waist circumference (p=0.04) and age (p=0.03) and had no significant relationship with other variables.Conclusion: Early detection and treatment of hyperuricaemia in obese patients will help reduce their overall risk of cardiovascular events. This is achieved by both non pharmacological and pharmacological means.Key words: Diabetes, Hyperuricaemia, Obesit

Prevalence of Overweight and Obesity in Maiduguri, North-Eastern Nigeria

BACKGROUND: The prevalence of obesity is on the increase worldwide including in many developing countries. There is no report on the magnitude of obesity among adults in Maiduguri, a major city in northeastern Nigeria.MATERIALS and METHODS: We selected a sample of 1650 men and women aged 15 years and above resident in Gwange ward in Maiduguri metropolitan council using a multistage sampling technique. Height, weight, waist (WC) and hip circumferences were measured. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Data were analyzed using SPSS version13. The ethics committee of the Universityof Maiduguri Teaching Hospital approved the study and consent was sought individually from the participants before being enlisted.RESULTS: The mean (SD) age of the respondents was 36.2 (14.4) years, with a range of 15 to 70 years. The mean (SD) ages of the males and  females were 34.9 (14.3) and 38.9 (14.0) years, respectively, (p<0.001). The overall crude prevalence rates of overweight and obesity were 27.1% and 17.1%, respectively. In men, 40.6% were either overweight or obese, while in women 51.9% were either overweight or obese. We observed thehighest prevalence rates of overweight and obesity in the middle age group. There were more obese females than males (14.05 vs. 4.3%) among both young and elderly (12.1% vs. 10.5%) subjects.CONCLUSION: The prevalence of overweight and obesity is high in Maiduguri metropolis particularly among women. Concerted efforts should be made to curb the menace of increasing rate of obesity in the metropolis through public enlightenment on the risks associated with obesity and the benefits of adopting a healthy lifestyle.KEY WORDS: Overweight, Obesity, Prevalence, Maiduguri

Anthropometric correlates of insulin resistance: a study of healthy Nigerian adults in Maiduguri

Indices of obesity, especially abdominal adiposity have been shown to correlate positively with the components of the metabolic syndrome in several studies. Objectives: The aim of this study was to determine the correlation between anthropometric indices and insulin resistance in healthy subjects. Methods: A representative sample of 100 subjects aged 15 to 70 years was recruited for the study. Weight, height, waist circumference (WC) and hip circumference were measured, while body mass index (BMI) and waist-to-hip ratio (WHR) were calculated for each participant. Fasting blood samples were drawn for plasma glucose and plasma insulin concentrations, respectively. The values obtained were used to calculate insulin resistance using the Homeostasis Model Assessment Method for Insulin Resistance (HOMA-IR). Results: Insulin resistance (IR) was found in 25(25%) of the study subjects. There were significant andpositive correlations between waist circumference and HOMA-IR (r=+0.20, p<0.05), as well as between BMI and HOMA-IR(r=+0.19, p<0.05).Both anthropometric indices however, only predicted 4.1% and 3.9% of the variation in HOMA-IR, respectively. The correlation between WHR and HOMA-IR was positive but non-significant (r=+0.12, p>0.05). Conclusion: Waist circumference exhibited the strongest correlation with HOMA-IR, closely followed by BMI and WHR. We recommend that measurement of waist circumference should continue to be used as a screening tool for identifying individuals with insulin resistance in our setting

Chronic kidney disease screening and renoprotection in type 2 diabetes

Background: Type 2 diabetes (T2D) is a major cause of chronic kidney disease. Control of hypertension and the use of angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II receptor blockers especially in those with proteinuria have been shown to protect against chronic kidney disease and delay its progression to kidney failure. Methods: We reviewed the medical records of 169 patients at 12 months with a view of auditing the screening for chronic kidney disease and the use of renoprotective measures. Results: Urinalysis was done in 49.1% and serum creatinine in 50.3%. No patient had glomerular filtration rate estimated. Seventy nine (67.6%) of the hypertensive patients were on anti-hypertensives. ACEI was used in 49 (45.8%) of these patients BP control was optimal in 29.1%. Conclusion: There is poor adherence to guidelines on chronic kidney disease screening and renoprotection in T2D

Exercise and other lifestyle habits of patients with type II diabetes mellitus in Jos, Nigeria

Background Diabetes mellitus is a chronic disorder with complications affecting millions of people worldwide. It has been projected that in the near future, it will affect people in the developing countries like Nigeria more than the developed world. Lifestyle modification including exercise is important in the management of this condition. The other lifestyle of patients with diabetes including cigarette smoking and alcohol ingestion also affects the glycaemic control and the development or worsening of complications in these patientsMethods This was a descriptive cross-sectional study carried out at the diabetes clinic of Jos University Teaching Hospital (JUTH) and a diabetes specialist clinic in Jos, North central Nigeria. Ninety patients with diabetes aged 18 years and above were recruited consecutively. Wheel chair bound patients, patients who had amputation in the past and patients who did not consent to the study were excluded from the study. Data was obtained using an interviewer administered questionnaireResults Fifty -four (60%) persons were males. The mean age was 56.8±11.5 years. 52.2 % participated in one form of exercise with 43 (91.5%) persons exercising for <150 minutes per week. The mean duration of exercise per week was 75.6 ±55.5 minutes. Those who exercised were younger, males and with lower HbA1c The . common form of exercise was walking. Barriers to exercise found include lack of time, pain/swelling in the legs, ill health and not knowing what exercise to do. Three (33.3%) out of the nine persons who took alcohol ingested it in significant amount and 1 (1.1%) person smoked cigarette.Conclusion The exercise habit of patients with diabetes in this environment is poor with some persons taking alcohol in significant quantity and smoking cigarette. Education and counseling of these patients therefore are important and should be done at every given opportunity.Key words: Diabetes mellitus, exercise, lifestyle habits

Breast Cancer Radiotherapy Associated Diabetes Mellitus Case Reports

Primary breast cancer when detected early can be treated by radical mastectomy alone. However, 20-30% of women treated as such later on, develop local or regional recurrence. This leads to an additional treatment with radiotherapy by the oncologist for the sake of the 20-30% of patients that may need it postoperatively. The additional treatment by the use of radiotherapy has its own side effect. These include, among other things radiation fibrosis of the lungs which is said to be very rare and has been reported to affect the apices of the lung with excessive fibrous tissue formation. Regional radiotherapy can affect the cellular mechanism of immunity leading to increase in micro metastases. Therefore because of the above reasons as side effects of radiotherapy, some oncologist do not give radiotherapy in immediate postoperative period. Diabetes mellitus has never been reported as a complication of theraupetic radiology of the breast in breast cancer, so we have decided to report these cases to keep clinicians on the alert of the possibilities of Diabetes mellitus after radiotherapy. Highland Medical Research Journal Vol.1(2) 2002: 29-3

Correlate Of Dyslipedaemia In Type 2 Diabetes Mellitus In Jos

Objective: To determine the pattern of lipid disorders among type II diabetes. Results: Hypercholesterolaemia was present in 43.5% of the patient while hypertriglyceridaemia was present in 34.8%. Mild hypercholesterolaemia and moderate hypertriglyceridaemia were the commons type of abnormalities that were seen. Conclusion: There was a significant correlation between lipid levels and body mass index of some groups of lipid abnormalities. Highland Medical Research Journal Vol.1(2) 2002: 30-3