Gestational diabetes mellitus in Cameroon: prevalence, risk factors and screening strategies

Copyright \ua9 2024 Sobngwi, Sobngwi-Tambekou, Katte, Echouffo-Tcheugui, Balti, Kengne, Fezeu, Ditah, Tchatchoua, Dehayem, Unwin, Rankin, Mbanya and Bell.Background: The burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population. Methods: We carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies. Findings: GDM prevalence was 5\ub79%, 17\ub77%, and 11\ub70% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3\ub714, 95%CI: 1\ub727-7\ub776)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5\ub79 mmol/L for RPG (c-statistic 0\ub762) and 7\ub71 mmol/L for 1-hour 50g GCT (c-statistic 0\ub776). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6\ub75 mmol/L (c-statistic 0\ub761) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66\ub79 and 41\ub70% of the cases. Interpretation: GDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield

Upper limits for undetected trace species in the stratosphere of Titan

In this paper we describe a first quantitative search for several molecules in Titan's stratosphere in Cassini CIRS infrared spectra. These are: ammonia (NH3), methanol (CH3OH), formaldehyde (H2CO), and acetonitrile (CH3CN), all of which are predicted by photochemical models but only the last of which observed, and not in the infrared. We find non-detections in all cases, but derive upper limits on the abundances from low-noise observations at 25{\deg}S and 75{\deg}N. Comparing these constraints to model predictions, we conclude that CIRS is highly unlikely to see NH3 or CH3OH emissions. However, CH3CN and H2CO are closer to CIRS detectability, and we suggest ways in which the sensitivity threshold may be lowered towards this goal.Comment: 11 pages plus 6 figure file

HIGH-RESOLUTION SPECTROSCOPY OF NITROUS ACID (HONO) AND ITS DEUTERATED SPECIES (DONO) IN THE FAR- AND MID-INFRARED REGIONS

Author Institution: Laboratoire Interuniversitaire des Systemes Atmospheriques (LISA), CNRS and Universites Paris-7 et -12, Creteil, FranceNitrous acid (HONO) is an important source for OH radicals in tropospheric photochemistry.} Currently it is measured in the atmosphere using its ultraviolet absorption bands} but it has also been detected in the mid-infrared spectral region using a tuneable diode-laser.} In order to complete and extend previous laboratory work on the infrared fundamental bands of {\it trans}-HONO} and {\it cis}-HONO} and also of its deuterated species (DONO)} we have carried out a number of new spectroscopic studies, focusing on \begin{itemize} \item{the first high-resolution spectra of {\it trans-} and {\it cis-}HONO and -DONO in the far-infrared region (30--120 cm$^{-1}$),} \item{the first high-resolution spectra and analysis of the $\nu_1$ bands of {\it trans-} and {\it cis-}DONO around 2600 cm$^{-1}$,} \item{new high-resolution spectra and analysis of the Coriolis-interacting $\nu_5$ and $\nu_6$ bands of HONO around 600 cm$^{-1}$.}} \end{itemize} In this talk we will present the main results and some comparisons with previous studies

Continuous interstitial glucose monitoring in non-diabetic subjects with end-stage renal disease undergoing maintenance haemodialysis

Haemodialysis improves uraemia-induced insulin sensitivity and is therefore likely to induce significant changes in circulating glucose concentrations in end-stage renal disease (ESRD). We aimed to assess clinically relevant circulating glucose changes in patients undergoing chronic maintenance haemodialysis using continuous interstitial monitoring. We investigated 14 non-diabetic ESRD subjects aged 40 6 +/- 2 4 years. Participants were examined 24-h day pre-dialysis, during the index dialysis session and 24-h post-dialysis with simultaneous measurement of capillary blood glucose and continuous interstitial glucose (CGMS) Participants performed five capillary blood glucose measurements the day before dialysis, and 10 during and after dialysis. Mean capillary blood glucose was 128 +/- 20 mg/dl the day before, 93 +/- 8 mg/dl during haemodialysis, and 105 +/- 13 mg/dl after haemodialysis. There was a significant trend towards lower blood glucose during the session from 105 +/- 16 mg/dl to a 3rd hour nadir of 83 +/- 15 mg/dl (Anova F = 2 89, p = 0 029) No hypoglycaemia was recorded Interstitial glucose profile was comparable to capillary glucose profile Glucose concentrations varied significantly from 126 +/- 13 mg/dl before to 112 +/- 12 mg/dl after haemodialysis respectively (p = 0 006) This study provides evidence for the use of CGMS in ESRD and haemodialysis, and demonstrates significant changes in glucose concentrations during and after haemodialysis that would guide treatment monitoring and adjustments. (C) 2010 Published by Elsevier Ireland Lt

Impact of diabetes mellitus on clinical presentation and prognosis of pancreatic cancer.

International audienceINTRODUCTION: The aim of this study was to investigate possible effects of diabetes mellitus on clinical manifestations and prognosis of pancreatic cancer (PC). PATIENTS AND METHODS: We retrospectively reviewed the clinical files of 122 patients with PC, and divided them into two groups: those with diabetes (56 patients) and those without diabetes (66 patients). The two groups were then compared for demographic profiles, clinical manifestations of PC, features of the tumor and fatal outcomes. RESULTS: Mean age, sex distribution, body mass index at cancer diagnosis, prevalence of hypertension, dyslipidemia, weight loss, abdominal pain, lumbar pain, signs of dyspepsia, and size, and histological features of the tumor were similar between the two groups. The cancer was located in the head of the pancreas in 50% of those with diabetes, and 80% of those without diabetes (P=0.04). The median survival time was similar. CONCLUSIONS: Clinical features, tumor size and prognosis of PC are similar in people with and without diabetes. Having diabetes does not seem to contribute to earlier diagnosis of PC

Fasting blood glucose and insulin sensitivity are unaffected by HAART duration in Cameroonians receiving first-line antiretroviral treatment

International audienceAims. - This study assessed the relationship between highly active antiretroviral therapy (HAART) duration and cardiometabolic disorders in HIV-infected Cameroonians. Methods. - HIV-infected Cameroonians aged 21 years or above were cross-sectionally recruited at the Yaounde Central Hospital, a certified HIV care centre, and their anthropometry, body composition (impedancemetry), fasting blood glucose (FBG) and lipid levels, and insulin sensitivity (IS; short insulin tolerance test) were measured. Results. - A total of 143 participants with various durations of HAART [treatment-naive (n=28), 1-13 months (n=44), 14-33 months (n=35) and 34-86 months (n=36)] were recruited. They were mostly women (72%), and had a mean age of 39.5 (SD: 9.8) years. Half (52%) were using a stavudine-containing regimen. There was a significant trend towards a positive change in body mass index and waist-to-hip ratio with increasing duration of HAART (all P = 0.02). Systolic (P = 0.04) and diastolic (P = 0.03) blood pressure, total cholesterol (P = 0.01), prevalence of hypertension (P = 0.04) and hypercholesterolaemia (P = 0.007) were also significantly increased with HAART duration, whereas triglycerides, FBG and IS were unaffected. Clustering of metabolic disorders increased (P = 0.02 for >= 1 component of the metabolic syndrome and P = 0.09 for >= 2 components) with HAART duration. Conclusion. - HAART duration is associated with obesity, fat distribution, blood pressure and cholesterol levels in HIV-infected Cameroonians, but does not appear to significantly affect glucose metabolism. (C) 2012 Published by Elsevier Masson SAS