The search for mitochondrial tRNALeu(UUR) A3243G mutation among type 2 diabetes mellitus patients in the Nigerian population

The study aimed to compare the incidence of the pathogenic point mutation A3243G in the gene tRNALeu(UUR) indicating sub-type 2 diabetes mellitus conducted within the Nigerian population with that reported in other populations. 112 patients diagnosed with type 2 diabetes (T2D) mellitus according to the World Health Organization criteria were selected based on family history and re-evaluated for associated disorders from the diabetic clinics in the Northern part of Nigeria. The mtDNA of these patients was extracted and the tRNALeu(UUR) gene screened for A3243G by PCR-RFLP method. Probands with maternal history were further investigated for other mutations using PCR-sequencing methods. None of the 112 patients were found to carry the A3243G mutation in the mitochondrial tRNALeu(UUR) gene in the homoplasmic or in the heteroplasmic form. However, C3254T was identified in two of our patients. This mutation was reported to be associated with gestational diabetes and linked with population from sub-Saharan Africa. The A3243G mutation in mitochondrial tRNALeu(UUR) is not a frequent cause of maternal diabetes in the Nigerian population contrary to other reported populations. However, further screening of an enlarged selected study group is necessary to fully determine the prevalence of this mutation in this population. This further search will help to fully appreciate the prevalence of maternal inheritance and diabetic deafness (MIDD) as extensively reported in other populations.Key words: Maternal diabetes, mitochondrial gene, maternal Inheritance and diabetic deafness, Nigeria, sub-Saharan Africa

Serum Lipid Indices and Renal Function Among Persons with Chronic Kidney Disease in Jos, North Central Nigeria

No Abstract

Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa.

BACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5-83.8 cm) and 81.0 cm (95% CI 79.2-82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63-65) than in men (53%, 95% CI 51-55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4-2.9, for men and 2.2, 95% CI 2.0-2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.International Journal of Obesity advance online publication, 31 October 2017; doi:10.1038/ijo.2017.240

Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa

BACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cutpoints for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5–83.8 cm) and 81.0 cm (95% CI 79.2–82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63–65) than in men (53%, 95% CI 51–55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4–2.9, for men and 2.2, 95% CI 2.0–2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes

Prevalence of risk factors for diabetes mellitus in a non-diabetic population in Jos, Nigeria

Background: Diabetes mellitus (DM) is assuming epidemic proportions worldwide, but probably more so in the developing world. Identification of risk factors for the development of type 2 diabetes mellitus is a necessary step in planning prevention programmes for diabetes mellitus. The objective of this study was to determine the frequency of risk factors for type 2 DM among inhabitants of Jos, a northern city on the Nigerian Plateau. Method: A district in central Jos was randomly picked. Census of the district was carried out to record the names of all eligible residents from 250 households selected systematically. A questionnaire was administered by trained interviewers. Socio-demographic data, family history of diabetes, and data on work related physical activity were recorded. Height, weight and waist and hip circumferences were also measured. BMI (kg/m2) and waist-hip ration were calculated Results: Of 902 subjects (≥ 15years of age), 825 (91.5%) responded. The mean (SD) age of 400 males and 422 females were respectively 36.4 (15.2) and 39.9 (17.3) years. About 50% of the respondents were inactive. 435 (52.7%) were currently taking alcohol. Twenty nine (3.5%) of the subjects admitted to parental history of DM. 177 (21.4%) were either overweight or obese. 32% of males and 86% of females had abnormal waist circumferences (WCE). 96 (23.8%) males and 316 (74.9%) females had abnormal WHR. BMI correlated strongly and significantly with WHR (r = 0.64,

Case Report: Dupuytren\'s contracture in a patient with Type 2 Diabetes Mellitus..

No Abstract Nigerian Journal of Medicine Vol. 16 (4) 2007: pp. 384-38

Clinical Trial Of Glimepiride Compared With Glibenclamide For Efficacy And Safety In Type 2 Diabetes Mellitus In Jos, Nigeria

Objective: The study was undertaken to compare the efficacy and safety of Glimepiride against Glibenclamide in the management of patients with type 2 DM in Jos, Nigeria. Study design: An open, randomised controlled trial. Setting: Diabetes Clinic of the Jos University Teaching Hospital, Jos, Nigeria. Subjects: Seventy four type 2 diabetic patients were randomised to either Glimepiride or Glibenclamide for at least 12 weeks. Measurements: Fasting plasma glucose (Primary outcome variable) and fasting plasma total cholesterol (TC), triglycerides (TG), HDL-cholesterol, and compliance (Secondary outcome variables) were the efficacy variables of interest. Adverse events and the laboratory variables of full blood count, liver function tests, electrolytes, urea, uric acid, and creatinine were the safety outcome variables. Results: Satisfactory blood glucose control was achieved in the majority (88.7%) of patients on 1-6mg Glimepiride daily and 5 to 20mg Glibenclamide daily. The proportion of patients who had good blood glucose control was significantly higher in the Glimepiride-treated group (85.7%) than in the cohort treated with Glibenclamide (52.8%),

Perception of insulin therapy among patients with type 2 diabetes mellitus in Jos, North Central Nigeria

Background -The implementation of insulin in the management of type 2  diabetes mellitus is often necessary for better glycaemic control. However,  many still consider insulin therapy as the last resort. Several factors come  to play in the acceptance of insulin as a form of therapy by patients. This study evaluated the perception of insulin therapy among patients with type 2 diabetes mellitus.Methods- This was a descriptive cross-sectional study carried out at the Jos University Teaching Hospital (JUTH) Jos, North Central Nigeria. One hundred and eighty five persons (100 insulin naïve persons and 85 persons on  insulin) were recruited consecutively. The insulin treatment appraisal scale (ITAS) was used to evaluate the perception of insulin therapy among these patientsResults- fifty five (64.7%) females were on insulin while 64 (64%) were insulin naïve. The mean age was 52 ± 11 years and 59 ± 10 years in those on insulin and insulin naïve persons respectively. Twenty one (24.7%) persons on insulin and 33 (33%) insulin naïve persons had tertiary level of education. Insulin naïve persons had higher mean total score of the 20 items, total score of the 16 negative items and total score of the 4 positive items compared with persons on insulin. Among persons on insulin, those with less than one year of education had a better perception of insulin therapy compared with persons who had six years or more of education; Duration of insulin use, gender and age had no impact on perception of insulin therapy.Conclusion- The perception of insulin therapy among persons with type 2 diabetes mellitus is poor.Key words-Insulin, insulin treatment appraisal scale, type 2 diabetes mellitus, perception of insulin therap

Prevalence and risk factors for diabetes and diabetic retinopathy: results from the Nigeria national blindness and visual impairment survey.

BACKGROUND: In Nigeria, urbanisation and increasing life expectancy are likely to increase the incidence of non-communicable diseases. As the epidemic of diabetes matures, visual loss from diabetic retinopathy (DR) will increase unless mechanisms for early detection and treatment improve, and health systems respond to the growing burden of non-communicable diseases. METHODS: A nationally-representative population-based sample of 13,591 participants aged ≥40 years selected by multistage-stratified-cluster-random-sampling with probability-proportional-to-size procedures were examined in 305 clusters in Nigeria between January 2005 to June 2007. All were asked about history of diabetes and underwent basic eye examination. Visual acuity (VA) was measured using logMAR E-chart. Participants with VA11.1mmol/l or had DR. Data in the subsample were used to estimate the prevalence and to analyse risk factors for diabetes and DR using multivariable logistic regression. Additional information on the types of DR was obtained from participants not in the subsample. RESULTS: In the subsample, 164 participants were excluded due to missing data; and 1,595 analysed. 52/1,595 had diabetes, a prevalence of 3.3% (95%CI 2.5-4.3%); and 25/52(48%) did not know. Media opacity in 8/52 precluded retinal examination. 9/44(20.5%) had DR. Higher prevalence of diabetes was associated with urban residence (Odds ratio [OR]1.87) and overweight/obesity (OR3.02/4.43 respectively). Although not statistically significant, DR was associated with hypertension (OR3.49) and RBG>15.0mmol/L (OR8.10). Persons with diabetes had 3 times greater odds of blindness. Of 11,832 other participants in the study sample, 175(1.5%) had history of diabetes; 28 had DR. Types of DR (total=37) included 10.8% proliferative, 51.4% macular oedema. CONCLUSION: The age-adjusted prevalence of diabetes in Nigeria was 3.25% (95%CI 2.50-4.30) and over 10% of people with diabetes aged ≥40 years had sight-threatening-DR. These data will enable the development of better public health strategies for the control of diabetes and planning services for DR to prevent vision loss