Epidemiological and Clinical Features of Diabetic Foot in Cotonou

This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Objective: To study the characteristics of diabetic feet in Cotonou. Results: The mean age of patients was 58.05 years ± 10.65 years, ranging from 35 years to 70 years. The sex ratio was 1.5. Duration of diabetes before the onset of diabetic foot was 11 years. The overall prevalence of diabetic foot was 21.53%. Of these, 95% had neuropathy, 70.40% had arterial disease and all had a foot infection. The amputation rate was 31.96% and the mortality rate was 17.21%. Conclusion: The occurrence of diabetic foot is earlier than in the West, and hence there is a need for early treatment of diabetes.

Nutritional supplementation on wound healing in diabetic foot:What is known and what is new?

Non-healing diabetic foot ulcers(DFU)are the most notable and striking complications of diabetes mellitus.More than 25% of nonhealing DFU can ultimately lead to amputation of the lower extremity within 6-18 mo after the first manifestation of the wound.Although wound healing is complex,nutritional status is crucial in soft tissue repair.Malnutrition is highly prevalent and overlooked in patients with diabetes and chronic wounds.Moreover,to date,we do not have clear recommendations or evidence about the use of nutritional supplements for improving wound healing in patients with DFU.In this article the authors briefly analyzed the current evidence on the use of nutritional supplements of proteins or amino acids,fatty acids,probiotics,vitamins,and trace elements in the wound healing process in patients with DFU.

STUDY ON OBESITY RELATED FACTORS: FFA, LEPTIN AND ADIPONECTIN IN SUBJECTS WITH VARYING GLUCOSE TOLERANCE

Objective To study the fasting serum levels of obesity related factors: FFA, leptin and adi-ponectin in subjects with varying glucose tolerance and their relationship with BMI, insulin sensitivity index and isletbeta-cell function. Methods Serum levels of FFA, leptin and adiponectin in 24 normal, 32 simple obese, 34IGT and 36 T2DM subjects were measured by ACS-ACOD assay or RIA. Results The serum levels of leptin andFFA in three groups:simple obese, IGT and DM were much higher than those in normal control (P <0. 001). Incontrast, serum level of adiponectin of simple obese, IGT and DM groups were significant lower than that of normalcontrol, among them DM subjects had the lowest level (P <0. 001). Correlation analysis showed that FFA was pos-itively correlated to BMI, WHR, FBG, fasting insulin level and negatively correlated to SI; adiponectin was negativelycorrelated to BMI, WHR, FBG, PBG, but positively correlated to SI and AIRg; and leptin was positively correlated toBMI, fasting insulin and AIRg when negatively correlated to FBG and SI. None of them was correlated to age.Conclusion Subjects with insulin resistance have high serum FFA and leptin levels but low serum adiponectin level.With the glucose tolerance deterioration, serum FFA level increases much higher while the adiponectin deceases muchlower. Unlike insulin, none of these obesity related factors can be used as the simple indicating or determining factorof SI, though each of them, to different extent, takes part in the development of insulin resistance.

Eating habits and lifestyle in a group Turkish primary education children

Background: The prevalence of child obesity is increasing rapidly worldwide as well as Turkey due to skipped main meals and increased snacking. The objectives were to study the prevalence rates of overweight and obesity in a group of Turkish children, and to analyze the relationship between eating habits and lifestyle and obesity. Methods: The study was carried out in 6 schools in urban regions in the city of Eskisehir, Western Turkey between February and May2008. Atotal of 1421 students aged 7 - 14 years (708 boys and 713 girls) were examined. Eating habits and life-style were obtained by evaluation of a standard set of 15 questions prepared using the literature. Results: Most obese students reported having a snack in the afternoon, not spending at least five hours of leisure time per week in physical activities, being high income level, that their mother’ education level was university, eating less fruits, eating less vegetables, having more dessert after any meal, eating more potato chips, watching television more, living a physically active life less, less breast feeding, that their father consumed alcohol, that their father was overweight/ obese, their mother wase overweight/obese (statistically important relationships for each one). Conclusions: A small portion of 7 - 14-year-old Turkish children are at increased health risk owing to overweight and obesity in an urban po- pulation in a developing country.

Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou

Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.

Is There Any Threshold for Vitamin D That Elevates Parathyroid Hormone

Objective: To evaluate vitamin D status in relation to serum levels for parathyroid hormone (PTH) and corrected calcium among endocrine outpatients. Methods: A total of 760 patients (mean(SD) age: 40.0(12.6) years, 94.6% were females) admitted to our endocrinology outpatient clinic were included and evaluated with respect to patient demographics, serum levels for 25-hydroxyvitamin D (25(OH) D, ng/mL), PTH (pg/mL) and corrected calcium (mg/dL) as well as the vitamin D status. Results: Vitamin D deficiency was determined in 65.0% and elevated PTH levels in 20.3% of patients. iPTH levels were significantly higher in females than in males (58.9(40.4) vs. 45.1(26.2) pg/mL, p = 0.031) and in summer than in winter cases (63.9(47.7) vs. 54.2(32.8) pg/mL, p = 0.002), whereas no difference was found in serum levels for 25(OH) D, corrected calcium and phosphate with respect to gender and season. Significantly higher levels for iPTH were noted in vitamin D deficient patients (60.7(43.9) pg/mL) than in normal (51.1(33.4) pg/mL) and vitamin D insufficient (57.1(26.0) pg/mL) cases (p = 0.03). iPTH levels were correlated positively with age (r = 0.116, p = 0.001) and negatively with corrected calcium (r = &minus;0.097, p = 0.008), P (r = &minus;0.224, p = 0.000) and 25(OH) D (r = &minus;0.134, p = 0.000), whereas no correlation was noted between 25(OH) D and corrected calcium levels. Conclusion: Our findings indicated that vitamin D deficiency in 65.0%, whereas PTH elevation only in 20.3% of endocrine outpatients, despite the significantly negative correlation of PTH to 25(OH) D and significantly higher levels of PTH among vitamin D deficient cases than in vitamin D insufficient and sufficient cases. Gender’s and seasonal differences had influence on serum levels for PTH but not on either 25(OH) D or corrected calcium, and no correlation was evident between 25(OH) D and corrected calcium levels.