French Guiana is a territory located more than 7000 km from France.It is also the largest French territory,with almost 84000 km2 and 90%of it is covered by forest.Some municipalities are isolated due to the scarcity o...French Guiana is a territory located more than 7000 km from France.It is also the largest French territory,with almost 84000 km2 and 90%of it is covered by forest.Some municipalities are isolated due to the scarcity of transportation and the poor road infrastructure.The population is extremely diverse ethnically and culturally,and includes more than thirty ethnic groups.Immigration is high because it is one of the richest countries in the area bordering northern Brazil,Suriname,Guyana,and as a result of socio-economic crises in some other countries such as Haiti,and it has permeable natural borders.Diabetes and obesity,are emerging issues,with double the prevalence of Mainland France,whereas infectious diseases,such as HIV,take second place.Therapeutic and educational management are challenging because they require the adaptation of tools and treatments to the multiculturalism and precariousness often encountered in these populations.The French and European recommendations are unsuited to the needs of the territory and must take into account the epidemiological,sociological and cultural parameters of these populations in order to provide appropriate and graded management of diabetes in the French Amazon.展开更多
Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functio...Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functional handicap. The objective of this work is to describe the osteoarticular rheumatological disorders in diabetics consulting or hospitalized in the rheumatology and internal medicine departments of the National Hospital of Niamey and the Magori Polyclinic. This was a cross-sectional study at the Rheumatology Department in collaboration with the Internal Medicine Department within the National Hospital of Niamey and Polyclinic Magori over a period of 7 months (December 2018 to July 2019). One hundred (100) diabetic patients with osteoarticular diseases were collected, 75% of whom were women with a female/male sex ratio of 0.33. The average age was 56 years with extremes of 21 and 90 years. Forty-three percent (43%) of the patients had diabetes for more than 10 years, with an average age of 13 years. The average BMI was 28.08 ± 5.42 kg/m<sup>2</sup>. Poor glycemic control was found in the majority of patients (92%). Gonarthrosis was the most common disease associated with diabetes (89%). In the context of joint stiffening syndrome, the most frequent problem was a protruding finger, found in 4% of patients, followed by retractile capsulitis in 3% of the 100 cases. Infectious complications were dominated by septic arthritis in 4% of patients. The presence of one or more degenerative complications of diabetes (nephropathy, retinopathy, nephropathy) was the most frequent factor associated with osteoarticular diseases in our diabetic patients. This work underlines the great variety and frequency of osteoarticular affections during diabetes, hence the interest in optimal glycemic control of a close collaboration between rheumatologists and endocrinologists in order to avoid as much as possible the development of these rheumatological affections which are the source of pain and functional handicap, being able to even engage the vital prognosis.展开更多
文摘French Guiana is a territory located more than 7000 km from France.It is also the largest French territory,with almost 84000 km2 and 90%of it is covered by forest.Some municipalities are isolated due to the scarcity of transportation and the poor road infrastructure.The population is extremely diverse ethnically and culturally,and includes more than thirty ethnic groups.Immigration is high because it is one of the richest countries in the area bordering northern Brazil,Suriname,Guyana,and as a result of socio-economic crises in some other countries such as Haiti,and it has permeable natural borders.Diabetes and obesity,are emerging issues,with double the prevalence of Mainland France,whereas infectious diseases,such as HIV,take second place.Therapeutic and educational management are challenging because they require the adaptation of tools and treatments to the multiculturalism and precariousness often encountered in these populations.The French and European recommendations are unsuited to the needs of the territory and must take into account the epidemiological,sociological and cultural parameters of these populations in order to provide appropriate and graded management of diabetes in the French Amazon.
文摘Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functional handicap. The objective of this work is to describe the osteoarticular rheumatological disorders in diabetics consulting or hospitalized in the rheumatology and internal medicine departments of the National Hospital of Niamey and the Magori Polyclinic. This was a cross-sectional study at the Rheumatology Department in collaboration with the Internal Medicine Department within the National Hospital of Niamey and Polyclinic Magori over a period of 7 months (December 2018 to July 2019). One hundred (100) diabetic patients with osteoarticular diseases were collected, 75% of whom were women with a female/male sex ratio of 0.33. The average age was 56 years with extremes of 21 and 90 years. Forty-three percent (43%) of the patients had diabetes for more than 10 years, with an average age of 13 years. The average BMI was 28.08 ± 5.42 kg/m<sup>2</sup>. Poor glycemic control was found in the majority of patients (92%). Gonarthrosis was the most common disease associated with diabetes (89%). In the context of joint stiffening syndrome, the most frequent problem was a protruding finger, found in 4% of patients, followed by retractile capsulitis in 3% of the 100 cases. Infectious complications were dominated by septic arthritis in 4% of patients. The presence of one or more degenerative complications of diabetes (nephropathy, retinopathy, nephropathy) was the most frequent factor associated with osteoarticular diseases in our diabetic patients. This work underlines the great variety and frequency of osteoarticular affections during diabetes, hence the interest in optimal glycemic control of a close collaboration between rheumatologists and endocrinologists in order to avoid as much as possible the development of these rheumatological affections which are the source of pain and functional handicap, being able to even engage the vital prognosis.
