Complementary and Alternative Medicine Use in Diabetes Mellitus

"BACKGROUND: Complementary and alternative medicine (CAM); an emerging aspect of the management of chronic diseases worldwide is not widely studied in Nigerian patients with diabetes mellitus (DM). OBJECTIVE: To assess the frequency and pattern of CAM utilization in people with DM . METHODS: This was a cross-sectional question-naire survey involving 263 patients with DM. Biodata; duration of DM; type and pattern of CAM utilization and adherence to prescribed medications were documented. The prevalence and possible determinants of CAM utilization were evaluated by determining the odds ratio for independent variables. RESULTS: There were 263 respondents with a mean age of 60 (10.7) years and with ages ranging from 28-80 years. The prevalence of CAM usage was 46and the female: male ratio was 2:1. Generally; CAM users were older than non-CAM users; (p= 0.006). The main forms of CAM used were biological based therapies and these included bitter leaf (Vernonia amygdalina); aloe vera; garlic; ginger; and ""local herbs"". Adherence to prescribed medications was observed by 94of respondents. CONCLUSION: We found that CAM usage is an important facet of management of DM among our patients with biological based therapies being the prevalent forms of CAM utilized. Despite CAM usage; adherence to prescribed medications was high. Further evaluation of the impact of CAM on glycaemia is needed."

A Two-Year Audit of Thyroid Disorders in an Urban Hospital in Nigeria

Thyroid disorders are the second commonly encountered disorders in endocrine clinics and are significant causes of medical morbidity and mortality. It is pertinent to note that in the Nigerian setting; there are challenges of sub-optimal investigative and therapeutic facilities especially as concerning thyroid disorders hence there is underreporting of this important group of endocrine disorders from our part of the world.The objective of this audit is to describe the pattern of presentation; investigation; management and outcome of thyroid disorders in patients attending the Lagos State University Teaching Hospital (LASUTH) Endocrine Center.This was a retrospective medical record review of patients with thyroid disorders who presented to the out patient department; the Medical and Emergency wards of LASUTH between June 2007-June 2009. The clinical; biochemical; serological and histological parameters were used to characterize the patients. Investigations done; treatment type; complications of thyroid disorders; hospitalization records and outcome of management were all documented.One hundred and seventy patients with thyroid disorders aged between 11 and 70 years were seen during the period under review. The male: female ratio was 1:7. Patients presenting with thyrotoxicosis were 128 in number thus giving an incidence rate per year of 64. Therapeutic options were essentially thionamides; betablockers; steroids; surgery; radioactive iodine (RAI) and thyroxine. The mean (SEM) duration of medication usage was 24.5 and the median medication duration was 24 months. RAI usage was low as its use was documented in 7of the subjects with thyroid dysfunction. The rate of occurrence of variable glucose intolerance was 28with frank diabetes mellitus diagnosed in 9of the cases of hyperthyroidism. Thyroid storm; psychiatric manifestations; thyrocardiac disease and cerebrovascular diseases were indications for hospitalizations. Two deaths were documented and these were due to thyrocardiac disease and thyroid storm.RAI usage is underutilized and the thionamides are the main stay of treatment for people presenting with thyrotoxicosis. Given the peculiarities of presentation of thyroid disorders in our practice and the challenges of poor accessibility to diagnostic and therapeutic facilities; it is imperative that management guidelines that take into consideration our resource poor background be set up

Foot Ulceration in Nigerian Diabetic Patients: a Study of Risk Factors

Diabetic foot ulceration is an important cause of morbidity and mortality in Nigerian diabetic patients. Identification of the risk factors for ulceration is; therefore; of paramount significance. This study aimed to determine these risk factors. Forty-seven (47) diabetic patients with past or present foot ulceration were studied together with an equal number of controls which were diabetic subjects with no past/present history of ulceration. Risk factors strongly associated with foot ulceration included peripheral vascular disease; male sex; nephropathy; retinopathy; foot deformities; history of previous foot ulceration or amputation; cataract formation; poor glycaemic control; neuropathy; and tinea pedis. Weakly associated risk factors were walking unshod; being of low socio-educational status; and smoking. We concluded that many risk factors for foot ulceration are potentially preventable. As part of a comprehensive footcare programme; education on footcare should be directed at patients; family members; and healthcare providers