ABSTRACT
Context: It is established that glycemic control measures involving diet and oral medication reduces glycated hemoglobin concentration (HbA1c) in type 2 diabetic patients. AIMS: To determine whether glycemic levels after diabetic treatment is affected by age, gender, obesity, and diabetic duration in type 2 diabetic patients. Settings and Design: A total of 52 type 2 diabetic patients participated in a 12-week diabetic management therapy involving oral medication (metformin) and lifestyle intervention (diet). Materials and Methods: We compared the glycated hemoglobin reduction after treatment between the elderly and non-elderly; males and females; obese and non-obese; and newly diagnosed and long-standing diabetics.Results: After the diabetic treatment, participants' mean HbA1c level indicated a reduction of 1.1 ± 1.31%, weight loss of 2.46 ± 1.79 kg, and BMI reduction of 0.94 ± 0.69 kg/m 2 . A total of 23 (44.2%) patients had an acceptable HbA1c level of <</i>6.5%. Significantly greater HbA1c reduction was observed in non-elderly, non-overweight/obese, and newly diagnosed diabetic patients compared to the elderly, overweight/obese, and long-standing diabetic patients respectively (P < 0.05 or P < 0.01). HbA1c reduction did not indicate sex differences. Conclusion: The present findings suggest lower responses to glycemic control therapy in elderly, overweight/obese, and long-standing diabetic patients when compared to the non-elderly, non-overweight/obese, and newly diagnosed diabetic patients. It is recommended that treatment criteria for type 2 diabetes should account for the age, level of adiposity, and diabetic duration of the patient in order to make optimal therapeutic decisions for the treatment of diabetes mellitus in adults.
ABSTRACT
Aim: To determine the prevalence of gestational diabetes and its risk factors among pregnant women in Abakaliki metropolis, Ebonyi State Nigeria. Method: A total of 250 pregnant women aged 15-44 yrs in their first and second trimester attending antenatal clinics in Ebonyi State University Teaching Hospital, Mile Four Maternity Hospital and Federal Medical Center Abakaliki were seen within the period of June 2010 to December 2011. Their age, parity, body mass index, gestational age and family history of diabetes were taken, while their gestational diabetes mellitus was assessed using 100g oral glucose tolerance test (OGTT). The plasma glucose response (PGR) was assessed and glucose tolerance status of each patient was interpreted using National Diabetes Data Group criteria. The prevalence of gestational diabetes was determined and its relationship with risk factors compared. Result: The study subjects had a mean gestational age of 26 ±6.4 weeks, mean parity of 1.5 and BMI of 26.5(+/-3.8) kg/m2. The prevalence rate of GDM diagnosed by 100g OGTT was 4.8%. This value increased significantly with increase in the age of the women. Inter-relationship between GDM and maternal age, gestational age, parity and family history was assessed using Chi-Square. The prevalence of GDM in pregnant women within the age of 15-24years was 3.3%, 25-34years had 4.2% and 34-44years had 17.6%. The prevalence of GDM increased significantly with increase in age of the subjects (P = 0.035). Prevalence of GDM according to the gestational age of 1st trimester, 2nd trimester and 3rd trimester were 7.7%, 5.6% and 3.9% respectively. The relationship however was not statistically significant (P = 0.736. The prevalence of GDM according to the parity of the women at 0, 1-4 and ≥5 were 5.1%, 4.1% and 8.0% respectively. The relationship also showed no significant difference (P = 0.689). The women with family history of diabetes had GDM prevalence of 4.5% while those without family history of diabetes had 4.8%. No significant difference was observed (P-value = 0.953) Conclusion: The prevalence of gestational diabetes mellitus in this region of the country was found to be 4.8%. The high value could be linked to malnutrition. This value was found to increase significantly with increase in the age of the women. No significant difference was observed when GDM was related to parity, family history of diabetes and gestational age. Since most women with GDM have no demonstrable risk factor, for this reason we advocate to screen all pregnant women.