Moderately Increased Albuminuria; Marker of Chronic Complications in Nigerian Diabetes Mellitus Type 2 Patients; Makurdi Perspective.

Background: Diabetes mellitus (DM) and its complications are on the increase especially in the developing countries with significant negative economic consequences on individuals, families and health systems. Objective: We, therefore compared albumin/creatinine ratio, microalbuminuria, and HbA1c among subjects of varying degree of complications with controls to ascertain if they can serve as markers of diabetic chronic complications to enhance early detection of chronic complications amongst diabetes mellitus patients in developing countries. Methods: 109 type 2 DM subjects (47 males and 62 females) and 100 non-DM controls of the same age range (40-80 yrs) were recruited for this study. The chronic complications found were: nephropathy, retinopathy, coronary artery disease, cerebrovascular disease, peripheral vascular disease and diabetic foot. These were further classified into micro vascular complications (nephropathy and retinopathy) and macrovascular complications (Coronary Artery Disease, Cerebrovascular Disease, Peripheral Vascular Disease and diabetic foot).Out of these 109 DM subjects, 36 were without chronic complications, 37 have microvascular complications only and 36 have a combination of microvascular and macrovascular complications. HbA1c, Urine microalbumin and creatinine were analysed using standard methods. Results: The mean levels of HbA1c, Microalbuminuria and albumin-creatinine ratio were significantly higher in DM subjects when compared to the control (p<0.05). Microalbumin, albumincreatinine ratio, and HbA1c were significantly higher in DM subjects with chronic complications than those without complications (p<0.05). However, DM subjects with both macro and micro complications had significant higher level of urine microalbumin, albumin-creatinine ratio, and HbA1c than those with microvascular complications only (p<0.05). Subjects aged 40-45 years had significant (p<0.01) albumin/creatinine ratio than subjects aged 51-55yrs as well as those >60 years. The male subjects had a significant (p<0.01) albumin/creatinine ratio and microalbumin respectively on comparing to their female counterpart Conclusion: Albumin-creatinine ratio is a simple, and less cumbersome tool which could serve as a predictor of complications in type 2 diabetes mellitus.

Glycaemic Response to Different Preparations of Yam in Diabetic and Non-Diabetic Nigerians

Post-pandial glycaemic responses to food can be affected by the method involved in the preparation of the food. Dietary intervention with food modification forms the corner- stone of management of type 2 diabetes worldwide. The effect of processing on yam; a staple food in Nigeria; was studied among diabetic and non-diabetic Nigerians. Despite undergoing more processing; amala prepared from yam flour had a better post-pandial glycaemic response index (PGRI) compared to other yam preparations; and this was also significantly higher among the diabetic subjects. Yam-based products; particularly amala; should be encouraged among diabetic Nigerians

Andropause: An emerging world health problem

Andropause is an emerging clinical concept that is gaining an increasing recognition; as the world becomes more aging. The clinical features though subtle are easy to identify and appropriate treatment of diagnosed cases will to a good extent alleviate a lot of age-related complaints and improve the general quality of life in the elderly men. Low level of clinical suspicion secondary to inadequate knowledge about this clinical entity remains the major obstacle to appropriate treatment. In this review; the literature has been perused and the definition; epidemiology; pathophysiology; clinical features; diagnosis and treatment are outlined