RESUMEN
Background & objectives: The impact of several environmental and genetic factors on diabetes is well documented. Though the association between the vitamin D receptor (VDR) gene polymorphisms and type 2 diabetes mellitus (T2DM) has been analyzed in different ethnic groups, the results have been inconsistent. The aim of this study was to evaluate the possible association between VDR FokI polymorphism and genetic susceptibility to T2DM in Tunisian population. Methods: A total of 439 unrelated patients with T2DM and 302 healthy controls were included in the study. Genomic DNA was extracted from blood and genotyped for the single nucleotide polymorphism (SNP) of FokI (T/C: (rs2228570) by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The genotype distribution and the relative allelic frequencies for the FokI polymorphism were not significantly different between T2DM and controls: in T2DM patients the frequencies of the CC, CT, and TT genotypes were 52.6, 41.0, and 6.1 per cent, respectively, and in controls the genotype frequencies were 55.6, 38.7, and 5.6 per cent, respectively. In our study, the TT genotype of the FokI polymorphism was not associated with T2DM (OR =1.19, 95% CI 0.63 - 2.25, P=0.577). Interpretation & conclusions: Our study showed no significant association of the FokI polymorphism in the vitamin D receptor gene with type 2 diabetes mellitus in Tunisian population.
RESUMEN
This cross-sectional multicentric study was carried out by 7 Tunisian centers in the aim to describe their behavior about permanent insulin treatment, for there type 2 diabetic patients. Three hundred patients were included, aged 59.2 +/- 0.6 years, whose BMI was 2 7.3 +/- 0.28 kg/m2 and diabetic duration was 10.2 +/- 0.4 years at the time of insulin treatment. Most of them were previously treated by the association of glibenclamide and metformin with a fasting glycaemia at 16.7 +/- 0.3 mmol/l and HbAC at 11.1 +/- 0.2%. The insulin treatment was indicated in 68% of the cases by a chronic poor control, in 7.3% by an acute decompensation and in 20% by degenerative complications. Insulin regimen included 2 daily injections [60% of the cases]. Oral agents were stopped in 77% of the cases. After a mean delay of 3.6h0.2 years, the average insulin dose was 0.5610.02 UI/kg/j, the, fasting glycaemia was lowered by 7.0 +/- 0.4 mmol/l and the HbA1c by 2.2 +/- 0.2%. The investigators estimate that the insulin treatment was justified in 77% of the cases and was inevitable in 11%