Diabetes mellitus and public health in Guadeloupe

Diabetes mellitus is now among the ten leading causes of death in the Caribbean. Studies of the prevalence of dysglycaemic disorder and risk factors for diabetes are necessary in order to design and implement tailored prevention programmes. The present study is of a representative sample of the adult population in Guadeloupe. The estimated prevalence of diabetes is 5.8% in adults, and that of impaired glucose tolerance is 7.4%. The percentage of insulin-treated patients is low, 14% of diabetics. The principal risk factors of diabetes,as classically recognised, are shown to operate. At the individual level, the presence of a diabetic parent is greater relative risk factor than obesity. However, considering the large percentage of persons who are obese, obesity seems to be the principal factor at which a primary prevention programme at the community level should be aimed, in order to limit the incidence of hyperglycaemic states

The assays of glycosylated proteins in haemoglobinopathies and theis use in screening for diabetes Mellitus

We compare the relative validity of HbA1c and fructosamine as indices of lon-term vlood glucose levels in populations with a common occurrence of haemoglobinopathies. In these patients, HbA1c levels are lower than AbA1c levels in non-haemoglobinopathy patients and do not reflect the glucidic status of the patients, unlike the fructosamine assay. This last test has a good potential to be used as a mass screening test for diabetes mellitus in the populations (Africa, Caribbean, USA) in either homozygous or heterozygous haemoglobinopathy patients. Moreover, fructosamine presents numerous technical advantages which facilitate the screening