Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients

Abstract. BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {elbow flexors (r = -0.57), knee extensors (r = -0.63), handgrip (r = ­0.82)}; ROM {wrist extension (r = -0.64) and ankle planterflexion (r = -0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r = 0.62) and ulcerative grading (r = 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression

Prevalence of Non-Invasive Risk Factors of Type 2 Diabetes among Higher Education Teachers in North-Western Nigeria

Background: Teaching is associated with a number of stressful circumstances that promote unhealthy lifestyles capable of fuelling risk factors for metabolic and cardiovascular disorders. This study investigated the prevalence of selected non-invasive risk factors of Type 2 Diabetes (T2D) among higher education teachers. Methods: Higher education teachers numbering 876 from three tertiary institutions in Kano; North- Western Nigeria were assessed on selected non-invasive risk factors of T2D including Body Mass Index (BMI); Waist Circumference (WC); Waist-Hip-ratio (WHR); Percent Body Fat (PBF) and family history of diabetes. Lifestyle including smoking; alcoholism and physical inactivity were also assessed. Results: Female-male ratio of participants was 1:5 while the age range was 24-58 years. Female teachers had higher prevalence of poor adiposity markers represented by overweight (33.8); obesity (12.7); high PBF (21.7) and WC in the high risk domain (53.5). They also had higher prevalence of hypertension (22.5) while men had higher prevalence of WHR (31.2) in the high risk domain. Positive family history of diabetes was 6.5(males); 7.5(females); physical activity at walking level 46.0(males); sedentary activity 85.9(females); current smoking habit 42.8(males); 4.3(females) and current alcohol consumption was 11.9for males and 0for female teachers. Conclusion: There may be considerable chances of developing T2D among the higher education teachers based on prevalence of the selected risk factors and the risk may be higher among the female teachers. Measures to change the modifiable risk factors for the better in this population are urgently needed

Rhinocerebral Mucormycosis in a Patient with Type 1 Diabetes Mellitus: Case Report

Background: Rhinocerebral mucormycosis is one of the severe forms of infections in persons with diabetes mellitus. Its occurrence is rare and is reported little in our environ- ment. We report a case of rhinocerebral mucormycosis in a patient with type 1 diabetes mellitus (DM) with the aim of drawing the attention of physicians to its existence in our nvironment and the need for aggressive management. Method: The case notes of a patient with type 1 DM presenting with features of rhinocerebral mucormycosis and the rele- vant literature of the subject was reviewed. Result: An eighteen-year old senior secondary school man with a one-year history of type 1 DM was admitted to the male medical ard of Aminu Kano Teaching Hospital (AKTH) with features of diabetic ketoacidosis (DKA); facial rashes involving the medial canthus of the right eye extending to the right para- nasal area and right nostril. The facial rashes which started initially as blisters later progressed to form ulcers with necroses. There was progressive deterioration in level of consciousness with a right hemiparesis. Magnetic resonance imaging (MRI) revealed multiple brain abscesses with dilatation and engorgement of the sphenoidal and maxillary sinuses. He was managed with broad-spectrum antibiotics; antifungals and wound debridement. He continued to deteriorate and died seven weeks later. Conlusion: Rhinocere- bral mucormycosis though rare; does occur especially in the setting of DM and requires an aggressive and a multidisciplinary approach to management