Relationship between random blood sugar and body mass index in an African population

Obesity is the most important modifiable risk factor in the pathogenesis of type-2 diabetes reported in most cross-sectional studies. However, racial factors seem to be important in the relationship between body mass index [BMI] and glucose intolerance. Three-hundred and seventeen subjects participated in the study. Mean age of subjects was 35.0 +/- 9.8 years [33.0 +/- 9.6 among females and 36.2 +/- 9.6 among males p= 0.1007]. Female subjects had significantly higher BMI than their male counterparts, [26.6 +/- 7.2 kg/m2 versus 24.0 +/- 5.4 kg/m2 p=0.0341]. Random blood sugar levels were, however, similar between males and females [85.2 +/- 27.0 mg/dl versus 85.9 +/- 14.7 mg/dl, p=0.8868]. There was a positive but non significant correlation between casual blood sugar and BMI among female subjects [r= +/- 0.1520, p>0.05]. In the males however, there was no correlation between these variables [r= -0.0395, p>0.5]. BMI is higher among females in this community and correlates with random blood glucose levels. Concerted efforts need to be made to address the issue of weight in this community within the framework of what is culturally acceptable

Insulinogenic indices among type 2 diabetic Nigerians

Abnormal pancreatic beta cell function is known to occur in type 2 diabetes mellitus. However, direct measurement of pancreatic beta cell function is cumbersome and virtually out of reach of most laboratories in developing countries. Fortunately, insulinogenic indices may be used as surrogate measures of beta cell function. To study insulinogenic indices among type 2 diabetic Nigerians. A cross sectional study involving 40 type 2 diabetic patients and 36 age- and sex-matched control subjects was undertaken. Diabetic patients and control subjects underwent standard oral glucose tolerance tests [OGTT]. Fasting and post OGTT plasma insulin levels were measured using an ELISA technique, while plasma glucose levels were determined by a glucose oxidase method. Insulinogenic indices were calculated at time 30, 60, 90 and 120 minutes of OGTT. Diabetic subjects and controls were statistically compared. At 30, 60 and 90 minutes of OGTT, type-2 diabetic patients had significantly much lower insulinogenic indices compared to control subjects [p < 0.001]. At 120 minutes of OGTT, however, the difference between the two groups was not statistically significant. Only BMI showed a positive correlation with insulinogenic index at 30 minutes of OGTT [r = +0.607, p < 0.001]. There was no significant correlation between insulinogenic indices and duration since diagnosis of diabetes mellitus. Type 2 diabetic patients exhibit lower insulinogenic indices suggesting poor pancreatic beta cell function

Insulin resistance in type 2 diabetic Nigerians

Considerable interest has been generated and still continues on the role of insulin resistance in the aetiology of glucose intolerance and its complications. There is evidence to suggest that racial factors are important in this regard. Whereas Caucasian studies suggest insulin resistance to be universal in type-2 diabetes, African-American studies on the other hand suggest the contrary in a significant proportion of type-2 diabetic African-Americans. No previous study has been undertaken in this aspect in type-2 diabetic Nigerians. To measure insulin resistance using the Homeostasis Model Assessment [HOMA] among type-2 diabetic Nigerians. A cross sectional study involving 40 type-2 diabetic subjects and 36 controls. The HOMA method was used to compute insulin resistance for each subject. Individual HOMA scores were subjected to statistical analysis between the two [diabetic and non-diabetic] groups. Forty type 2 diabetic patients and 36 healthy age and socio-economic status matched control subjects were studied. Mean HOMA scores were significantly higher among type 2 diabetic subjects than controls. Ten [27.8%] of the control subjects demonstrated HOMA insulin resistance values greater than one compared to 35 [87.5%] of type-2 diabetic patients [p<0.05]. It is concluded although type-2 diabetic patients exhibit more insulin resistance than control subjects, insulin sensitive variants of type-2 diabetes is also found in this population

Indices of obesity among type-2 diabetic Hausa-Fulani Nigerians

Obesity has been identified as the most important modifiable risk factor in the aetiology of type-2 diabetes mellitus. In clinical practice, body mass index [BMI] is the commonest index used to define the presence and degree of obesity. Unfortunately, BMI does not define the presence or absence of central obesity which has been shown to be the most pathogenically important in the causation of metabolic disorders including type-2 diabetes. Waist-hip ratio [WHR] has been shown to be a sensitive and reliable index of intra-abdominal obesity as well as intra-abdominal to subcutaneous fat ratio. To define obesity rates using BMI and WHR among type-2 diabetic northern Nigerians. Subjects and Methods: Forty type-2 diabetic subjects and 36 healthy controls were studied. Mean BMI among type-2 diabetic patients was 24.93+ 4.43 Kg M-2 versus 22.93 +/- 4.02 Kg M-2 [p<0.02]. Overweight occurred in 14[35%] of diabetic subjects versus 8 [22.0] of control subjects. Obesity on the other hand was observed in two [5.0%] of diabetic patients and none among control subjects. Type 2 diabetic patients had significantly much higher WHR compared to control subjects [1.03 +/- 0.08 versus 0.92 +/- 0.08 respectively, p<0.001]. Central obesity was recorded in 38 [95%] type 2 diabetic patients compared to [%] of control subjects. Current cut-off points using BMI may suggest that obesity is not common among type-2 diabetic Northern Nigerians although central obesity is quite common. There may be a need to revisit the cut off points to define obesity in this population

Total insulin output is low in type-2 diabetic Nigerians

Plasma insulin levels among type 2 diabetic patients are modulated by racial and ethnic factors. In contrast to the plethora of reported studies on plasma insulin levels among type 2 diabetic patients in technically advanced regions of the world, there is paucity of such information in Africa in general. To study insulin output among type 2 diabetic Nigerians. Forty type-2 diabetic and 36 healthy subjects underwent a standard oral glucose tolerance test [OGTT]. Fasting and post OGTT plasma insulin levels were measured using an ELISA technique. Integrated insulin responses were calculated using trapezoidal estimation to compute total insulin output. Student's t test was used to compare means; the level of statistical significance in each case was taken as p < 0.05. The age and sex distribution of diabetic patients and control subjects were similar [p >0.5]. Average duration of diabetes was 5.6 +/- 4.3 years [range 1 -20 years] Total insulin output was significantly lower among type 2 diabetic patients than in control subjects [360 +/- 82.1 microunits per ml and 745.1 +/- 109.0 micro-units per ml respectively P<0.00 1]. Type-2 diabetic patients in this study exhibit hypoinsulinaemia; this could be the explanation for the pattern of diabetic complications among type 2 diabetic Nigerians observed in previous studies