Frequency and determinants of phytotherapy use in patients with type 2 diabetes in the Dschang Health District, Cameroon: a cross-sectional study

Introduction: phytotherapy is widely used in Africa for the management of many diseases. Data on the use of phytotherapy in people with type 2 diabetes are scarce. We aimed to determine the frequency and factors associated with the consumption/use of phytotherapy products among patients with type 2 diabetes in the Dschang Health District. Methods: we conducted a cross-sectional study from January to May 2022, including community-dwelling or hospitalized patients with type 2 diabetes who had lived in the Dschang Health District for at least one year. Informed consent was obtained from all patients. Data were collected using a pre-designed questionnaire. Variables collected included socio-demographic characteristics, diabetes knowledge and practices, and perceptions of care. Results: we included 403 (249 women) patients with type 2 diabetes with a mean (SD) age of 63 (± 14.86) years). Among them, 240 (59.55%) used phytotherapy, either in combination with conventional treatment (168 (41.69%) participants) or not (72 (17.86%) participants), to treat diabetes. The most common reasons for using phytotherapy were easy accessibility and belief in its efficacy. Most patients used both treatments because they thought the combination was more effective. In univariable analysis, we observed a statistically significant association between level of education (p=0.003), socioeconomic level (p<0.001), place of residence (p=0.003), duration of diabetes (p=0.007), and use of phytotherapy. In multivariable analysis, only age between 51 and 60 years (OR: 0.50, 95% CI 0.298 - 0.8521; p=0.01) was associated with the use of phytotherapy. Conclusion: people living with T2D in the Dschang Health District frequently use phytotherapy as an antidiabetic remedy, especially those aged between 51 and 60 years, those with low education level, low socioeconomic level and medium duration of diabetes. There is a need to evaluate its effectiveness in treating diabetes and its adverse effects.

Effect of Topical Capsaicin on Painful Sensory Peripheral Neuropathy in Patients with Type 2 Diabetes: A Double-Blind Placebo-Controlled Randomised Clinical Trial.

Objective The aim of this study was to evaluate the efficacy of capsaicin in inducing significant pain relief in a population of sub-Saharan African type 2 diabetic patients with painful peripheral neuropathy. Design This was a prospective double-blind placebo-controlled randomised clinical trial. Setting A single tertiary-level hospital diabetes center in Yaounde, Cameroon. Participants Twenty-two participants with type 2 diabetes mellitus, presenting with painful diabetic neuropathy, aged 18 years and above. Intervention Participants were equally randomised to capsaicin or placebo. Each drug was to be applied on the lower limbs thrice daily. Follow-up was done every two weeks for eight weeks.  Main outcome measure Reduction in the median pain score from baseline, as assessed by the Visual Analogue Scale.  Results Twenty-two participants aged 57.5 (50-60) years with a median pain intensity of 6.8 units in the capsaicin group and 5.8 units in the placebo group were included; at inclusion, there was no significant difference in the two groups (p=0.29). After two weeks, the value of pain intensity was 3.3 [2.5-4.0] vs 5.0 [4.0-7.4] (p=0.003); at week four, 3.0 [2.5-3.3] vs 5.0 [4.2-5.5] (p=0,02); at week six, 3.3 [2.5-4.0] vs 4.8 [4.0-6.0] (p=0.03); and at week eight, 6.6 [6.0-7.0] vs 5.2 [5.0-6.0] (p=0.54) for capsaicin and placebo respectively. Conclusion This study, carried out due to a paucity of information on the effect of capsaicin and painful diabetic neuropathy in sub-Saharan African diabetes patients, shows that capsaicin significantly reduces neuropathic pain with worsening after eight weeks of use. Trial registration number Pan Africa Trial Registry: PACTR202003714748946.

The clinical and psychological profiles of patients with hypogonadism, followed in 3 reference hospitals of Cameroon: an observational study.

INTRODUCTION: Hypogonadism refers to a syndrome that results from failure of gonads to function properly. The main concern is considerable rise in morbidity, as shown by increased cardiovascular risk, infertility, osteoporosis and above all, the psychological impact on the life of the patients with hypogonadism. Judicious steroid replacement and culturally-sensitive psychological support before and during steroid therapy remains the key tool in the management of this condition. The present study aimed at filling the knowledge gap on hypogonadism in Cameroon. METHODS: We conducted a cross-sectional study over a period of 12 months, in 3 reference hospitals of Cameroon. We included males and females diagnosed with hypogonadism, aged 16 to 50 years and 16 to 45 years respectively. After a complete clinical examination, patients were invited to fill the modified middlesex hospital questionnaire for psychoneurotic evaluation. RESULTS: We recruited 59 patients with a sex ratio of 1:1. The mean age of the females and males were 27.7 ± 9.1years and 30.8 ± 11.7 years respectively. Normosmic Idiopathic Hypogonadotropic Hypogonadism (NIHH) was the most common presentation. Compulsive obsessive traits, phobic anxiety and hysterical trait, were most pronounced in these patients. Testosterone titers significantly correlated positively with testicular size and negatively with body mass index (BMI). A significant positive correlation was found between the testicular volumes measured with ultrasound (US) and with the orchidometer. CONCLUSION: Normosmic idiopathic hypogonadotropic hypogonadism is the most common presentation of hypogonadism in the study population. There is a significant psychosocial impact requiring further investigation and attention.

Effect of Body Lotions on Capillary Blood Glucose Measurement - Interference of Hydroquinone-Containing Body Lotion with Capillary Glucose Measurement.

The reliability of capillary blood glucose measurements is tremendously important for patients' care and follow-up. Some factors independent of glucose control could however affect readings during ambulatory monitoring of capillary glucose levels in patients with diabetes mellitus. We sought to evaluate the impact of three body lotions commonly used in Cameroon on different strata of glycaemia. We explored their influence over time on measured capillary glucose values. We enrolled 16 participants. Eligible individuals were adult patients with diabetes (n=12) stratified into three levels of capillary glucose values (100 ± 40 mg/dL [5.55 ± 2.22 mmol/L], 200 ± 40 mg/dL [11.1 ± 2.22 mmol/L] and 300 ± 40 mg/dL [16.65 ± 2.22 mmol/L]) and normoglycaemic individuals (n=4). We measured capillary blood glucose before application, immediately after, then 5, 30 and 60 minutes after application of sweet almond oil, corticosteroid cream and hydroquinone lotion. The measurements made on impregnated body lotion-permeated fingers were compared to that of a clean finger. We observed a significant increase (delta [95% confidence interval, CI]: 119.5% [77.4-222.1]) of capillary glucose level immediately after administration of hydroquinone-containing body lotion (p<0.001). Capillary glucose values after the use of corticoid cream and sweet almond oil was stable 5, 30 and 60 minutes after application (p=0.875 and p=0.883 respectively). In the case of the hydroquinone-containing body lotion, there was a significant difference between capillary glucose level at 5 minutes (delta [95%CI]: 81.6% [55.3-214.2]; p<0.001), 30 minutes (delta [95%CI]: 71.6% [21.8-134.6]; p<0.001) and 60 minutes (delta [95%CI]: 58.3% [2.8-133.3]; p=0.013) after application compared to the value obtained from the clean finger. We observed from our study that there were significant variations in capillary blood glucose measurements induced by the use of hydroquinone lotion.