Diabetes in Sub-Saharan Africa: Distribution Based on Social Status in Libreville (Gabon).

OBJECTIVE: Many researchers continue to believe that urbanization is a major contributor to diabetes. We seek to demonstrate that the social status associated with urbanization has an impact on the prevalence of diabetes in Libreville, Gabon in sub-Saharan Africa. METHODS: Our study was conducted in Libreville, the capital of Gabon; the city has a population of 397,000. Our study analyzed data from the registries of patients hospitalized in 2013 in the main diabetes center in Libreville. RESULTS: The results revealed that, for 2013, 798 patients were hospitalized with diabetes at a prevalence of .2%. We found differences (P<.05) between women (423) and men (375). Mean age for women was 52.02 years and 48.88 years for men. The number of existing cases hospitalized was significantly more than new cases. All levels of society were represented in our study: students (42); military (36); administratives (99); technicians (180); unemployed (295); and retired (146). The results showed that the unemployed (36%), particularly women (29.40%) are most affected by diabetes. CONCLUSIONS: Our results show the impact of social status on the increase of diabetes in Libreville. We found that urbanization, associated with insecurity especially in women, had an effect on the prevalence of diabetes in Libreville. These results indicate that, apart from the non-modifiable factors (age, race, ethnicity), insecurity is a modifiable factor that should be taken into account.

Craniofacial development and physiological state after early oral breathing in rats.

In this study we determined whether craniofacial development in rats could be influenced by an early temporary (3 d) nasal obstruction associated with forced oral breathing. The rats were killed at specific time points after surgery. Plasma samples were taken for biochemical analyses, and cephalometric measurements were performed. Shortly after nasal obstruction, the vertical nasomaxillary complex and the longitudinal skull base proved to be smaller in both sexes of test rats compared with controls. This was maintained in male rats but not in female rats. In female rats, only the longitudinal skull base remained somewhat shorter as the animals grew older. Reversible nasal obstruction was further associated with reduced dimensions of the olfactory bulbs lasting into adulthood and an initial decrease in lung weight. One day after implementing nasal obstruction, basal corticosterone levels had increased (by over 1,000%) and stayed at a high level in female rats. In male rats, however, the corticosterone level seemed to return to normal by day 90. Oral breathing was also associated with a lower level of thyroid hormone, especially at the shorter term intervals in both sexes. We conclude that a 3-d nasal obstruction period in young rats leads to long-term hormonal changes and to craniofacial structural adaptation.

Effects of short term forced oral breathing in rat pups on weight gain, hydration and stress.

Nasal obstruction is a risk factor in sleep-disordered breathing with a negative impact on the quality of life in humans. We investigated hydration changes produced by short term reversible, bilateral, nasal obstruction in young developing rat pups. Physiological parameters of growth (weight gain and gastric content weight) and dehydration were analyzed during two periods; during nasal obstruction at post-natal day 8 (days 9, 11 and 13), plus 7 and 90 days after recovery of nasal breathing (day 15 and adulthood). Body weight gain in oral breathing rat pups was slower compared to controls. Gastric weight was decreased significantly only in oral breathing rat pups on days 9 and 11 while plasma osmolality and vasopressin levels increased (indicators of dehydration). There were no differences between controls and treated rat pups by day 15, or at adulthood. Short term nasal obstruction-induced forced oral breathing, decreased gastric content which had a negative impact on growth and blood glucose concentration in the short term for female rat pups. Plasma corticosterone levels increased during the dehydration but were normal in males by 90 days. This could be a model for blocked nose syndrome in the newborn. Possible long term consequences on development are discussed.