ABSTRACT
OBJECTIVES: The aim of this study was to compare the prevalence of abnormal glucose tolerance in patients stemming from two French ethnic groups and admitted for acute coronary syndrome (ACS) to intensive coronary care unit. MATERIALS AND METHODS: During a period of six months, 53 and 60 consecutive patients were enrolled at Fort-de-France (Martinique, French West Indies, Afrocaribbeans, group F) and at Bordeaux (France, Europeans, group B), respectively. Glucometabolic state was classified according to medical history and fasting glycemia measured from the fourth day after ACS. RESULTS: At baseline, 36% of the patients of group F and 20% of the patients of group B had previously known diabetes (p=0.06). Prevalence of hypertension was higher in Afrocaribbeans than in Europeans (60 versus 40%, p<0.05). According to fasting glycemia, newly detected diabetes were found in six Afrocaribbeans and only one was found in Europeans; two patients in group F and three patients in group B displayed impaired fasting glycemia. As a whole, 51% of Afrocaribbeans and 27% of Europeans showed abnormal glucose tolerance (p<0.05). Furthermore, Afrocaribbeans displayed lower levels of triglycerides and higher levels of HDL cholesterol than Europeans (p<0.05). CONCLUSION: Our study suggested a higher prevalence of impaired glucose metabolism in French Afrocaribbeans than in European counterparts after ACS. Furthermore, French Afrocaribbeans displayed a more favorable lipoprotein profile. These characteristics look like that of the American and British Afrocaribbeans, maybe because of a common genetic origin.
Subject(s)
Glucose Intolerance/epidemiology , Glucose Intolerance/metabolism , Myocardial Infarction/epidemiology , Myocardial Infarction/metabolism , Acute Coronary Syndrome/epidemiology , Acute Coronary Syndrome/metabolism , Age Factors , Aged , Anthropometry , Black People , Blood Glucose/metabolism , Caribbean Region/ethnology , Cholesterol, HDL/blood , Critical Care , Diabetes Mellitus/epidemiology , Ethnicity , Female , France/epidemiology , Glucose Tolerance Test , Humans , Male , Middle Aged , Sex Factors , Triglycerides/blood , White PeopleABSTRACT
OBJECTIVE: To determine the prevalence of open angle glaucoma in a hospital-based sample of diabetic people living in Martinique. DESIGN: Retrospective study during 23 months. PARTICIPANTS: A total of 917 patients were examined and received a complete eye examination for diabetes. MAIN OUTCOME MEASURES: A form was established with all examination data, patient ID, non ophthalmological data (blood pressure, body mass index, type of diabetes...) and ophthalmological data with intra-ocular pressure and optic disc cup. RESULTS: Glaucoma was present in about 9.8 percent of patients and there were 3.28 times more females than male. With regard to the type of diabetes, 1.11 percent were type 1, 18.89 percent were type 2, and 80 percent were insulin treated but not all insulin dependent. The prevalence of diabetic retinopathy is similar in the glaucomatous group and in the non-glaucomatous group. High blood pressure was present in 80 percent of glaucoma patients versus 58.8 percent in the non-glaucoma group. CONCLUSION: This 9.8 percent prevalence of glaucoma is the only data on open angle glaucoma so far available in Martinique. High blood pressure is a main risk factor for glaucoma in Martinique. Diabetes represents also a risk factor for glaucoma in Martinique. The sex ratio showed 3 times more females than males in the diabetic population. (AU)
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diabetic Retinopathy/drug therapy , Glaucoma, Open-AngleABSTRACT
Management of very high insulin requirements in rare extreme insulin resistance syndromes is difficult and poorly documented. We report a case of a type B insulin-resistant patient requiring approximately 10,000 units of insulin per day, i.e. beyond the possibilities of current insulin formulations and delivery devices. Only the Panomat C10 portable pump model (Disetronic) and U500 Humulin (Lilly) allowed the required rate of 400 units per hour to be attained only when the reservoir was changed twice daily and the site and catheter were changed once daily. Three months after discharge, the patient was in good general and local condition, but with only fair diabetes control (glycated haemoglobin 9.5%).
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Insulin Infusion Systems , Insulin Resistance , Insulin/administration & dosage , Adult , Blood Glucose/metabolism , Body Weight , Diabetes Mellitus, Type 1/physiopathology , Female , Glycated Hemoglobin/analysis , Glycosuria , Humans , Infusions, Intravenous , Injections, Subcutaneous , Insulin/therapeutic use , Plasma ExchangeABSTRACT
HLA-A,B,C, and DR frequencies have been determined in 34 Coloured Martinican IDDM patients to establish the HLA and IDDM associations. HLA A3, B15, B18, Cw3 and DR4 antigens associations with IDDM are confirmed by this study. We found an increase of B21 similar to that found in Asiatic Indians. As in some African Black populations and in Cape coloured people, A1, B8, and DR3 are not increased in our population. We should point out that our patients' ages of onset were low, and that some studies have found DR4 association in young patients and DR3 in older ones. The protective role of DR2 is confirmed here. B35 and Cw4 negative associations have been found. We have observed that the antigens associated with IDDM are decreased in our control population, except DR4, and that the negative associated DR/ and Cw4 antigens are increased compared to the Continental French population. This corresponds with the low IDDM incidence in Blacks and Coloured people.
