[Renal failure in Tunisian patients with type 2 diabetes: frequency and related factors]. / L'insuffisance rénale chez des diabétiques de type 2 Tunisiens hospitalises: frequence et fateurs associés.

BACKGROUND: Frequent screening of renal failure and good glycaemic control in diabetic patients can avoid this severe complication. AIM: To evaluate the frequency of renal failure and the associated risk factors among type 2 diabetic Tunisian in-patients. Glomerular filtration rate was estimated using the Cockcroft-Gault formula. Renal failure was diagnosed on figure of glomerular filtration rate inferior than 60 ml/min. RESULTS: Six hundred eighty-nine patients were included. The sex ratio was 0.65. The mean age was 60 ± 11 years. The frequency of renal failure was 19.8% (137 patients) with dominance of a moderate form defined by a glomerular filtration rate between 30 and 59 ml/min (82.5% of patients). Patients with renal failure were older and less obese than diabetic patients without this complication (p<0.00001 and 0.02 respectively). The duration of both diabetes and hypertension was higher in presence of renal failure (p=0.0001 and p<0.001 respectively). Patients with renal failure had more often hypertension and dyslipidemia than patients with normal renal function (p<0.001 and p=0.01 respectively). A personal history of severe retinopathy treated by laser, of coronary disease or of stroke was significantly associated to renal failure (p=0.002, p<0.0001 and p=0.001 respectively). CONCLUSION: The frequency of renal failure observed in Tunisian patients diagnosed with type 2 diabetes is high. Hypertension and dyslipidemia should be carefully treated to prevent or delay the evolution to the renal failure.

[Factors influencing homocysteineamia in type 2 diabetic patients]. / Facteurs modifiant l'homocysteinemie chez un groupe de diabetiques de type 2.

Previous studies have suggested that hyperhomocysteinaemia (Hcy) could be a strong and independent cardiovascular risk factor. Many factors could influence the serum concentration of Hcy such as vitamin B 12, folic acid, renal failure, hypothyroid status, ovarian failure and cancers. So the aim of our study was to evaluate the prevalence of hyperhomocysteinaemia among 54 type 2 diabetic patients and to study, its relationship with vitamin B12, folic acid and Metformin. Were excluded all patients with an evident cause of hyperhomocysteinaemia. Mean age of patients was 52.8 years. Mean Hcy was 11.7 + 6.9 micromol/l. The prevalence of hyperhomocysteinaemia was 27.8% in our group. There were eight (14%) patients with vitamin B12 deficiency and three among them had hyperhomocysteinaemia. There was no folic acid deficiency and no relationship with Metformin treatment. We suggest a wide screening of hyperhomocysteinaemia in type 2 diabetic patients and folic acid or vitamin B12 supplements if necessary.