[Ketoacidosis in type 1 diabetes mellitus: 73 cases in Dakar]. / Acidocetose Chez Le Sujet Diabetique De Type 1 : A Propos De 73 Cas Colliges A Dakar.

INTRODUCTION: The follow-up of diabetes mellitus in children and teenagers remains a challenge. Ketoacidosis is the most frequent acute metabolic complication and is of bad prognosis. The objective of this study was to evaluate etiologicals factors of decompensation and evolutions in type 1 diabetes. PATIENTS AND METHODS: We conducted a transversal and prospective study from January 2009 to October 2010. All type 1 diabetic patients hospitalized for ketoacidosis had been included. For every patient, we have studied the epidemiologicals, etiologicals and clinicals factors as well as the outcomes. RESULTS: The prevalence was to 55.3 % among all ketoacidosis. Sex-ratio (Men/Women) was 0.78, mean age to 25.73 years and mean duration of diabetes was 3.9 years. Ketoacidosis was inaugural in 26 % of cases. Except Kussmaul dyspnea, prevailed digestives symptoms (87.6 %). Coma was noted in 82.1 % among whom 54.7 % had no previous diabetic follow-up. A decompensation factor was found in 93.1 % of which an infection (78 %) or stop insulin (53.42 %). Prevailing infectious sites were urogenitals (24.6 %), respiratories (20.5 %). The outcome was fatal in 6.8 % of the cases. It was about 24.3 years middle-aged, 1,6 year diabetes mellitus mean duration, without regular follow-up in 80 % of the cases. Other associated factors were coma stage 2 or 3 (80%), infection (60 %), hypokalemia (40 %). CONCLUSION: Ketoacidosis is frequent in type 1 diabetic patients and has a bad prognosis. Infection and stop insulin are major factors of decompensation. Its prévention requires an adapted therapeutic education associated to a regular follow-up of patients.

[Descriptive study of diabetic foot at the Marc Sankale Diabetes Center. Report of 105 cases]. / Etude descriptive du pied diabetique au centre du diabete marc sankale. A propos de 105 cas.

INTRODUCTION: Diabetic foot is a major complication of diabetes due to its frequency and its high risk of evolution to amputation. We report 105 cases recruited at the diabetes centre Marc Sankale. METHOD: It's a prospective study including all diabetic patients who attended the diabetes centre for any foot lesion during a one year period. Besides clinical examination data, results of glycaemia, foot X-ray Doppler and bacteriological analysis of the pus were collected. RESULTS: foot lesion represented 2.8% of diabetologist causes of consultation. Mean age of occurrence was 55 +/- 14 years in 63% women and 37% men. Diabetes was type 2 in 90% cases, poorly controlled in 63.92 % cases. Foot lesion was dominated by infection (97%), isolated or associated to peripheral vascular disease (32.4%) or neuropathy (13.3%). 67 patients had medical treatment and healed their wounds in 3 months in 76% cases. 38 other cases needed surgery : major amputation (15%), minor amputation (13%) debridment (9%) and revascularization (1%). CONCLUSION: Diabetic foot is a frequent reason for consultation at the National diabetes centre. Despite all the improvements made after the implementation of the patient's educational program, treatment starts late because of economical and cultural reasons that increase morbidity.

[Frequency of microalbuminuria during diabetes in Dakar, Senegal]. / Fréquence de la microalbuminurie au cours du diabète a Dakar (Senegal).

Nephropathy is one of the complications occuring during diabetes and it is diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited and distributed into two groups, A (n = 270) and B (n = 317). Microalbuminuria was determined by immunonephelemetry for group A and immunoturbidimetry for group B. The results showed respectively 15.5% and 20.19% pathological cases in the two groups (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes, there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B; no statistically significant differences were observed either in the same group or from one group to another. These frequencies might reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

[Frequency of micoalbuminuria during diabetes in Dakar (Senegal)]. / Frequence de la microalbuminurie au cours du diabète à Dakar (Sénégal).

Nephropathy is one of the complications occuring during diabetes diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited in groups A (n = 270) and B (n=317). Microalbuminuria was determined by immunonepheletry for A and immunoturbidimetry for B. The results pointed out respectively 15.5% and 20.19% pathological cases (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B ; no stastically significant differences were observed either in the same group or from one group to another. These frequencies would reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

[Hypercholesterolemia in diabetes in Dakar. Sociodemographic and etiological factors and therapeutic bases]. / Hypercholestérolémie au cours du diabète à Dakar. Facteurs socio-démographiques et étiologiques et bases thérapeutiques.

This study took place between January and September 1996. The inclusion criteria was a blood cholesterol concentration of at least 2.5 g/l. Thirty-three patients were included. They were aged from 37 to 77 years, with a mean age of 59 (+/- 9.4) years. Twenty-six were women and seven were men. The mean age of the women was 58.9 (+/- 10) years and that of the men was 61 (+/- 6.1) years. Sixteen patients were from urban areas, 14 from semi-rural areas and 3 were of rural origin. The mean duration of diabetes was 9 (+/- 6.5) years. Mean post-prandial blood glucose concentration was 2.2 (+/- 1.0) g/l. Mean body mass index was 25.6 (+/- 5.6). Mean systolic blood pressure was 15.0 (+/- 2.5) cm Hg and mean diastolic blood pressure was 9.0 (+/- 1.3) mm Hg. Blood cholesterol concentration was between 2.5 g/l and 5.6 g/l, and mean HDL cholesterol concentration was 0.7 (+/- 0.4) g/l. Mean blood triglyceride concentration was 1.0 (+/- 0.4) g/l. Body mass index was negatively correlated with high cholesterol levels (r = -0.29). Hypercholesterolemia was primary, with no associated high triglyceride concentration. Cholesterol levels were also negatively correlated with post-prandial blood glucose concentration (r = -0.1). Thus, treatment should involve the prescription of drugs to reduce blood lipid concentration rather than just the restriction of lipid intake.