Diabetes in urban Guinea-Bissau; patient characteristics, mortality and prevalence of undiagnosed dysglycemia

Abstract

Background: The burden of diabetes mellitus in Sub-Saharan Africa is growing rapidly, and yet the prevalence and patient characteristics are still largely unknown. Objectives: We analyzed clinical and demographic characteristics of Type 2 diabetes (T2DM) patients attending a diabetes clinic in Guinea-Bissau from February 2008 to April 2014, and estimated the prevalence and risk factors of unknown-impaired fasting plasma glucose (FPG) and diabetes, as well as excess mortality associated with T2DM. Methods: We characterized T2DM patients attending the national diabetes clinic in Bissau. Diabetes was diagnosed based on FPG. We matched T2DM patients 1:1 with non-diabetes community controls on age and sex to determine relevant risk factors for T2DM using logistic regression. Furthermore, we matched patients 1:6 with community controls to assess longterm survival (until February 2019) in a Cox regression using calendar time as the underlying timescale. Verbal autopsies determined the cause of death among T2DM patients and controls. Results: The mean age among T2DM was 50.6 (SD 11.1), and the mean FPG at first consultation was high (13.2 mmol/L (SD 5.1)). Ethnicity, family history of diabetes, hypertension, and anthropometrics differed among T2DM patients, community controls with impaired FPG, and healthy controls. Family history of diabetes (OR = 5.65, 95% CI: 3.10-10.3) and elevated waist circumference (2.33, 1.26-4.29) were significant risk factors for T2DM. 20.4% (59/289) of community controls had abnormal FPG. T2DM patients had an excess mortality hazard ratio of 3.53 (95%CI: 1.92-6.52). Deaths caused by bacterial infections, including foot ulcers, were more common among T2DM patients, compared with community controls (54% (7/13) vs. 19% (5/27) (P = 0.02)). Conclusion: Several risk factors including were associated with T2DM in Guinea-Bissau. We found a high prevalence of elevated FPG among randomly selected community controls. In combination with higher mortality among T2DM patients, an urgent need for better treatment options and increased awareness.

Prevalence of Diabetes and Associated Factors Among Government Employees of Mizan-Aman Town and Zonal Sector Office, Bench Sheko Zone, Southwest Ethiopia Region, 2022

“…This result is also similar to the results of various studies. 16,17,36,44 A healthy diet/serving ≥5 servings per week and good knowledge were found to protect office workers from diabetes. Consuming ≥5 servings of fruits and vegetables per week has been proven to prevent the risk of developing diabetes.…”

“…reported. 34,44,45 The result shows that most of the officials working in sector offices (83.8%) were unaware of genetics/ family history which was one of the main factors affecting diabetes. This study found that a lack of moderate-intensity activity for a week was strongly associated with diabetes, consistent with results from other studies.…”

Glucose Detection Based on pH-sensitive Liposomes

“…(1)(2)(3)(4) Such complications can result in retinopathy leading to blindness, nephropathy giving rise to renal failure, and peripheral nerve damage with increased risks of extremity ulcers, amputation, and cardiovascular diseases. (4)(5)(6)(7)(8) Therefore, great effort has been made to achieve the efficient detection and treatment of diseases. Analytical techniques with a detection limit of nM order have been developed for the detection of diseases, including electrochemical or optical sensors.…”

Implementation and evaluation of a specialized diabetes clinic in Guinea Bissau: lessons learnt from the field

“…In GB, precise estimates for the prevalence of DM are not available, owing to a lack of research studies or surveys of high standards. According to available studies conducted in selected populations in GB, the prevalence of DM ranges from 1.7 % up to 14.3% [ 8 - 10 ]. This prevalence is lower than those reported in global and regional prevalence surveys [ 2 , 11 , 12 ].…”

“…This situation led researchers to call for the implementation of prevention and early diagnosis measures for DM in GB, to avoid burdening the local fragile health system [ 9 , 10 ]. In this context, we conducted a situational analysis of DM care in GB to identify main issues faced in DM management in the country [ 13 ].…”