Islet cell autoantibodies in African patients with Type 1 and Type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study

Lutale, Janet; Thordarson, Hrafnkell; Holm, Pål Ivar; Eide, Geir Egil; Vetvik, K

doi:10.1186/1740-2557-4-4

Cited by 36 publications

(38 citation statements)

References 35 publications

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“…The sparse epidemiological data from other countries in sub-Saharan Africa suggest a high prevalence of a similar disease pattern (Levitt, 2008;Gill et al, 2009). Previous studies have shown that markers of islet cell autoimmunity are detectable in much o50% of insulin-requiring diabetic patients in Ethiopia and other African countries, a frequency considerably lower than that of Caucasian populations where these markers are typically found in 80-90% of newly diagnosed cases (Peters et al, 1986;McLarty et al, 1990;Lutale et al, 2007). Thus, although autoimmune type 1 diabetes does occur in sub-Saharan Africa, the Ethiopian data suggest that the most prevalent form of insulin-requiring diabetes is a non-autoimmune condition.…”

Section: Introductionmentioning

confidence: 99%

Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion

et al. 2010

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Background/Objectives: Most insulin-requiring diabetes patients in Ethiopia have an atypical form of the disease, which resembles previous descriptions of malnutrition-related diabetes. As so little is known about its aetiology, we have carried out a case-control study to evaluate its social and nutritional determinants. Subjects/Methods: Men and women with insulin-requiring diabetes (n ¼ 107), aged 18-40 years, were recruited in two centres, Gondar and Jimma, 750 km northwest and 330 km southwest of the capital, Addis Ababa, respectively. Controls of similar age and sex (n ¼ 110) were recruited from patients attending other hospital clinics. Results: Diabetes was strongly associated with subsistence farming, odds ratio ¼ 3.5 (95% confidence interval: 1.5-7.8) and illiteracy/low levels of education, odds ratio ¼ 4.0 (2.0-8.0). Diabetes was also linked with a history of childhood malnutrition, odds ratio ¼ 5.5 (1.0-29.0) the mother's death during childhood, odds ratio ¼ 3.9 (1.0-14.8), and markers of poverty including poorer access to sanitation (P ¼ 0.004), clean water (P ¼ 0.009), greater overcrowding (P ¼ 0.04), increased distance from the clinic (P ¼ 0.01) and having fewer possessions (P ¼ 0.01). Compared with controls, people with diabetes had low mid upper arm circumference, body mass index (BMI) and fat/lean body mass (Po0.01). In addition, men with the disease tended to be shorter, were lighter (P ¼ 0.001), with reduced sitting height (P ¼ 0.015) and reduced biacromial (P ¼ 0.003) and bitrochanteric (P ¼ 0.008) diameters. Conclusions: Insulin-requiring diabetes in Ethiopia is strongly linked with poor education and markers of poverty. Men with the disease have associated disproportionate skeletal growth. These findings point towards a nutritional aetiology for this condition although the nature of the nutritional deficiency and its timing during growth and development remains obscure.

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Section: Introductionmentioning

confidence: 99%

Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion

et al. 2010

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“…Similarly, a study carried out in Tanzania revealed lower frequencies of GAD and IA-2 autoantibodies compared to Caucasian type 1 diabetic patients. 37,39 Only one paper looked at the frequency of all four autoantibodies in 86 newly diagnosed type 1 diabetic children from Tunisia. 31 The authors found that 78 (90.7%) children were positive for one or more autoantibody.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology and pathogenesis of type 1 diabetes mellitus in Africa

Padoa

2011

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Type 1 diabetes is a serious, debilitating disease, with life-threatening complications, and the financial burden associated with the management of this disease is enormous. Early diagnosis and intervention can improve morbidity and mortality. Unfortunately, in Africa, type 1 diabetes is poorly characterised, and there is sparse information regarding the aetiology and epidemiology of this disease. However, there is some evidence of a later age of onset in African type 1 diabetic patients, compared to European diabetics, and it is thought that the prevalence of type 1 diabetes is lower in African populations than in the Western world.

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“…Because populations with Type 1 diabetes in Asia and Africa exhibit less than 50% prevalence of diabetes related autoantibodies, the American diabetes association (ADA) [5] and the World Health Organization [11] have subclassified Type 1 diabetes into Types 1a and 1b, where Type 1a is autoimmune mediated, and Type 1b is nonautoimmune mediated, or idiopathic Type 1. There appear to be no significant clinical differences between patients with or without circulating autoantibodies [12][13][14][15].…”

Section: Introductionmentioning

confidence: 64%

“…Earlier reports had found that islet cell autoantibodies to be rare among Asians, Malaysians, Arabic and African origins [12][13][14][15][20][21][22][23][24][25][26] compared to Caucasians [8,27]. In this study, we investigated the prevalence of GADAs and ICA in patients with recently diagnosed diabetes in northwest of Iran.…”

Section: Discussionmentioning

confidence: 95%

Islet cell autoantibodies in patients younger than 20 years of age with recently diagnosed diabetes in Northwest of Iran

Marandi

Rajaii

Aliasgarzadeh

et al. 2011

Int J Diabetes Dev Ctries

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The presence or absence of islet cell autoantibodies is one of the most direct ways to distinguish between type 1 and 2 diabetic patients. The objective of the present study was to assess the prevalence of β-cell autoantibodies such as glutamic acid decarboxylase-65 antibodies (GADAs) and islet cell antibodies (ICA) among patients younger than 20 years of age with recently diagnosed diabetes in northwest of Iran. From 2006 to 2008, 163 patients were enrolled in this study. They were clinically classified into two groups: 136 with type 1 diabetes (T1D) and 27 with type 2 diabetes (T2D). Serum levels of GADAs, ICA and C-peptide were determined with enzyme linked immunosorbent assay (ELISA) kits. Fasting blood glucose and HbA1c levels were also determined. Chisquare test, independent t test and one-way analysis of variance were used for data analysis. The prevalence of GADAs in T1D patients was 33.1%, slightly lower than that of ICA 35.3%. Forty-eight patients (35.3%) with T1D were positive for ICA compared to only one (3.7%) in T2D patients. The overall occurrence of any autoantibody in T1D patients (60.3%) was significantly higher than that of T2D patients (18.5%) (P<0.001). There was a statistically different association with family history of diabetes among the autoantibody positive versus autoantibody negative patients with T1D (P<0.01). Our results confirmed the presence of GADAs and ICA in T1D patients in Iran, though roughly at a lower prevalence than that reported for Caucasian T1D patients, but very similar to other nonCaucasian ethnic populations.

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Islet cell autoantibodies in African patients with Type 1 and Type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study

Cited by 36 publications

References 35 publications

Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion

Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion

The epidemiology and pathogenesis of type 1 diabetes mellitus in Africa

Islet cell autoantibodies in patients younger than 20 years of age with recently diagnosed diabetes in Northwest of Iran

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