Les nouveaux diabétiques observés à l’Hôpital Joseph Raseta Befelatanana d’Antananarivo (2002-2003)

Abstract

Introduction. Diabetes mellitus is a heavy burden on public health in low-income countries. In Madagascar, few studies are available regarding diabetes mellitus in its discovery time. The aim of our study was to report the epidemiological and clinical aspects during discovery time of diabetes in Endocrinology service for a period of 12 months. Methodology. This is a descriptive retrospective survey realized in the service of Endocrinology of the Befelatanana Hospital, Antananarivo, from December 1st , 2002 to November 30, 2003. The retained patients were those who had newly diagnosed diabetes. Results. One hundred thirty patients were selected for the study. The incidence of diabetes in the service was 17.8%. The average age of patients was 46.9 years. The sex ratio was 1.06. One hundred two patients (78.5%) were type 2 diabetics. The average time between the first clinical manifestations of diabetes and diagnosis was 25 days. Most of our patients were symptomatic at the time of the discovery of their diabetes. The main signs associated with diabetes were physical asthenia (70%), weight loss (65.3%), polyuria (63.8%) and polydipsia (61.5%). Inaugural keto-acidosis had occurred in thirteen patients (10%). Coronaropathy occupied the first place (24.6%) in regarding degenerative complications already found at diagnosis of diabetes. Diabetic foot infection was the most common infectious complication. Insulin therapy was prescribed in 76.9% of our patients after hospitalization. Conclusion. In our practice, diabetes is often diagnosed late and at stage of complications. Efforts in screening for this disease are neces- sary; the results of this study will be used by practitioners as a tool to reinforce this strategy.