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Acute Metabolic Complications of Diabetes in the Oueme-Plateau Provincial Teaching Hospital: Epidemiological, Clinical, Paraclinical and Evolutionary Aspects

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Open Journal of Internal Medicine 2024年第1期14卷 83-92页

作者： Finangnon Armand Wanvoegbe comlan jules gninkoun Hubert Dedjan Kouessi Anthelme Agbodande Van Carrel Yongolo Prosper Singbo Elisé Boko Manchouhoud Alalade Adele Cakpo Ingrid Thomas Angele Azon Kouanou Internal Medicine Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Endocrinology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Endocrinology Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Internal Medicine Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin

Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute metabolic complications (AMC) of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a descriptive cross-sectional study with data collection based on the medical records of patients presenting with acute metabolic complications of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital during the 3 years study period (from January 2020 to December 2022). Results: Over 788 patients hospitalized during the study period, 157 had an acute metabolic complication of diabetes, which is a hospital prevalence of 19.9%. Among these 157 cases, 140 were suitable for analysis and therefore constituted our study sample. The mean age of the patients was 49.9 ± 14.7 years, with 19 as minimum and 90 years as maximum. Most of them were women (52.4%). Hypertensive diabetics accounted for 54.9% of cases. Ketoacidosis was the most common complication (62.1%), followed by hyperosmolar hyperglycemic syndrome (23.6%) and hypoglycemia (14.3%). Infection (69.3%) and therapeutic noncompliance (22.9%) were the most common triggers. The average length period of their hospital stay was 7.1 ± 5.1 days, and the outcome was satisfactory in 87.9% of the cases. Unfortunately, there were 3.6% deaths during hospitalization. Conclusion: Acute metabolic complications of diabetes were dominated by ketoacidosis. Infection was the dominant factor in decompensation. Therapeutic education of diabetic patients as well as clinical and biological monitoring must be more stringent and rigorous.

关键词： Acute Metabolic Complications Diabetes Ketoacidosis Porto-Novo

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Diabetic Ketosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

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Journal of Diabetes Mellitus 2016年第4期6卷 301-306页

作者： comlan jules gninkoun Adébayo Sabi Cossi Alassani Yempabou Sagna Philippe Adjagba François Djrolo Department of Internal Medicine-Endocrinology Metabolism and Nutrition Unit Cotonou Benin University Hospital of Borgou Parakou Benin Department of Internal Medicine University Hospital Yalgado Ouedraogo Ougadougou Burkina Faso Cardiology and Vascular Disease Unit Cotonou Benin

We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

关键词： Ketoacidosis Diabetes Complications Ketosis-Prone

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Therapeutic Itinerary and Causes of Delay in Specialized Consultation of Patients Admitted for Diabetic Foot

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Journal of Diabetes Mellitus 2018年第4期8卷 125-130页

作者： comlan jules gninkoun Mensah S.Attikleme Roberto Dossou Tores Prudencio Adebayo Sabi Cossi Alassani Francois Djrolo Endocrinology Metabolism and Nutrition UnitFaculty of Health Sciences of CotonouCotonouBenin University Clinic of Internal Medicine and Medical Oncology CotonouBenin Teaching Hospital of Borgou-Alibori ParakouBenin

Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients’ itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine;1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was particularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties.

关键词： Therapeutic Itinerary Diabetic Foot Delay Complication Amputation

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Fatty Liver Linked to Reduced Frequency of Ocular Complications in T2DM

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Journal of Diabetes Mellitus 2020年第3期10卷 154-168页

作者： comlan jules gninkoun Sylvie A. Ahn K. Daniel Amoussou-Guenou Evariste Bouenizabila Michel F. Rousseau Michel P. Hermans Service d’Endocrinologie & Diabétologie Faculté des Sciences de la Santé Cotonou Bénin Division of Cardiology Cliniques Universitaires St-Luc and P&#244 le de Recherche Cardiovasculaire Institut de Recherche Expérimentale et Clinique (IREC) Université catholique de Louvain Brussels Belgium Departmental Hospital and University Centre Service de Médecine interne-Endocrinologie CHUD/OP Porto-Novo Université d’Abomey-Calavi Abomey-Calavi Bénin Service de Maladies Métaboliques et Endocriniennes Centre Hospitalier et Universitaire de Brazzaville Brazzaville Congo Division of Endocrinology & Nutrition Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC) Université catholique de Louvain Brussels Belgium

Purpose: Non-alcoholic fatty liver (NAFL) is comorbid to obesity, metabolic syndrome and type 2 diabetes mellitus (T2DM). It is unclear whether NAFLD constitutes a direct risk factor for macrovascular disease in T2DM. This study aimed at revisiting the cardiometabolic traits linked to NADL and micro-/ macrovascular complications in a biethnic Caucasian and African cohort. Methods: Cross-sectional analysis of 568 of T2DM patients (515 Caucasians;53 Africans) in whom the presence of NAFL was identified by ultrasonography and the cardiometabolic phenotype was exhaustively characterized, including carbohydrate homeostasis, comprehensive lipidogram including Lp(a), cumulative exposure to hyperglycemia, and prevalent micro/macrovascular complications. Results: FL was present in 73% of Caucasians and 36% of Africans (p − in both groups. A marked reduction in diabetic retinopathy (DR), ocular hypertonia and cataracts were found in FL+ of the two ethnicities. In FL+ Caucasians, relative risk of DR was −38%, cataracts −35%, and ocular hypertonia −42%. In FL+ Africans, risk of overall microangiopathy was −66% and that of DR −86%. Conclusions: An inverse association was observed between NAFL and the presence of diabetic retinopathy, cataract and ocular hypertonia. The ophthalmoprotection conferred by liver steatosis was found in Caucasians and Africans. Among the latter, hepatic steatosis was linked to lower lipopro

关键词： Fatty Liver Type 2 Diabetes Microangiopathy Retinopathy Coronary Artery Disease Lipoprotein(a)

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Lower Limb Arteriopathy in Diabetics at the Oueme-Plateau Provincial Hospital in Porto-Novo: Frequency and Associated Factors

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Open Journal of Internal Medicine 2023年第4期13卷 295-303页

作者： Finangnon Armand Wanvoegbe comlan jules gninkoun Corine Houehanou Kouessi Anthelme Agbodande François Akotegnon Hubert Dedjan Rolande Quenum Manchouhoud Alalade Adebayo Alassani Albert Dovonou Angele Azon-Kouanou Internal Medicine/Endocrinology Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Internal Medicine Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Department of Epidemiology Biostatistics Health Environmental and Fundamental Sciences National Training School for Senior Technicians in Public Health and Epidemiological Surveillance Parakou Benin Internal Medicine Department Borgou-Alibori Provincial Teaching Hospital Parakou Benin

Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.

关键词： ALL Diabetes OALL Porto-Novo Systolic Pressure Index

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Dietary Habits of an Ambulatory Diabetic Population at the University Hospital of Conakry, Guinea

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Open Journal of Endocrine and Metabolic Diseases 2021年第6期11卷 129-135页

作者： Mamadou Mansour Diallo Alpha Mamadou Diallo jules comlan gninkoun Amadou Kaké Mamadou Chérif Diallo Thierno Amadou Wann Djénabou Diallo Kadiatou Diallo Elhadj Yaya Baldé Joseph Samah Bangoura Amadou Bah Naby Moussa Baldé Service d’Endocrinologie Diabétologie et Maladies Métaboliques Centre Hospitalier Universitaire de Conakry Conakry Guinée Service d’Endocrinologie Diabétologie Centre National Hospitalier Universitaire (CNHU) de Cotonou Cotonou Bénin Service de Médecine Interne Centre Hospitalier Universitaire de Conakry Conakry Guinée Service de Cardiologie Centre Hospitalier Universitaire de Conakry Conakry Guinée

Background: A healthy diet is essential for optimal diabetes management. However, dietary habits vary from one region to another, making it challenging to standardize practices. Objective: To describe the diet habits of patients living with diabetes in Guinea. Methods: We conducted a dietary habits survey among 102 patients living with diabetes followed-up at the University Hospital of Conakry in Guinea between January and March 2012. Data were collected by individual interview on the basis of a three-item questionnaire: diabetes data, diet mode, and food composition. Results: In total, 85% of patients were consuming 3 meals daily;13.7% had a collation and 25% had snacking habits. The meal was individual in 82.4% and collective in 17.6% of patients. The main foods consumed daily were: rice (93.1%), fish (93.1%), palm oil (91.1%), bread (87.2%). Foods consumed regularly (2 to 3 times a week) were: meat (49%), eggs (23.5%), dairy products (34.3%), fruit (43.1%), vegetables (40.2%) and peanut oil (21.5%). The food bans reported were: regular sugar (100%), sodas (62.7%), peanuts (84.3%) and sweetened fruits (55.8%). Conclusion: Combining dietary recommendations and dietary habits is essential for appropriate management of diabetic patients. The assessment of local food glycemic indexes and the training of dietitians remains a challenge in our context.

关键词： Diet Habits Diabetes Guinea

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Factors Associated with Hypovitaminosis D in People Living with HIV/AIDS (PLWHA) Followed up in Porto-Novo in 2019

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Food and Nutrition Sciences 2021年第11期12卷 1020-1027页

作者： Alassani Adébayo gninkoun comlan jules Mizèhoun-Adissoda Carmelle Dovonou C. Albert Attinsounon Cossi Wanvoégbè Armand Medicine and Medical Specialties Faculty of Medicine University of Parakou Parakou Benin Medicine and Medical Specialties Faculty of Medicine University of Abomey-Calavi Abomey-Calavi Benin

Background: Vitamin D deficiency is very common among PLWHA compared to the general population and is promoted by several factors. Aim: To identify the factors associated with hypovitaminosis D in people living with HIV/AIDS (PLWHA) followed up in Porto-Novo in 2019. Methods: This was a cross-sectional, descriptive and analytical study. PLWHA who were monitored on an outpatient basis and who gave their consent were included in this work. Subjects unable to answer questions or under ongoing vitamin D supplementation or suffering from chronic liver diseases were not included. Hypovitaminosis D was defined by a blood level of 25 hydroxy-vitamin D less than 30 ng/mL. Results: A total of 270 PLWHA were included in the study. The mean age of the patients was 39.51 ± 6.85 years with a female predominance (73.3%). The frequency of hypovitaminosis D was 56%. Hypertension, low protein intake, anemia and low glomerular filtration rate were associated with vitamin D deficiency. Conclusion: Vitamin D deficiency is common among PLWHA, which justifies routine screening, especially among those at risk.

关键词： Hypovitaminosis D PLWHA Malnutrition Denutrition Porto-Novo

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