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Dynamics in the Prevalence of Insulin Resistance between 2005 and 2023 in Type 2 Diabetics in south kivu in the East of the Democratic Republic of Congo: Cross-Sectional Studies

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Journal of Diabetes Mellitus 2024年第1期14卷 28-40页

作者： Dieudonné Masemo Bihehe Ahadi Birindwa Bwihangane Jean-Paulin Mukonkole Mbo Christian Tshongo Muhindo Michel Hermans Philippe Bianga Katchunga Hô pital général de référence de Panzi Faculté de Médecine Université Evangélique en Afrique Bukavu DR Congo Département de Médecine interne Université de Kisangani Provine de la Tshopo DR Congo Département de Médecine interne Université Catholique de Bukavu Bukavu DR Congo Service d’endocrinologie et de diabétologie Cliniques universitaires Saint-Luc Université Catholique de Louvain Bruxelles Belgique Département de Médecine interne Cliniques Universitaires de Bukavu Université Officielle de Bukavu Bukavu DR Congo

Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence of insulin resistance and associated risk factors in diabetic patients in the Democratic Republic of Congo between 2005 and 2023. Method: We measured fasting blood glucose and insulin levels and looked for metabolic syndrome parameters (2009 criteria) in type 2 diabetes patients in 2005-2008 (n = 176) and in 2018-2023 (n = 303). The HOMA model was used to measure insulin sensitivity and islet β-cell secretory function. Results: Between 2005 and 2013, the trend was towards an increase in the prevalence of insulin resistance (from 13.1% to 50.8%;p Conclusion: This present study shows an increase in insulin resistance in Congolese urban areas and a persistence of atypical diabetes mellitus in Congolese rural areas, confirming the particularity of the pathophysiology of the disease in African areas currently influenced by the epidemiological transition. Further studies using an appropriate methodology are required.

关键词： Prevalence Diabetes Mellitus Insulin Resistance Metabolic Syndrome south kivu

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Vitamin D, Parathyroid Hormone, Insulin Sensitivity and Islet β-Cell Secretory Function in Diabetic Patients from south kivu in the Democratic Republic of Congo: Cross-Sectional Study

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Journal of Diabetes Mellitus 2024年第2期14卷 81-94页

作者： Dieudonne Masemo Bihehe Ahadi Birindwa Bwihangane Jean-Paulin Mukonkole Mbo Michel Hermans Philippe Bianga Katchunga Faculté de Médecine H&#244pital Général de Référence de Panzi Université Evangélique en Afrique Bukavu DR Congo Département de Biologie Faculté des Sciences Université Officielle de Bukavu Bukavu DR Congo Département de Médecine Interne Université de Kisangani Kisangani DR Congo Service d’endocrinologie et de Diabétologie Cliniques Universitaires Saint-Luc Université Catholique de Louvain Bruxelles Belgique Département de Médecine Interne Cliniques Universitaires de Bukavu Université Officielle de Bukavu Bukavu DR Congo

Background: The role of vitamin D and parathyroid hormone in the metabolic profile of type 2 diabetes mellitus in sub-Saharan Africa has not been adequately assessed. The aim of this study was to determine the prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin sensitivity and β-cell secretory function among Congolese type 2 diabetics. Methodology: Fasting glycaemia, fasting insulin, 25OH D3 and human parathyroid hormone (hPTH) were measured in one hundred and eighty-four type 2 diabetic patients followed as outpatients in south kivu. Levels of 25OH D3 65 pg/ml defined low vitamin D and elevated parathyroid hormone levels, respectively. The HOMA model was used to measure insulin sensitivity and β-cell secretory function. Results: Medians (IQR) were 25.3 (20.4 - 32.4) ng/ml for 25OH D3 and 53.7 (38.4 - 115.7) pg/ml for hPTH. 58.7% of diabetics had insulin resistance, 126 (68.5%) had low vitamin D and 80 (43.5%) had hyperparathyroidism. In multivariate analysis, hPTH (partial r = −0.28;p = 0.0002) and 25OH D3 (partial r = 0.16;p = 0.03) showed an independent association with insulin sensitivity after adjustment for body mass index and waist circumference. Finally, hPTH (partial r = 0.27;p = 0.0002) was the sole determinant of β-cell secretory function. Conclusions: This study confirms the high prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin resistance and impaired islet β-cell secretory function among Congolese with type 2 diabetes mellitus. Vitamin D and calcium supplementation should be envisaged for cases of deficiency in this region.

关键词： Vitamin D Parathyroid Hormone Diabetes Mellitus Insulin Resistance south kivu

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Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in south-kivu/Dr Congo

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 162-182页

作者： Nyakio Olivier Kibukila Fabrice Tambwe Albert Kakudji Prosper Kalenga Prosper Kakoma Jean Baptiste Department of Gynecology and Obstetrics Faculty of Medecine Evangelical University in Africa (EUA) Bukavu Democratic Republic of the Congo Denis MUKWEGE Excellence Center Bukavu Democratic Republic of the Congo Department of Gynecology-Obstetrics Faculty of Medicine University of Lubumbashi Bukavu Democratic Republic of the Congo Department of Surgery Faculty of Medecine Official University of Bukavu (UOB) Bukavu Democratic Republic of the Congo Department of Surgery Faculty of Medecine University of Burundi Bujumbura Burundi

Background: Cervical cancer is one of the most common cancers in women in the world. The recrudescence of dysplastic lesions is increasing, especially in developing countries, because of the absence of screening. The objective of this work is to determine the prevalence of dysplastic lesions of the cervix in women who are sexually active in South Kivu province. Methods: It was a cross-sectional, descriptive and analytical study of 625 women who came for gynecological consultation, all of whom had cervical-uterine Pap smears, during the period from January 1st, 2017 to December 31st, 2018 at Panzi General Referral Hospital (South Kivu, DR Congo). Data analysis was done using Epi Info software version 7. Results: The median age of the respondents was 34 years, 47.0% of them were married, and 59.0% had a low socio-economic level. The majority had first sexual intercourse between the ages of 15 and 20 (67.5%), a number of former sexual partners estimated at 1 - 5 (87.8%), did not use tobacco (97.4%) and did not use contraception (78.1%). Pap smear was normal in 82.88% of cases, inflammatory in 2.4% of cases and with cytologic abnormalities in 14.72% of cases. Rates of dysplastic lesions were significantly higher among women aged ≥35 years (p = 0.0245), brides (p = 0.0183) and nulliparas (p = 0.0042). Multivariate analysis revealed the adjusted OR (95% CI) statistically insignificant (p Conclusion: Cervical cancer remains a real scourge in the world, especially in sub-Saharan Africa, where the diagnosis is often made when the pathology is at its stage alm

关键词： Dysplasic Lesions Cervix south kivu DRC

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