[Main complications of diabetes mellitus in Africa].

Ann Med Interne (Paris)

Service de Médecine Interne, Clinique Médicale II, Centre Marc Sankale, BP 5062, Fann-Dakar, Sénégal.

Published: December 2000

AI Article Synopsis

  • The prevalence of diabetes mellitus in Africa is rising, leading to increased complications, including ketoacidosis in both juvenile and type 2 diabetes, with serious outcomes like coma and high mortality rates.
  • Infections, particularly from Staphylococcus and Gram-negative microorganisms, are common and often fatal, coupled with complications like pulmonary tuberculosis and a high incidence of retinopathy and neuropathy among patients.
  • Socioeconomic factors contribute to poorer blood glucose control and health outcomes, with significant percentages of the diabetic population experiencing impotence and cardiovascular issues.

Article Abstract

In Africa, a rise in complications of diabetes mellitus has gone in hand with the growing disease prevalence, clearly demonstrating the importance of assessing complications. Diabetes mellitus constitutes a major financial burden in developing countries in Africa with relatively limited resources. Ketoacidosis is observed in 24% of juvenile diabetes and is the inaugural sign in 76% of all cases, progressing to coma in 34%. Even in type 2 diabetes, acidoketosis occurs in 34% of the cases. Infection is particularly frequent and is often fatal in tropical Africa because of the involvement of Staphyococcus and Gram-negative microorganisms. Hyperleukocytosis and anemia are correlated with ineffective antibiotic therapy. Pulmonary tuberculosis is the ninth most frequent complication of diabetes. Overall mortality is 14.9 per 1000 person-years of diabetes. Mean age at death is 51.6 years for women and 57.6 years for men after a mean 12.5 year disease duration. Thirty percent of all deaths result from acute metabolic complications, infections and stroke. More than half of the patients with insulin-dependent-diabetes have retinopathy. Differences observed in patients with different ethnic origins is linked basically to unfavorable social and economic conditions that worsen the risk of poor blood glucose control. Retinopathy accounts for 32% of all ocular complications, similar to other African data and more generally in ophthalmology centers. The rate of neuropathy is high, reaching 70% in patients with microangiopathy. Impotence concerns 48.7% of the diabetic population with a mean age of 41.4+/-15.5 years. Coronary artery disease had a recognized influence on hemoglobin diseases, particularly when the coronarography is normal. Lower limb arteriopathy is observed in 18% of the diabetic patients.

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