Metabolic and Clinical Significance of Diabetes Mellitus Type 2; Implication for Rising Prevalence in Nigeria

Type 2 diabetes mellitus (DM2) is now a global epidemic which is also ravaging developing countries including Nigeria. Its impact in the country is significant with the disease found to impact on hospital admissions, mortality and life expectancy of patients. Previous investigations done in Nigeria showed that DM2 patients have poor glycaemic controls with resultant high levels of disease morbidity and mortality. This was demonstrated by consistently elevated mean HbA1c levels (> 8.0%) in Nigerian diabetics over a decade of assessment of care of the patients. Similarly the prevalence of diabetic retinopathy rose by more than 200% between 1989 and 2008. Diabetic morbidity which is underpinned by hyperglycaemia is associated with diabetic retinopathy, nephropathy, foot ulcers and other clinical conditions such as hyperlipidaemia, altered sympathetic system, bone disorders, infertility, defective body sodium handling and renal compromise. Some investigators believe that persons of African ancestry are more susceptible to some diseases associated with DM2. This includes documented increased renal glomerular hyperfiltration in patients of African ancestry. The disease complications are linked to metabolic derangements which if properly understood and managed, may help to reduce the impact of the rising prevalence of DM2 in Nigeria. Furthermore, if the Nigerian medical team is aware of the peculiar susceptibility of blacks to DM2 complications, they will be able to apply appropriate treatment for improved care, despite rising disease prevalence.

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Metabolic and Clinical Significance of Diabetes Mellitus Type 2; Implication for Rising Prevalence in Nigeria

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp.v1.i2.2018.55 ◽

2018 ◽

Vol 1 (2) ◽

pp. 108-117

Author(s):

E K Oghagbon

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Hospital Admissions ◽

African Ancestry ◽

Global Epidemic ◽

Appropriate Treatment ◽

Body Sodium ◽

Clinical Conditions ◽

The Impact

Type 2 diabetes mellitus (DM2) is now a global epidemic which is also ravaging developing countries including Nigeria. Its impact in the country is significant with the disease found to impact on hospital admissions, mortality and life expectancy of patients. Previous investigations done in Nigeria showed that DM2 patients have poor glycaemic controls with resultant high levels of disease morbidity and mortality. This was demonstrated by consistently elevated mean HbA1c levels (> 8.0%) in Nigerian diabetics over a decade of assessment of care of the patients. Similarly the prevalence of diabetic retinopathy rose by more than 200% between 1989 and 2008. Diabetic morbidity which is underpinned by hyperglycaemia is associated with diabetic retinopathy, nephropathy, foot ulcers and other clinical conditions such as hyperlipidaemia, altered sympathetic system, bone disorders, infertility, defective body sodium handling and renal compromise. Some investigators believe that persons of African ancestry are more susceptible to some diseases associated with DM2. This includes documented increased renal glomerular hyperfiltration in patients of African ancestry. The disease complications are linked to metabolic derangements which if properly understood and managed, may help to reduce the impact of the rising prevalence of DM2 in Nigeria. Furthermore, if the Nigerian medical team is aware of the peculiar susceptibility of blacks to DM2 complications, they will be able to apply appropriate treatment for improved care, despite rising disease prevalence.

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A comparison of the risk factors of diabetic retinopathy between type 2 diabetes mellitus patients with and without metabolic syndrome

Archives of Medical Science ◽

10.5114/aoms/133705 ◽

2021 ◽

Author(s):

Chao-Hsien Lee ◽

Peng-Lin Tseng ◽

Wei-Ting Chang ◽

Yi-Chien Chen ◽

Tsai-Tung Chiu

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Betel Quid ◽

Betel Quid Chewing ◽

The Impact

IntroductionThis study was aimed at analyzing, modeling, and comparing the risk factors of diabetic retinopathy (DR) among type 2 diabetes mellitus (DM) patients with and without metabolic syndrome (MS).Material and methodsA cross-sectional study from July 2017 to July 2019 was performed by tracing type 2 DM patients who received treatment at an out-patient clinic and a mydriatic examination by an ophthalmologist in a single institute in south Taiwan. A total of 802 patients without DR were recruited and divided into two groups based on whether they had MS for this study. We analyzed the impact of DR based on the potential and related factors of these two groups.ResultsThe sample consisted of 802 patients; 282 patients did not have MS, and 520 did. A comparison of the risk factors of DR among the patients with and without MS revealed that the level of glycated hemoglobin (HbA1c) was a co-risk factor of DR. However, female sex, betel quid chewing, family history of DM, and higher total cholesterol were found to be risk factors of DR among the patients who had MS. Betel quid chewing, especially, could exacerbate the disease condition of DM and elevate the risk of DR.ConclusionsOf those risk factors, betel quid chewing may be the main reason for DM deterioration and raised risk of DR. Hence, we recommend that the chewing of betel quid should be avoided to prevent DR.

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The association of T786C and G894T polymorphisms of eNOS gene with diabetic retinopathy in Greece

European Journal of Ophthalmology ◽

10.1177/11206721211054724 ◽

2021 ◽

pp. 112067212110547

Author(s):

Nikolaos Gouliopoulos ◽

Gerasimos Siasos ◽

Dimitra Oikonomou ◽

Evangelos Oikonomou ◽

Theodosia Konsola ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Demographic Data ◽

Diabetic Patients ◽

Enos Gene ◽

Ophthalmological Examination ◽

The Impact

Purpose To investigate whether eNOS T786C (rs2070744) and G894T (rs1799983) gene polymorphisms are associated with diabetic retinopathy in Greek diabetic patients. Materials 271 patients with type-2 diabetes mellitus participated in our study; 130 suffered from diabetic retinopathy and 141 not. All the patients underwent a complete ophthalmological examination, while clinical and demographic data were assessed. Furthermore, they were genotyped for rs2070744 and rs1799983 single nucleotide polymorphisms of eNOS gene. Results Regarding the clinical and demographic data, no significant differences were detected between the studied groups, except for hemoglobin A1c levels and the frequency of insulin treatment (higher in patients with diabetic retinopathy). The frequency of rs1799983 GT genotype was significantly elevated in patients with diabetic retinopathy (55% vs. 40%, P = 0.011) and was associated with a 2-fold increased risk of developing retinopathy (OR 1.92, 95% CI 1.16–3.17). Furthermore, we demonstrated that the aforementioned genotype was significantly and independently associated with increased odds for retinopathy onset in diabetic subjects (OR 2.23, 95% CI 1.28–3.90, P = 0.005), regardless of the impact of other confounders. Conclusions We documented that rs1799983 GT genotype could be recognized as an independent risk factor of retinopathy in Greek patients with type-2 diabetes mellitus, while no role for rs2070744 polymorphism was identified. Further research in different ethnic groups will clarify the exact association of these polymorphisms with the risk for diabetic retinopathy development.

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The role of incretin-based therapies in the management of type 2 diabetes mellitus: perspectives on the past, present and future

Diabetes Mellitus ◽

10.14341/dm11493 ◽

2020 ◽

Vol 22 (5) ◽

pp. 461-466

Author(s):

Juris J. Meier

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetes Management ◽

Therapeutic Potential ◽

Dipeptidyl Peptidase 4 ◽

Receptor Agonists ◽

Clinical Conditions ◽

The Impact

The ever-increasing burden of type 2 diabetes mellitus (T2DM) worldwide, has led to the emergence of several antidiabetes drugs with different modes of action. Incretin hormones and their effect on glucose metabolism and pathogenesis of T2DM has been a landmark discovery in the management of this increasingly prevalent metabolic disorder. Glucagon like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are the two major classes of incretin-based therapies that regulate glucose mechanism through multiple pathways, demonstrate weight loss (GLP-1 receptor agonists) or a weight-neutral effect (DPP-4 inhibitors), and are associated with a low risk of hypoglycaemia and other adverse events. In addition, evidence reflects their possible therapeutic potential in the treatment of other clinical conditions such as obesity, cardiovascular disease and liver disorders. This review explores the availability and the impact of GLP-1 receptor agonists and DPP-4 inhibitors as potential therapeutic strategies for T2DM along with their future in the landscape of diabetes management and other clinical conditions.

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