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Abstract Background Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the in-utero regulation of foetal growth. Methods 30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, i.e., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, i.e., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR. Results The serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, i.e., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women. Conclusions Our results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.

Background : Type 2 diabetes (T2D) adversely affects health-related quality of life (QoL). However, little is known about the QoL of diabetic patients in Benin, where the disease is a growing concern. Thus, this study aims to assess the QoL and its associated factors among T2D patients in Cotonou, southern Benin. Methods : A total of 300 T2D patients (age > 18 years) were enrolled, and the diabetes-specific quality of life (DQoL) and Natividad self-care behaviors' (SCB) instruments were used for data collection. DQoL scores were calculated, and factors associated with DQoL explored using logistic regression. Results : The mean of patients' DQoL was 38.1 ± 4.1, with 43% having low QoL. In terms of DQoL, 56.3% reported a high diabetes impact, followed by low life satisfaction (53%) and high worry about diabetes (32.7%). In the logistic regression analysis, education, marital status, occupation, family history of diabetes, complications, and social support were associated with DQoL. SCB factors, including healthy eating, problem-solving, coping strategies, and risk reduction, were significant predictors of DQoL. Conclusions : Patients' empowerment, starting with self-management education, is essential to improve the QoL of T2D patients in Cotonou. However, the programs need to target low education, low socioeconomic status, low social support, and overweight patients.

Background: Type 2 diabetes (T2D) is becoming an epidemic with significant disability and premature death in Sub-Saharan Africa, including Benin. However, little is known about the level of knowledge, attitude, and practice (KAP) necessary for diabetic patients to enhance therapeutic outcomes and prevent diabetes complications. The study aimed to assess patients' KAP levels and identify the factors associated in Cotonou, southern Benin., Methods: A cross-sectional study was conducted from July to August 2019 among 300 diabetic patients from four health centers. Data was collected using validated questionnaires. KAP levels were determined by calculating the scores, and multivariate logistic regression was used to explore factors influencing KAP scores., Results: About 53, 52, and 47% of all patients had good knowledge, attitude, and practice towards diabetes. In logistic regression, factors such as being female, married, educated, government/non-government employee, and longer duration of diabetes were significantly associated with good knowledge. Being married, having a longer duration of diabetes, and good knowledge were significantly associated with a good attitude while being educated, having a longer duration of diabetes, and good knowledge with good practice., Conclusions: Lack of knowledge, poor attitude, and inadequate practice were found in this surveyed community, suggesting a need for structured educational programs to assist diabetic patients. However, education should be considered a priority for male, newly diagnosed, and uneducated patients.

Factors associated with plasma levels of adiponectin and leptin were studied in adult subjects without diabetes from Cotonou in Benin (West-Africa). Seventy (70) men and 45 women were included in the study. Anthropometric variables were measured and a venous blood sample was drawn from each subject, after an overnight fasting period, for measurement of plasma glucose, insulin, leptin, and adiponectin levels. HOMA-IR was determined to assess insulin resistance. Adiponectin and leptin levels were higher in women than in men (with adiponectin 18.48 ± 12.77 vs.7.8 ± 10.39 μg/mL, P < 0.0001, and leptin 30.77 ± 19.16 vs. 8.66 ± 8.24 ng/mL, P < 0.0001). Fasting insulin level and HOMA-IR were also higher in the females. Hyperleptinemia was observed in 66,96% of subjects and hypoadiponectinemia was present in 44.35% of subjects. In both men and women, leptin correlated with age (r = 0.2; P = 0.02), BMI (r = 0.572; P < 0.0001), waist circumference (r = 0.534; P < 0.0001), fasting insulin (r = 0.461; P < 0.001), and HOMA-IR (r = 0.430; P < 0.0001). No significant correlation was observed for adiponectin levels with these variables. Only in women, adiponectin was inversely correlated with fasting glucose (r = -0.423; P < 0.004). These data confirm previous descriptions of leptin but suggest that variations in factors determining serum adiponectin levels observed between ethnicities could also been seen between populations from the same ethnicity., (© 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.)

The present study was carried out to determine glucose tolerance and insulin sensitivity in adult subjects of a west African population. 103 subjects recruited in the town of Cotonou were included in the study. After anthropometric measurement, they were subjected to an oral glucose tolerance test (OGTT). Serum glucose and insulin levels were determined throughout the OGTT. Homeostatic model of assessment of insulin resistance (HOMA-IR), MATSUDA insulin sensitivity index (MATSUDA-ISI) and insulinogenic index (IGI) have been determined to evaluate insulin sensitivity and beta cells function. Normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT) and combined glucose intolerance (CGI) were observed in respectively 53.40%, 1.94%, 35.92% and 8.74% of subjects. The prevalence of IFG and or IGT (IFG/IGT) was higher in obese subjects (66.67%) than in subjects with normal BMI (41.17%). Fasting hyperinsulinemia was observed in 82% of subjects. Mean values of HOMA-IR were not significantly different in NGT (6.86 ± 0.7) and in IFG/IGT subjects (7.47 ± 0.57). In contrast to HOMA-IR, mean value of Matsuda-ISI was significantly lower in IFG/IGT than in NGT subjects (1.47 ± 0.1 versus 1.96 ± 0.13, p<0.01). Matsuda-ISI values were also significantly lower in obese subjects (1.33 ± 0.12) than in subjects with normal BMI (1.93 ± 0.13). The mean insulinogenic index value in IFG/IGT subjects (42.5 ± 4.36) was not significantly different of that in NGT subjects (50.3 ± 5.21). These data show that the glucose tolerance disorders observed in subjects of the present study are more related to a decrease in insulin sensitivity than to an alteration of the beta cells function.

Objectives: The study was initiated to assess patient knowledge about diabetes mellitus, identify food claims and finally to identify the daily practices., Materiel and Methods: The study was sectional and descriptive. The study population consists of diabetic seen in CNHU-HKM the outpatient Cotonou. Data collection is done by a questionnaire., Results: Deficiencies were noted in knowledge of patients on diabetes mellitus.Several allegations have been identified. Patients think that the diabetic should not eat fruits, rice or corn dough. The practice of physical activity is low. Difficulties were encountered preventing compliance with diet, the practice of physical activity and glycemic control., Conclusion: Of challenges remain to improve the knowledge, attitudes and practices of patients. Therapeutic education is necessary for all diabetics., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Introduction: Benin Republic, a very low-income-sub- Saharan African developing country, has a severely resource-constrained health system. There is hardly any data available on the pattern of pituitary tumour in this country METHODS: A single surgeon, hospital-based retrospective analysis of the pattern, presentation and clinical / surgical course of7a prospective cohort of pituitary tumours seen over a 5-year period is presented RESULTS: There were 38 cases, 20 (52.6%) female; 27% of all brain tumours seen. They were macroadenomas in 97. 4%, and greater than 4cm in 63.2%. They occurred mainly (86.8%) in people aged 15 to 59 years. Delayed neurosurgical presentation, mean 5.16years (range 1-23years) was the rule in 94.7%%; and, visual and endocrinological dysfunction the two most prominent symptomatology. Due to severe logistic constraints, neuroimaging evaluation was possible with cranial CT only in about 90% of the cases. Also only 9 cases (23.7%) did eventually receive the planned neurosurgical operative treatment, in 5 cases of which even this surgical treatment Was only facilitated by some foreign neurosurgical missions., Conclusions: Pituitary adenomas represent a sizeable proportion of brain tumours in Benin Republic. National health care resources in this low income African country for their optimal clinical / radiological evaluation, and surgical treatment, are grossly inadequate; indeed, almost non-existent.

Aim: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications., Methods: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications., Results: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country's gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication., Conclusion: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders.

The Borgou region of northern Benin is a major cotton producing area and consistently uses higher amounts of pesticides than other areas of the country. Organochlorine pesticides (OCPs), poorly handled, have been widely used and are still illegally present. We therefore hypothesized that serum OCP levels would be high in Borgou. As part of a case-control study on diabetes status and pesticide exposure, we measured the distribution of serum concentrations of 14 OCPs by gas chromatography with mass spectrometry. A sample of 118 diabetic subjects was selected using a four-stage cluster sampling with 54.2% of men and 45.8% of women; 43% lived in urban areas, 14.4% were obese and 39.8% had high economic status. The four detected OCPs were p,p'-DDT, p,p'-DDE, β-HCH and trans-nonachlor with respective geometric means (geometric standard deviation) of 497.1 (4.5), 20.6 (7.9), 2.9 (3.4), and 2.0 (2.3) ng/g of total serum lipids. OCP levels were significantly higher in obese, wealthier and more educated subjects and in those living in urban areas as compared to the other groups, particularly for p,p'-DDE, p,p'-DDT and β-HCH. Levels of DDT and DDE were higher than reported in other countries where DDT is no longer permitted. The low DDT/DDE ratio of 0.05 suggests past human exposure through food contamination. There is thus a need to reinforce governmental regulations for a more responsible use of pesticides in the country, in order to reduce health risks associated with persistent organic pollutants., (Copyright © 2014 Elsevier Ltd. All rights reserved.)