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3. Mortality amongst children and adolescents with type 1 diabetes in sub‐Saharan Africa: The case study of the Changing Diabetes in Children program in Cameroon.

Author

Katte, Jean Claude, Lemdjo, Gaelle, Dehayem, Mesmin Y., Jones, Angus G., McDonald, Timothy J., Sobngwi, Eugene, and Mbanya, Jean Claude

Subjects
*INSULIN therapy, *ACQUISITION of data methodology, *CONFIDENCE intervals, *MORTALITY, *MULTIVARIATE analysis, *TYPE 1 diabetes, *DIABETES, *RETROSPECTIVE studies, *MEDICAL records, *ELECTRONIC health records, *METROPOLITAN areas, *RESIDENTIAL patterns, *PROPORTIONAL hazards models, *EDUCATIONAL attainment, *CHILDREN, *ADOLESCENCE
Abstract

Introduction: Type 1 diabetes in Africa has been associated with high mortality attributed mainly to poor insulin access. Free insulin provision programs for people with type 1 diabetes have been introduced across Africa recently. We aimed to determine the mortality rate and associated factors in a cohort of children and adolescents with type 1 diabetes who receive free insulin treatment in sub‐Saharan Africa. Methods: We conducted a retrospective analysis using the Changing Diabetes in Children (CDiC) medical records in Cameroon between 2011 and 2015. Results: The overall mortality rate was 33.0 per 1000 person‐years (95% CI 25.2–43.2). Most deaths (71.7%) occurred outside of the hospital setting, and the cause of death was known only in 13/53 (24.5%). Mortality was substantially higher in CDiC participants followed up in regional clinics compared to the main urban CDiC clinic in Yaounde; 41 per 1000 years (95% CI 30.8–56.0) versus 17.5 per 1000 years (95% CI 9.4–32.5), and in those with no formal education compared to those who had some level of education; 68.0 per 1000 years (95% CI 45.1–102.2) versus 23.6 per 1000 years (95% CI 16.5–33.8). In Cox proportional multivariable analysis, urban place of care (HR = 0.23, 95% CI 0.09–0.57; p = 0.002) and formal education (HR = 0.42, 95% CI 0.22–0.79; p = 0.007) were independently associated with mortality. Conclusion: Despite free insulin provision, mortality remains high in children and adolescents with type 1 diabetes in Cameroon and is substantially higher in rural settings and those with no formal education. [ABSTRACT FROM AUTHOR]

Published
2022
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4. Human herpesvirus 8 infection DNA positivity is associated with low insulin secretion

Author

Lontchi-Yimagou, Eric, Legoff, Jérôme, Nguewa, Jean-Louis, Boudou, Philippe, Balti, Eric V, Noubiap, Jean J, Kamwa, Vicky, Atogho-Tiedeu, Barbara, Azabji-Kenfack, Marcel, Djahmeni, Eric N, Etoa, Martine, Lemdjo, Gaelle, Balla, Vanessa, Dehayem, Mesmin Y, Foufelle, Fabienne, Mbanya, Jean-Claude, Gautier, Jean-François, Sobngwi, Eugène, Faculty of Medicine and Pharmacy, and Diabetes Pathology & Therapy

Subjects
Adult, Male, Herpesvirus 8, Human/genetics, Secretory Pathway, virus diseases, Cameroon/epidemiology, Case-control studies, Middle Aged, DNA, Viral/genetics, Host-Pathogen Interactions, Diabetes Mellitus/blood, Herpesviridae Infections/blood, Humans, risk factors, Female, Viral load, Insulin/blood, Biomarkers/blood
Abstract

BACKGROUND: Viruses have been considered potential triggers for the development of diabetes. This study assessed insulin secretion and insulin sensitivity in human herpesvirus 8 (HHV8)-infected and uninfected sub-Saharan African people with diabetes. METHODS: In all, 173 people with non-autoimmune diabetes were enrolled consecutively: 124 with type 2 diabetes mellitus (T2DM) and 49 with ketosis-prone diabetes (KPD) admitted in hyperglycemic crisis. Those with KPD were further subdivided into those with new-onset ketotic-phase KPD (n = 34) or non-ketotic phase KPD (n = 15). All participants were screened for HHV8-specific antibodies and genomic DNA. Blood samples were collected for analysis of fasting glucose, HbA1c, lipid profile, and C-peptide, with insulin resistance and secretion estimated by homeostasis model assessment. RESULTS: Among the 173 diabetic participants, 88 (50.9%) were positive for HHV8 antibodies (Ac-HHV8+), including 15 (8.7%) positive for HHV8 DNA (DNA-HHV8+). The seroprevalence of HHV8 was similar between T2DM (55.6%) and KPD (61.2%) subjects. Of those with and without ketotic-phase KPD, 35.3% and 46.7% were Ac-HHV8+, respectively. Body mass index was significantly in lower DNA-HHV8+ than DNA-HHV8- subjects. Low-density lipoprotein and total cholesterol were significantly higher, but C-peptide and homeostatic model assessment of β-cell function (HOMA-β) were significantly lower in DNA-HHV8+ than DNA-HHV8- participants. After excluding DNA-HHV8+ participants, triglyceride concentrations were significantly higher in Ac-HHV8+ (n = 73) than Ac-HHV8- (n = 85) subjects. In contrast, HOMA-β was significantly higher among Ac-HHV8+ than Ac-HHV8- participants. CONCLUSIONS: In the present study, HHV8 DNA positivity was associated with low insulin secretion in this sub-Saharan African diabetes population.

Published
2018
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5. Human herpesvirus 8 infection DNA positivity is associated with low insulin secretion: A case‐control study in a sub‐Saharan African population with diabetes

Author

Lontchi‐Yimagou, Eric, primary, Legoff, Jérôme, additional, Nguewa, Jean‐Louis, additional, Boudou, Philippe, additional, Balti, Eric V., additional, Noubiap, Jean J., additional, Kamwa, Vicky, additional, Atogho‐Tiedeu, Barbara, additional, Azabji‐Kenfack, Marcel, additional, Djahmeni, Eric N., additional, Etoa, Martine, additional, Lemdjo, Gaelle, additional, Balla, Vanessa, additional, Dehayem, Mesmin Y., additional, Foufelle, Fabienne, additional, Mbanya, Jean‐Claude, additional, Gautier, Jean‐Francois, additional, and Sobngwi, Eugene, additional

Published
2018
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6. Acute phase ketosis-prone atypical diabetes is associated with a pro-inflammatory profile: a case-control study in a sub-Saharan African population

Author

Lontchi-Yimagou, Eric, primary, Boudou, Philippe, additional, Nguewa, Jean Louis, additional, Noubiap, Jean Jacques, additional, Kamwa, Vicky, additional, Djahmeni, Eric Noel, additional, Atogho-Tiedeu, Babara, additional, Azabji-Kenfack, Marcel, additional, Etoa, Martine, additional, Lemdjo, Gaelle, additional, Dehayem, Mesmin Yefou, additional, Mbanya, Jean Claude, additional, Gautier, Jean-Francois, additional, and Sobngwi, Eugène, additional

Published
2018
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7. Sarcopenie, masse musculaire et performances fonctionnelles chez les patients diabétiques âgés d’au moins 60 ans à Yaoundé

Author

Balla, Vanessa, primary, Sobngwi, Eugène, additional, Sini, Victor, additional, Azabji, Marcel, additional, Dehayem, Mesmin, additional, Mendane, Francine, additional, Ngassam, Eliane, additional, Etoa, Martine, additional, Ntoutoum, Andre, additional, Lemdjo, Gaelle, additional, and Mbanya, Jean Claude, additional

Published
2018
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8. Effets de Stevia rebaudiana sur la réponse glycémique et insulino-sécrétoire à un repas test chez le patient diabétique de type 2

Author

Abeng Bokam, Mireille Claudia, primary, Nnanga, Emmanuel, additional, Lemdjo, Gaelle, additional, Mbanya, Armand, additional, Bongha, Hélène, additional, Well, Estelle Amandine, additional, Ebong Ayangma, Marion Yasmine, additional, Dehayem, Mesmin, additional, Sobngwi, Eugène, additional, and Mbanya, Jean Claude, additional

Published
2017
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