We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

Introduction: Le diabète est une pathologie métabolique chronique en pleine expansion dans le monde. La décompensation cétosique constitue l’une de ses complications métaboliques qui dépend de plusieurs variables. L’objectif de ce travail était de décrire les facteurs de décompensations cétosiques du diabète chez des patients hospitalisés au CNHU de Cotonou. Méthode: Il s’agit d’une étude rétrospective, descriptive et analytique qui s’est déroulée du 1er Juin 2016 au 31 Mai 2019. Elle a porté sur les patients diabétiques hospitalisés dans le service d’endocrinologie au cours de la période d’étude et ayant une hyperglycémie supérieure ou égale à 2,5 g/l, une cétonurie au moins égale à deux croix associée à une glycosurie positive. Résultats: Au total, 196 patients ont été inclus. L’âge moyen était de 43,73 ans ± 16,2 ans. On notait une légère prédominance féminine avec un sex ratio de 0,960,96. La prévalence des décompensations cétosiques était de 28,99 %. Les principaux facteurs de survenue des décompensations cétosiques étaient les infections dans 67,86 % des cas et l’inobservance dans 29,59 % des cas. Les foyers infectieux les plus fréquents étaient génito-urinaires dans 23,30 %, respiratoires dans 18,04 % et le paludisme dans 32,33 % des cas. Le sexe féminin était statistiquement plus souvent associé aux infections urogénitales. Conclusion: Les principaux facteurs de décompensation n’ont pas évolué et demeurrent de façon prépondérante les infections. L’étude des determinants de ces infections pourrait servir à une prévention plus ciblée. Introduction: Diabetes is a chronic metabolic disease with a rapidly increasing incidence worldwide. Diabetic ketoacidosis (DKA) is one of its metabolic complications, depending on several factors. Our objective was to describe the factors that trigger DKA in patients hospitalized at the CNHU of Cotonou. Methods: This was a retrospective, descriptive and analytical study that took place from June 1, 2016 to May 31, 2019. It focused on diabetic patients hospitalized in the endocrinology department during the study period and presenting with hyperglycemia greater than or equal to 250mg/dL, ketonuria at least equal to two crosses associated with positive glycosuria. Results: A total of 196 patients were included. The mean age was 43.73 ± 16.2 years. There was a slight female predominance with a sex ratio (M/F) of 0.96. The prevalence of DKA was 28.99%. The main factors associated with DKA were infections in 67.86% of cases and non-compliance with treatment in 29.59% of cases. The most frequent infections were genitourinary in 23.30% of cases, respiratory in 18.04% of cases and malaria in 32.33% of cases. Female gender was statistically more often associated with urogenital infections. Conclusion: The main factors associated with DKA did not change over time and remained mainly infections. The study of the determinants of these infections could be used for more targeted prevention.

Purpose: Non-alcoholic fatty liver (NAFL) is comorbid to obesity, metabolic syndrome and type 2 diabetes mellitus (T2DM). It is unclear whether NAFLD constitutes a direct risk factor for macrovascular disease in T2DM. This study aimed at revisiting the cardiometabolic traits linked to NADL and micro-/ macrovascular complications in a biethnic Caucasian and African cohort. Methods: Cross-sectional analysis of 568 of T2DM patients (515 Caucasians; 53 Africans) in whom the presence of NAFL was identified by ultrasonography and the cardiometabolic phenotype was exhaustively characterized, including carbohydrate homeostasis, comprehensive lipidogram including Lp(a), cumulative exposure to hyperglycemia, and prevalent micro/macrovascular complications. Results: FL was present in 73% of Caucasians and 36% of Africans (p < 0.0001). FL+ were more obese, more atherogenic dyslipidemic (Caucasians) and had lower lipoprotein(a) (Africans). All-cause macroangiopathy, ischemic heart disease or stroke did not significantly differ between FL+ and FL− in both groups. A marked reduction in diabetic retinopathy (DR), ocular hypertonia and cataracts were found in FL+ of the two ethnicities. In FL+ Caucasians, relative risk of DR was −38%, cataracts −35%, and ocular hypertonia −42%. In FL+ Africans, risk of overall microangiopathy was −66% and that of DR −86%. Conclusions: An inverse association was observed between NAFL and the presence of diabetic retinopathy, cataract and ocular hypertonia. The ophthalmoprotection conferred by liver steatosis was found in Caucasians

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Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients' itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine; 1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was par-How to cite this paper: Gninkoun, C.Journal of Diabetes Mellitus ticularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties. The implementation of universal health insurance and an information, education and communication program could certainly reduce the periods allowed for recourse to care and therefore to reduce the amputation rate.