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The prevalence of type 2 diabetes (T2D) is rapidly increasing in sub-Saharan Africa, where sickle cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of the development of T2D complications. Therefore, this study was conducted to determine whether T2D complications were more prevalent among Senegalese individuals with SCT and T2D than among those with T2D only. RESEARCH DESIGN AND METHODS Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined SCT and T2D (T2D-SCT) (n = 60), T2D (n = 52), SCT (n = 53), and neither T2D nor SCT (control) (n = 56). Human aortic endothelial cell (HAEC) expression of inflammatory and adhesion factors was measured after treatment with tumor necrosis factor-a and subjects' plasma. Effects of AGE inhibition or tiron on HAEC expression of E-selectin were measured. RESULTS Retinopathy, hypertension, and reduced renal function were more prevalent, and arterial stiffness, blood viscosity at high shear rates, and thixotropic index were higher, in the T2D-SCT group compared with the other groups. Multivariable analysis showed that plasma AGE concentration was significantly associated with arterial stiffness. E-selectin expression was elevated in HAECs treated with T2D-SCT plasma compared with the other groups, but AGE inhibition reversed this. CONCLUSIONS SCT could potentially augment the risk of the development of T2D-related complications, including retinopathy, nephropathy, and hypertension. Type 2 diabetes (T2D) is an insidious disease characterized by progressive insulin resistance, resulting in elevated levels of blood glucose (1). Hyperglycemia results in increased levels of advanced glycation end products (AGEs), oxidative stress, chronic low-grade inflammation, and platelet hyperactivity (2). These biological alterations lead to impaired endothelial function, increased vasoconstriction, abnormal

Fasting glucose (FG) and glycated hemoglobin A1c (HbA1c) perform sub-optimally in people of African origin, especially in individuals with sickle-cell trait (SCT). The purpose of this study was to compare the relationships between HbA1c, FG, and fructosamine in individuals from Senegal with and without SCT. HbA1c, FG, and fructosamine were measured in 203 adults from Senegal (100 control: 45 with type 2 diabetes (T2D); 103 SCT: 51 with T2D). Significant, positive correlations were observed between HbA1c and FG, fructosamine and FG, and fructosamine and HbA1c in both groups. The limits of agreement were inappropriately large in both groups for the Bland-Altman plots of HbA1c and FG (control: -95.97 to 83.97%; SCT: -115.9 to 91.52%), fructosamine and FG (control: -100.6 to 99.89%; SCT: -105.6 to 100.6%), and fructosamine and HbA1c (control: -52.03 to 38.98%; SCT: -88.04 to 71.41%). In both groups, the greatest proportion of subjects were considered above the clinical cut-point for hyperglycemia when fructosamine was used as the criterion (control: 33%; SCT: 44.6%), and the lowest percentage of subjects were classified as over the clinical cut-point when HbA1c was used as the criterion (control: 21%; SCT: 27.7%).Substantial disparities between HbA1c, FG, and fructosamine were observed in both groups, and these differences were exaggerated in the SCT group. Therefore, these three biomarkers should not be considered to be interchangeable measures of glycemic control. These biomarkers should be used thoughtfully, and special care should be taken when using them in individuals with SCT.

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Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299 mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%); creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.

Introduction: In Senegal, the frequency of diabetes mellitus is estimated at 3.2% and its management by the general patrician (gp) is dissatisfied. The objective was to evaluate the decentralized monitoring of diabetes mellitus and other cardiovascular risk factors by a trained general practician. Patients and methods: It was a retrospective, descriptive study conducted from June 1, 2013 to 31 May, 2015 in Dakar, where included the files of subjects with diabetes mellitus regularly followed. The data collected were epidemiological, diagnostic and therapeutic. Results: It was of 125 diabetics patients with a mean age of 56.4 years old. At the inclusion, their diabetes had a mean duration of 6.3 years and a mean average HbA1c of 10.4%. The complications were a neuropathy in 58 cases (46.4%), an arteritis in 46 cases (36.8%), a nephropathy in 16 cases (12.8%) and a retinopathy in 28 cases (22.4%). Other cardiovascular risk factors were an arterial hypertension in 74 cases (59.2%), smoking in 11 cases (8.8%), kidney disease in 16 cases (12.8%), and LDLcholesterol > 1.6 g/l in 39 cases (31.2%). In total, 87 patients (69.6%) were at high cardiovascular risk and among them, 81.6% had LDL-cholesterol > 1g/l. At inclusion, anti-diabetic treatment was oral mono-therapy in 53 cases (42.4%), an insulin therapy in 49 cases (39.2%). After 12 month of follow-up, the dual therapy anti-diabetic was increased from 13.6% to 34.4%. The others associated drugs were anti-hypertensives in 72 cases (57.6%), statins in 29 cases (23.2%) and anti-platelet agent in 46 cases (36.8%). Only 31.2% of the patients with nephropathy were under the renin angiotensin system blockers. Statins and the anti-platelet agents were prescribed respectively at 25.2% and 47.1% of the 87 patients at high cardiovascular risk. During follow-up, the target HbA1c < 7% was reached in 76 cases (60.8%). Conclusion: our study shows the importance and the interest of a trained general practician for the management of non-communicable diseases. However, it would be necessary to strengthen training in the care of other cardiovascular risk factors.How to cite this paper: Diédhiou, D., Sow, D., Diallo, I.M., Diouara, A., Ndour, M.A.,