Objective: To compare vitamin D status in an African population living at 10 ЊN with a Norwegian population living at 60 ЊN. Design: Serum samples from 30 healthy young Ethiopians and 31 full term pregnant women from Addis Ababa were collected in September, and from 24 healthy Norwegians in March and 23 pregnant women from Oslo in February to June. Methods: Serum (s) levels of calcidiol and intact parathyroid hormone (iPTH) were measured. Results:The median values for s-calcidiol were significantly lower in Ethiopians compared with Norwegians (young Ethiopians 23.5 nmol/l vs young Norwegians 81 nmol/l, P < 0.001; pregnant Ethiopians 25 nmol/l vs pregnant Norwegians 36 nmol/l, P < 0.05) while those for s-iPTH were significantly higher (young Ethiopians 5.7 pmol/l vs young Norwegians 2.4 pmol/l, P < 0.001; pregnant Ethiopians 4.8 pmol/l vs pregnant Norwegians 2.8 pmol/l, P < 0.02). Conclusion:In spite of abundant availability of ultraviolet radiation, the population from Addis Ababa had a high rate of biochemical vitamin D deficiency compared with the Norwegian group.

We systematically inspected insulin injection sites in 100 insulin-requiring patients attending the Diabetic Clinic of the Tikur Anbassa Hospital (TAH) in order to identify local complications related to incorrect injection technique: local complications were found in 53 cases: skin hyperpigmentation and/or indurations in 30 patients; and fat atrophy or hypertrophy in 31 patients. Illiteracy was significantly more common among those with local complications (18/53 versus 6/47, chi 2 5.03, P < 0.05). Mean fasting blood glucose on the day of the inspection was significantly higher (14.9 + 6.3 mmol/l versus 10.5 + 6.1 mmol/l, P < 0.001) and a fasting blood glucose > 10 mmol/l more common (41/53 versus 20/47, chi 2 14.1, P < 0.0005) in those with than in those without local complications. There was no significant difference between the two groups in mean duration of diabetes (6.9 + 5.6 years versus 6.6 + 5.8 years), frequency of hypoglycaemic episodes (12/53 versus 5/47, chi 2 1.76, P > 0.05) or mean daily insulin dose (44 + 18 units versus 44 + 22 units per day). Therefore, we concluded that local complications resulting from incorrect injection technique, a common finding in the group of patients studied, may be common among insulin requiring diabetic patients in general. Incorrect insulin injection causes local complications and disfigurement which may compromise compliance. Furthermore, insulin absorption tends to be erratic from intradermal and fat hypertrophy sites thus interfering with effective diabetic control. Insulin injection sites should be inspected routinely to detect and correct family technique promptly.

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OBJECTIVE -To study basal C-peptide (BCP) and postglucagon C-peptide (PGCP) levels in Ethiopians with diabetes.RESEARCH DESIGN AND METHODS -A total of 56 subjects with type 1 diabetes, 97 subjects with type 2 diabetes, and 50 control subjects were recruited from a hospital in Ethiopia. BCP was determined in all subjects and PGCP in 86 subjects.RESULTS -Mean (ϮSEM) BCP, PGCP, and the increment after glucagon in type 1 diabetic subjects (0.14 Ϯ 0.04, 0.22 Ϯ 0.11, and 0.08 Ϯ 0.05 nmol/l, respectively) were lower (P Ͻ 0.001) than those in type 2 diabetic subjects (0.66 Ϯ 0.04, 1.25 Ϯ 0.10, and 0.56 Ϯ 0.06 nmol/l, respectively) or control subjects (0.54 Ϯ 0.04, 1.52 Ϯ 0.26, and 1.11 Ϯ 0.24 nmol/l, respectively). The mean BCP level was higher in type 2 diabetic subjects than control subjects (P ϭ 0.015), whereas the mean increment was lower (P ϭ 0.005). Insulin-treated type 2 diabetic subjects, compared with non-insulin-treated type 2 diabetic subjects, had lower mean BCP In both the type 1 and type 2 diabetic groups, those with BCP levels Ͻ0.2 nmol/l had lower BMI than those with higher BCP levels (P ϭ 0.023 and P Ͻ 0.001, respectively).CONCLUSIONS -Combined with clinical criteria, C-peptide levels are good discriminators between type 1 and type 2 diabetes in Ethiopians and may also be useful in identifying subjects with type 2 diabetes who require insulin therapy. There is a subgroup of type 2 diabetic subjects with features of type 1 diabetes. Diabetes Care 25:453-457, 2002

With the aim of assessing continuing diabetes education and obtaining baseline information, we have evaluated the knowledge of 139 randomly selected diabetic patients from the Diabetes Clinic of Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia. Seventy-five Type 1 (insulin-dependent) and 64 Type 2 (non-insulin-dependent) diabetic patients, with a mean age of 36 +/- 14 (+/- SD) (range 15-78, median 36) years, and mean duration of known diabetes 6.3 +/- 5.5 (range 1-30, median 5) years participated in the study. Knowledge was assessed by a questionnaire which examined three principal areas: general knowledge on diabetes mellitus, diet plus self care, and chronic complications. Twenty-eight (20.1%), did not attend any and 59 (42.5%) attended the diabetes education programme more than once. The Adjusted Percentage Score (APSCORE) was 69 +/- 1.4 (SEM). Type 1 diabetic patients had a significantly higher score (p < 0.001) for overall knowledge when compared to Type 2 patients. In both groups the knowledge on chronic complications was very poor when compared to the other areas (p < 0.001). No sex difference in knowledge was seen. Higher school and diabetes education attendance had a significant influence on the knowledge of diabetes. However, better knowledge about diabetes was not associated with better glycaemic control as measured by the fasting blood glucose concentration. The wide difference in knowledge, the low rate of attendance at diabetes education sessions, and the very low awareness about chronic complications is very worrying. To achieve the intended aim the diabetes education programme needs to be revised.