Painful diabetic neuropathy is a frequent complication of diabetes. Its diagnosis is clinical. Our goal is to determine the prevalence of painful diabetic neuropathy in this population. We also analyzed the relationship between this neuropathy and certain parameters, concerning the patient and his diabetes. It is a cross sectional study conducted at the department of endocrinology and internal medicine of Avicenne hospital Marrakech-Morocco, among a cohort of 300 diabetic outpatients. We used the DN4 questionnaire (Douleur Neuropathique en 4 questions), for diagnosis. The results showed a prevalence of 15%. In this study: advanced age, female gender, duration of diabetes greater than 10 years, and the lack of medical follow up were found to be statistically significant risk factors for painful diabetic neuropathy, in addition to some diabetes-related comorbidities such as hypertension, dyslipidemia, sedentary life style and diabetic retinopathy. Painful diabetic neuropathy remains undertreated, in fact 74% of our patients did not receive any specific treatment, knowing that the progress in developing effective and well-tolerated therapies has been disappointing.
Introduction: Morgagni-Stewart-Morel (MSM) syndrome is defined as the presence of hyperostosis frontalis interna (HFI) associated with metabolic, endocrine, and neuropsychiatric disorders. Here, we present an MSM syndrome case involving a woman with symptoms of depression and infertility. Case Report: A 38-yearold woman admitted for inaugural diabetic ketosis and she reported a history of severe frontal headache of which she had suffered for several years associated to depression, obesity, and infertility. Axial cranial computed tomography (CT) scan showed bilateral thickening of the inner table of the frontal bone. Her endocrine dysfunctions and neuropsychiatric symptoms are interpreted as components of Morgagni-Stewart-Morel syndrome and may correlate with the severity of the frontal hyperostosis and the cortical atrophy. Conclusion: We describe a case of MSM syndrome, presenting many of the clinical features described in the literature. The exact etiology of HFI and MSM syndrome remains unclear; the most interesting theories relate to estrogen dysfunction, obesity and leptin dysfunction, and genetics.
Hajj (Pilgrimage) is one of the five pillars of Islam. During Hajj, the person's life routine changes, weather, diet and habits are different; therefore diabetes that depends on a stable routine would predictably be significantly affected. The aim of this study is to highlight the epidemiology, clinical data of diabetic Moroccan Pilgrims. We performed a prospective study conducted over a period of 50 days from the 07 august 2017 until 11 September 2017, based on questionnaire. The total number of patients was 80 (40 men and 40 women), all of them belong to type 2 diabetes mellitus. The mean of age was 62.85 y (+/-8,9 SD). The mean of duration of diabetes was 9.37ans (+/-7.3 SD) .The mean of Random Plasma Glucose was 1.58 g/l (SD+/-0.4). In our study, 11.3% of patients had diabetic nephropathy, 13.8% had diabetic neuropathy and 1.3% had heart disease. We admitted 4 patients (5%) for DKA. Poor diabetes control in pilgrims with diabetes predisposes to morbidity and increases risk of acute complications. Patients with diabetes insist on performing Hajj, thereby creating a medical challenge for themselves and their health care providers.
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