Control of cardiovascular risk in black Africans with type 2 diabetes in Senegal (Contrôle du risque cardio-vasculaire chez les diabétiques de type 2 noirs africains au Sénégal)

Abstract

IntroductionMorbidity and mortality from diabetes are compounded by associated cardiovascular risk factors. For this reason, taking care of these risk factors is a public health goal.In this study we evaluated the level of control of cardiovascular risk factors in black Africans with type 2 diabetes in Senegal.MethodsBetween March 2007 and July 2008, we recruited type 2 diabetes patients from outpatient care in a specialised hospital in Senegal. Data were collected on a survey form designed for this purpose. An electrocardiogram and laboratory examinations were also performed. The level of control of diabetes and associated cardiovascular risk factors were assessed, as recommended by the American Diabetes Association (ADA).ResultsA total of 318 type 2 diabetes subjects (237 women) were recruited. The average age was 58.2 ± 9.2 years (40–85). The mean duration of diabetes was 6.9 ± 5.9 years. The average glycaemic level was 1.4 ± 0.5 g/l and glycated haemoglobin was 7.6 ± 3.2%. The average length of patient follow up was 6.7 ± 6.1 years with a single annual consultation; 63.2% of the patients were on an insulin + biguanide combination, with good diabetes control (HbA1c < 7%) in 25% of cases. Antihypertensive drugs were prescribed in 28.1% of hypertensive patients. More than half (51.9%) of these hypertensive patients were treated with angiotensin converting enzyme inhibitors. Their blood pressure was well controlled (< 130/85 mmHg) in 5.4% of the hypertensive patients (10/185). The low-density lipoprotein (LDL) cholesterol goal was achieved in 18.5% of cases (5/27).ConclusionThis study shows that the prevalence of cardiovascular risk factors is higher among black Africans suffering from type 2 diabetes. The control of these factors was not optimal in our study.

Assessment of Diabetes Control Level and Associated Cardiovascular Risk Factors

“…In our work, we noted a female predominance with a sex-ratio of 0.35 as found by Yameogo et al with a sex-ratio of 0.3 [9] and Belhadj in Algeria [11].…”

“…This female predominance in our study could be explained by the fact that women are the majority of patients attending hospital structures in our context. This hypothesis had already been defended by Yameogo et al in a similar study [9].…”

“…In our series, tobacco consumption was found in 2 patients (0.6%). This rate was lower than that of 6% found by Yameogo [9]. Charpentier and Belhadj reported prevalence close to 11% and 10% of smokers in their populations, respectively [13] [16].…”

“…Just under a quarter of patients in our work remained sedentary (24.23%); without any significant difference between the two sexes. In his series, Yameogo et al found that four out of five patients were sedentary [9]. Mbaye et al also found a prevalence of 79.7% of physical inactivity among diabetics in their series [11].…”

“…The prevalence of obesity in our study was 21.16%. Yameogo et al found a lower prevalence of 9.11% of obese patients while Charpentier et al in France found a higher prevalence of 39% [9] [13].…”