Mortality and natural progression of type 1 diabetes patients enrolled in the Rwanda LFAC program from 2004 to 2012

Marshall, Sara L.; Edidin, Deborah V.; Arena, Vincent C.; Becker, Dorothy J.; Bunker, Clareann H.; Gishoma, Crispin; Gishoma, Francois; LaPorte, Ronald E.; Kaberuka, Vedaste; Rubanzana, Wilson; Sibomana, Laurien; Orchard, Trevor J.

doi:10.1007/s13410-016-0536-z

“…16,40 The Mali study population also had a younger age of death and shorter duration of diabetes prior to death compared to research from Rwanda, where mean age at death was 19.4 years and duration of diabetes 4.1 years. 15 The increasing known incidence and lower mortality combined to sharply increase prevalence at all ages. It is likely that prevalence will continue to rise with the reduction in mortality.…”

Section: Discussionmentioning

confidence: 99%

“…control and a high rate of complications and premature death from diabetes. 6,[12][13][14][15][16][17] In 2007, the French non-government organization Santé Diabète (which has a full time delegation in Mali) and the Life for a Child program (LFAC), commenced an intervention to provide care for all young people <26 years of age with diabetes in Mali. Before this, very limited care was available, and most children and youth with diabetes in Mali died within a couple of years of diagnosis.…”

mentioning

confidence: 99%

Rapid increases in observed incidence and prevalence of Type 1 diabetes in children and youth in Mali, 2007–2016

Sandy

¹

,

Besançon

²

,

Sidibé

³

et al. 2021

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Aims: Determine incidence, prevalence and mortality of Type 1 diabetes (T1D) in children and youth <25 years (y) in Mali during the first 10 years of the Santé Diabète/Life for a Child program. Methods: Data were collected from the prospective program register. Diagnosis of T1D was clinical, based on presentation, clinical features, immediate requirement for insulin, and no suggestion of other diabetes types.Results: Total of 460 cases were diagnosed with T1D <25 years in 2007-2016.

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“…Even with accurate diagnosis, mortality has been high in studies in sub-Saharan Africa[ 26 - 28 ], but there are indications it is falling - for instance in Rwanda it was found to be between 13.9-40.2 per 1000 patient years, depending on the fate of those lost to follow-up[ 29 ]. The figure of 32/1000 from this study is in this range - and in Rwanda like in Ghana, care is improving as supplies are made available[ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of diabetes at diagnosis among children and adolescents at an endocrine clinic in Ghana

Ameyaw

¹

,

Asafo-Agyei

²

,

S

³

et al. 2017

WJD

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AIMTo determine the clinical features of diabetes in children and adolescents in Ghana.METHODSRetrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auguest 2016.RESULTSOne hundred and six subjects presented with diabetes. Ninety (84.9%) were diagnosed by clinical features and family history as type 1, and 16 (15.1%) type 2. For type 1 subjects, age range at diagnosis was 0.9-19.9 year (y), peak age of onset 12-13 year, and 3.3% were < 5 year, 21.1% 5- < 10 year, 45.6% 10- < 15 year and 30.0% 15- < 20 year. Seventy-one point one percent were female. Common clinical features were polyuria (100%), polydipsia (98.9%), and weight loss (82.2%). Mean BMI SD was -0.54, range -3.84 to 2.47. 60.0% presented in diabetic ketoacidosis (DKA). Nine had infections at onset (skin, abscess, leg ulcer). Mean ± SD HbA1c at diagnosis was 12.7% ± 1.9% (115 ± 21 mmol/mol). Four have since died: Hypoglycaemia (2), recurrent DKA (1), osteosarcoma (1). Two other type 1 cases died of DKA at presentation in emergency before being seen by the paediatric endocrinologist. Crude mortality rate including these 2 cases was 32.2/1000 patient years. Type 2 cases were 81% female, age of onset 9-19 year. Mean BMI SD was 1.49, range -0.87 to 2.61. Forty-three point eight percent presented in DKA. All type 2 cases had acanthosis nigricans. Overall, 9.8% did not have home refrigeration, most using clay pot evaporative cooling for insulin storage.CONCLUSIONType 1 occurs with a female preponderance and high DKA rates. Type 2 also occurs. Typology based on clinical features is difficult. Community and professional awareness is warranted.

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“…Even with accurate diagnosis, mortality has been high in studies in sub-Saharan Africa [26][27][28] , but there are indications it is falling -for instance in Rwanda it was found to be between 13.9-40.2 per 1000 patient years, depending on the fate of those lost to follow-up [29] . The figure of 32/1000 from this study is in this range -and in Rwanda like in Ghana, care is improving as supplies are made available [30] .…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of diabetes at diagnosis among children and adolescents at an endocrine clinic in Ghana

Ameyaw

¹

,

Sb

²

,

S

³

et al. 2018

ESPE

0

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AIM To determine the clinical features of diabetes in children and adolescents in Ghana. METHODS Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auguest 2016. RESULTS One hundred and six subjects presented with diabetes. Ninety (84.9%) were diagnosed by clinical features and family history as type 1, and 16 (15.1%) type 2. For type 1 subjects, age range at diagnosis was 0.9-19.9 year (y), peak age of onset 12-13 year, and 3.3% were < 5 year, 21.1% 5-< 10 year, 45.6% 10-< 15 year and 30.0% 15-< 20 year. Seventy-one point one percent were female. Common clinical features were polyuria (100%), polydipsia (98.9%), and weight loss (82.2%). Mean BMI SD was-0.54, range-3.84 to 2.47. 60.0% presented in diabetic ketoacidosis (DKA). Nine had infections at onset (skin, abscess, leg ulcer). Mean

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Mortality and natural progression of type 1 diabetes patients enrolled in the Rwanda LFAC program from 2004 to 2012

Cited by 14 publications

References 19 publications

Rapid increases in observed incidence and prevalence of Type 1 diabetes in children and youth in Mali, 2007–2016

Rapid increases in observed incidence and prevalence of Type 1 diabetes in children and youth in Mali, 2007–2016

Clinical profile of diabetes at diagnosis among children and adolescents at an endocrine clinic in Ghana

Clinical profile of diabetes at diagnosis among children and adolescents at an endocrine clinic in Ghana

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