The epidemiology and pathogenesis of type 1 diabetes mellitus in Africa

Padoa, Carolyn J.

doi:10.1080/22201009.2011.10872264

Cited by 11 publications

(21 citation statements)

References 59 publications

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“…The patient profile in the present study also differed from the Indian and Malaysian studies in that most of the subjects were African and early onset T2D appears to be less frequent in patients of African origin than other ethnic groups. 11,22,23 Of note, a higher proportion of Asian subjects in the current study were diagnosed with T2D than T1D (T1D 25.8% vs. T2D 40.7%). This may reflect variances in ethnic susceptibility to different types of diabetes.…”

Section: Discussionmentioning

confidence: 56%

“…[7][8][9][10]20 The age cut-off point chosen in the current study was < 35 years and this was based on earlier observations that later age of onset of diabetes is reported in African communities (22-29 years) compared with European communities. 4,11,22,[24][25][26] Also, African patients had a bimodal peak of age of onset, with the first peak between 14 and 17 years and the second between 30 and 31 years. 26 In the current study, all 27 KPD patients were African, older at diagnosis and heavier than subjects with T1D and T2D.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of subjects with diabetes mellitus diagnosed before 35 years of age presenting to a tertiary diabetes clinic in Durban, South Africa, from 2003 to 2016

Govender

Elmezughi

Esterhuizen

et al. 2018

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Background: Most patients diagnosed with diabetes mellitus < 35 years will have type 1 diabetes (T1D). The increase in youthonset type 2 diabetes (T2D) parallels the obesity epidemic and in African subjects ketosis-prone type 2 diabetes (KPD) may occur in this age group. Objectives, setting and subjects: To evaluate the clinical, biochemical and immunologic characteristics of patients diagnosed with diabetes < 35 years presenting to a tertiary diabetes clinic in Durban, South Africa over 13 years. Design: A retrospective chart review of patients < 35 years diagnosed with diabetes was conducted. Data included clinical and laboratory variables, complications and follow-up status. Results: The study included 517 patients of whom 445 (86.1%) were diagnosed with T1D, 27 (5.2%) with T2D, 27 with KPD (5.2%) and 18 (3.5%) with other forms of diabetes. Mean age of the total group was 28 ± 10 years. Subjects with T1D were younger at diagnosis with a lower BMI than both T2D and KPD. HbA1c was higher in subjects with T1D. Overall mortality was low (3.5%) and follow-up was poor in all groups. Conclusion: The majority of young people with diabetes in KwaZulu-Natal, South Africa, have T1D, with small numbers of other types. Glucose control is poor with a high loss to follow-up.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Characteristics of subjects with diabetes mellitus diagnosed before 35 years of age presenting to a tertiary diabetes clinic in Durban, South Africa, from 2003 to 2016

Govender

Elmezughi

Esterhuizen

et al. 2018

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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“…Type 1 diabetes is the most frequent endocrinopathy (International Diabetes Federation: IDF). It is a state of chronic hyperglycemia related to insulin deficiency, resulting from autoimmune destruction in insulin-secreting pancreatic beta cells, for which symptoms appear after 80% of the pancreatic cells are destroyed, including polyuria, polydipsia and signs of variable dehydration [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…This number as well as the prevalence of type 1 diabetes has increased over the past three decades around the world, and Africa is no exception [1,[3], [4], [5], [6]]. For treatment requires costly substitutive insulin therapy making both the family and the patient in Africa bear this double burden related to the cost and outcome of this pathology [7].…”

Section: Introductionmentioning

confidence: 99%

Type 1 diabetes mellitus in Gabon

Damiens

–Zandzou

Ibounde

et al. 2019

International Journal of Pediatrics and Adolescent Medicine

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Background and ObjectiveType 1 diabetes mellitus (T1DM) is the most frequent endocrinopathy in children. Its replacement therapy requires insulin, without which, death is inevitable. This treatment is expensive and a financial burden for diabetic children and their families, especially in Africa.In the absence of a national T1DM register, the purpose of this study was to describe epidemiological aspects of type 1 diabetes in children in Gabon, specify the difficulties met by the patients during the follow-up and identify factors explaining poor therapeutic observance and metabolic control.Material and methodsProspective transversal monocentric study. Data were firstly extracted from the registers of the Endocrinology Department of the University Hospital of Libreville (CHUL), Gabon, between 2010 and 2017.Secondly, patients were interviewed by telephone about the availability and cost of insulin, their self-monitoring of blood glucose, and diet.Results306 patients (154 girls and 152 boys) were diagnosed with T1D during the study period and followed-up in the Endocrinology Department at CHUL. Mean age at diagnosis was 17 ± 7 years (5% of patients were over 5 years of age, 30% were >20 years old). Mean follow-up period was 4.0 ± 2.0 years. 16% of the patients were hospitalized at least 2 times per month for ketoacidosis.Hospital mortality was about 7%. Number of factors linked with poor therapeutic observance (high cost of treatment, lack of patients’ therapeutic education, etc.) were identified.ConclusionT1D prevalence is constantly increasing worldwide, but at slower pace in Africa in comparison to developed countries. Difficulties to access to high standard care and population poverty in Sub-Saharan Africa, represents a major independent factor of poor therapeutic observance.

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“…T1D incidence, treatment, and metabolic control data in low income countries are not univocal [7]. Among African populations a lower incidence is reported than in Western populations, varying from 1.5/100,000 people/year in Tanzania to 10.1/100,000 people/year in Sudan [8] with a difference age associated as recently reported in Ghana where the T1D incidence in children 0-9 yeas-old decreased from 5.1% in 1992-1994 to 3.6% in 2016-2018, while increased among adolescents (from 35.4% in 1995-1997 to 63.2% in 2016-2018) [9]. The dissimilar T1D incidence between countries and ethnic groups is probably due to differences in the genetic susceptibility and environmental factors exposure [10].…”

Section: Introductionmentioning

confidence: 99%

Endocrine Disrupting Chemicals and Type 1 Diabetes

Predieri

Bruzzi

Bigi

et al. 2020

IJMS

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Type 1 diabetes (T1D) is the most common chronic metabolic disease in children and adolescents. The etiology of T1D is not fully understood but it seems multifactorial. The genetic background determines the predisposition to develop T1D, while the autoimmune process against β-cells seems to be also determined by environmental triggers, such as endocrine disrupting chemicals (EDCs). Environmental EDCs may act throughout different temporal windows as single chemical agent or as chemical mixtures. They could affect the development and the function of the immune system or of the β-cells function, promoting autoimmunity and increasing the susceptibility to autoimmune attack. Human studies evaluating the potential role of exposure to EDCs on the pathogenesis of T1D are few and demonstrated contradictory results. The aim of this narrative review is to summarize experimental and epidemiological studies on the potential role of exposure to EDCs in the development of T1D. We highlight what we know by animals about EDCs’ effects on mechanisms leading to T1D development and progression. Studies evaluating the EDC levels in patients with T1D were also reported. Moreover, we discussed why further studies are needed and how they should be designed to better understand the causal mechanisms and the next prevention interventions.

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The epidemiology and pathogenesis of type 1 diabetes mellitus in Africa

Cited by 11 publications

References 59 publications

Characteristics of subjects with diabetes mellitus diagnosed before 35 years of age presenting to a tertiary diabetes clinic in Durban, South Africa, from 2003 to 2016

Characteristics of subjects with diabetes mellitus diagnosed before 35 years of age presenting to a tertiary diabetes clinic in Durban, South Africa, from 2003 to 2016

Type 1 diabetes mellitus in Gabon

Endocrine Disrupting Chemicals and Type 1 Diabetes

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