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[The non-insulin-dependent diabetic (type II) in Tahiti]
C Gras1, N Lecordier, A Spiegel
1Médecin des Hôpitaux, Service de Médecine, Centre Hospitalier Territorial, Papeete, Tahiti.
Insights
This study monitored 51 non-insulin-dependent diabetes patients in French Polynesia, revealing high complication rates, especially after 10 years of disease duration. Poor glycemic control was prevalent, underscoring the need for effective diabetes management strategies.
Area of Science:
- Endocrinology
- Public Health
- Epidemiology
Context:
- Monitoring of 51 non-insulin-dependent diabetes patients in Papeete, French Polynesia.
- Study period: July 1988 to December 1991 (average 26.5 months follow-up).
- Inclusion criteria: Polynesians diagnosed with non-insulin-dependent diabetes.
Purpose:
- To assess the clinical characteristics, risk factors, complications, and glycemic control in Polynesian non-insulin-dependent diabetes patients.
- To review treatment modalities and patient outcomes during the monitoring period.
Summary:
- High prevalence of risk factors including obesity (67%) and heredity (43%).
- Significant complication rates: microangiopathy (nephropathy 25%, retinopathy 29%), macroangiopathy, neuropathy (17%), hypertension (55%), and diabetic feet (32% with 8 amputations).
- Poor glycemic control observed: 80% with mean glycemia >1.50, 54% postprandial glycemia >2g, 34% HbA1c >9%.
Impact:
- Complication rates increase significantly with disease duration; patients with over 10 years of diabetes averaged two complications.
- One mortality case and 881 hospitalization days recorded, highlighting the disease burden.
- Findings underscore the critical need for improved diabetes management and prevention strategies in the Polynesian population.
Abstract:
The authors report on the monitoring in the Diabetology Service of the Territorial Hospital Center of Papeete (French Polynesia) of 51 Polynesians, diabetics non insulin-dependent over periods of 12 to 30 months (average 26.5 months) from July 1988 to December 1991. 31 males and 20 females (sex-ratio 1.5). Mean age: 55.9 (extremes: 22 and 76 old years). Non insulin-dependent diabetes risk factors: heredity (43%), obesity (67%), new-born babies with a weight more than 4 kg (10%). Revealing factors of diabetes: systematic check-up (37%), clinical complications (36%), cardinal signs (20%). Recorded complications are: 1. microangiopathy: nephropathy (25%) including 7 renal insufficiency and 2 patients under dialysis; retinopathy (29%); 2. macroangiopathy: cardiovascular accident 1 case; angor 4 cases; obliterative arteritis of inferior limbs 5 cases; 3. neuropathy 9 cases (17%); 4. high arterial tension 55%; 5. metabolic complications (20%): 4 acidocetosis; 2 hyperosmolar coma; 4 severe hypoglycemia; 6. 16 diabetic feet (32%) among them 8 amputations; 7. 45 infectious complications in 27 patients are reviewed. Review of the complications according to diseases ancientness; before 10 years of evolution, each patient suffered of at least one complication, after 10 years, each patient got an average of 2 complications. Review of diabetic balance: 80% of the patients present a mean glycemia greater than 1.50; 54% present a postprandial glycemia greater than 2 gr. and 34% a A1 C Hb greater than 9%. The possible treatments are reviewed. During this monitoring, mortality was one case; 35 patients were admitted totaling 881 days of hospitalization.