Evaluation of the care for diabetes patients by general practitioners in the province of Khouribga, Morocco

Diabetes is a disease of concern due to its increasing frequency and high cost of care. This cross sectional study evaluated the types of care provided to diabetes patients in primary care for management of the condition. Between December 2010 and March 2011, 54 general practitioners [GPs] in health centres in Khouribga province were asked to complete a pretested questionnaire on their care of diabetes patients. For type 2 diabetes, 46% of the GPs would prescribe diet and lifestyle treatment alone. The practice setting influenced how treatment was managed for type1 diabetes patients: 88.5% of rural doctors prescribed premixed insulin versus 58.3% of urban GPs [P = 0.02]. Insulin analogues were prescribed by 20.8% of urban GPs as against 3.8% of rural GPs [P = 0.09]. There are several shortcomings in the quality of care for diabetes patients. Training GPs could be a solution, especially with the lack of specialists in our country

Effect of quinine therapy on plasma glucose and plasma insulin levels in pregnant women infected with Plasmodium falciparum malaria in Gezira state

To determine if quinine has a metabolic effect during treatment of severe or complicated malaria, we studied its effects on plasma glucose and plasma insulin levels in 150 pregnant women with malaria referred to Madani maternity teaching hospital, Gezira state and 50 healthy pregnant controls. Levels were determined at baseline [day 0] before the start of quinine treatment, after 2 days of treatment [2 hours after the 4th dose] and after 7 days of treatment [day 8]. There was a statistically significant increase in plasma insulin concentrations during the quinine infusion and fall in plasma glucose concentration [P<0.001]. Quinine administered at the recommended dose and rate can disrupt plasma glucose homeostasis although it is still the drug of choice for severe and complicated malaria in Sudan

New biochemical markers in chronic heart failure

We investigated the plasma levels of tumour necrosis factor-alpha [TNF-alpha], leptin and insulin, and their relation to body mass index [BMI] in 80 male patients who presented with chronic heart failure [mean age: 47 +/- 4 years] at Tanta University Hospital. Plasma leptin, TNF-alpha and insulin were significantly increased and BMI significantly decreased in New York Heart Association classes III and IV patients. TNF-alpha, leptin and insulin were positively correlated, and TNF-alpha and BMI and leptin and BMI were negatively correlated in stages III and IV of heart failure. We conclude that cytokine neuroendocrine activation may form part of advanced stage heart failure. It may also be responsible for worsening cachexia, and can be used as a marker to determine disease severity