Oral glucose tolerance testing outcomes among women at high risk for gestational diabetes mellitus.

AIMS: This study aimed to determine the prevalence and relationships with known risk factors of gestational diabetes mellitus (GDM) at University College Hospital, Ibadan, Nigeria. METHODS: Records of all women referred for oral glucose tolerance testing at the metabolic research unit of the Hospital over a 2 year period were reviewed. Diagnosis of GDM was made in accordance with WHO criteria. GDM diagnosis was classified as early and late based on a gestational age <24 weeks and >24 weeks respectively. Body mass index (BMI) measurements were performed for women who presented in the first trimester. Various statistical tools including student t test and Pearson's coefficient of correlation were used. RESULTS: A total of 765 records were reviewed. The crude prevalence rate was 13.9%. The prevalence rate among women in the first trimester was highest at 17.4% although most of the diagnoses were made in the third trimester (55.7%). A positive family history and a family history of GDM were associated significantly with a higher fasting and 2 h post-load glucose values, irrespective of current GDM diagnosis. The most consistent associations with a diagnosis of GDM were a positive family history and a history of GDM. Age above 30 years at oral glucose testing also showed significant association. There was no BMI threshold associated with a significant risk of GDM for those women presenting in the first trimester. CONCLUSIONS: GDM is a common metabolic condition in Nigeria. Onset before the 24th week of pregnancy is not uncommon.

Diabetes, sexual dysfunction and therapeutic exercise: a 20 year review.

Most trials on the effect of exercise on patients with diabetes mellitus focused on their glycaemic control, only a few focused on sexual dysfunction. A comprehensive two-decade literature review (1989-2009) from peer-reviewed journals was undertaken to examine the roles if any, of therapeutic exercise as an intervention for sexual dysfunction in patients with diabetes. Because of the paucity of studies on this subject, meta-analyses, small and non-randomized trials cited on Medline, Pedro, Embase, Scirus, Highwire and the Cochrane Library of systematic reviews were examined. Sexual dysfunction in general, links between diabetes and sexual dysfunction and management options for sexual dysfunction including therapeutic exercises were reviewed. In women, diabetes is reported to slightly increase he risk of decreased sexual arousal, inadequate lubrication and pain on sexual intercourse, while erectile dysfunction is the most common presentation of sexual dysfunction in men. The literature is scanty but shows some effectiveness of therapeutic exercise in managing sexual dysfunction in patients with diabetes. However, this review shows that i) pelvic floor exercises ii) biofeedback techniques iii) electrical stimulation and iv) vaginal dilators are effective in managing sexual dysfunction secondary to other disease factors in the non-diabetic populations. More research is recommended to further establish the efficacy of therapeutic exercise in managing sexual dysfunction in patients with diabetes.

Low prevalence of hepatitis-C viral seropositivity among patients with type-2 diabetes mellitus in a tertiary hospital.

Recently, there have been increasing reports of high prevalence of hepatitis-C virus (HCV) in patients with type-2 diabetes, mostly in western nations. This suggests that type-2 diabetic patients could be considered to be at special risk of acquiring HCV and possibly that diabetes has an etiological relationship with HCV. Ninety patients with type-2 diabetes attending the medical outpatient clinic of the University College Hospital (UCH) and 90 nondiabetic controls with comparable age, sex and risk factors of exposure to HCV were recruited into the study. All subjects were screened for anti-HCV using a third-generation rapid enzyme immunoassay (Dialab anti-HCV cassette). Data were analyzed using Student's t test, Chi-squared test and Fisher's exact test. None of the diabetic patients tested positive for anti-HCV, while 1.1% of the control group tested positive for anti-HCV. There appears to be low prevalence of anti-HCV among type-2 diabetic patients in UCH Ibadan, and therefore no demonstrable risk of HCV in our patients.