Interest of the waist-to-height ratio to predict metabolic syndrome in type 2 diabetic patients.

INTRODUCTION: Metabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease. AIM: To determine the optimal cut-off point of the waist-to-height ratio (WHtR) at which MetS can be identified with maximum sensitivity and specificity in a sample of Tunisian type 2 diabetic patients. METHODS: We enrolled 457 type 2 diabetic patients in a cross-sectional study. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. WHtR was calculated. MetS was defined according to the IDF criteria. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value of WHtR in MetS screening with maximum sensitivity and specificity. RESULTS: The overall prevalence of MetS was 79.8%, it was higher in women than in men (85.5% vs 61.4%; p.

Nephropathy in type 2 diabetics : predictive factors and evolving aspects.

INTRODUCTION: Diabetic nephropathy (DN) is the most common cause of end-stage renal disease. AIM: To study the evolution of nephropathy in a group of type 2 diabetics in order to determine the predictive factors of progression. METHODS: We conducted a longitudinal retrospective, descriptive study witch involved 100 type 2 diabetics patients with confirmed DN for at least 10 years. The patients were divided into 2 groups according to the evolution of their DN: stable DN (group 1) and progressive DN (group 2). RESULTS: At the time of diagnosis of DN, the majority (82%) of the patients were in the stage of incipient DN while 18% were in the stage of established DN. Univariate regression analysis showed that higher baseline values of albuminuria (p=0.038), creatinine (p=0.001), systolic blood pressure (p=0.009), uricemia (p=0.01) as well as a lower glomerular filtration rate (GFR) (p<0.001), and smoking (p=0.023) were significantly associated with an unfavorable evolution of DN.A high mean value during monitoring in albuminuria (p<0.001), creatinine (p<0.001), systolic blood pressure (p<0.001), uric acid (p<0.001) as well as a lower GFR (p<0.001), and a higher frequency of hypertriglyceridemia (p=0.004) were considered to be risk factors for an unfavorable development of DN detectable during follow-up. CONCLUSION: We have found several predictors of the progression of DN in our work whose multifactorial approach could improve the outcome of our patients as well as their quality of life.

Assessment of oral health status among uncontrolled diabetic mellitus patients in Tunisia.

AIM: To assess oral health status of Tunisian diabetic mellitus patients. METHODS: We carried a cross-sectional study among 100 uncontrolled diabetic mellitus patients. An oral health survey was developed to collect their socio-demographic characteristics and to assess their oral health behavior. Each patient benefited of an oral examination. Clinical and biological data were collected from medical file of patients. RESULTS: In terms of number of brushings, 44% of diabetic mellitus patients brushed their teeth at least twice a day, 25% brushed once a day, 10% occasionally and 21% did not used to brush their teeth. The last visit to a dentist dated since less than a year ago for 48% of participants and 8% reported that they hadn't never visit a dentist. Oral hygiene and the rate of dental consultation were correlated with gender but not with glycemic control. Only 17% had complete dentition, 75% were partially dentate and 8% were completely edentulous. More than half of the diabetics had at least 5 missing teeth. About 67% had had experienced tooth decay. The presence of tooth decay was not correlated with glycated hemoglobin (HbA1c). The examining dentist estimated that nine out of ten patients required dental care. CONCLUSION: The oral health status of diabetic mellitus patients in Tunisia was bad. The need for dental care was real and high but often overlooked. The establishment of a national oral health care policy seems to be a national priority today.