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Papers by Fabian Puepet
Nigerian Postgraduate Medical Journal
Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. To describ... more Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. To describe the pattern of glomerular filtration rate abnormalities and its clinical correlates in Nigerians with type 2 diabetes mellitus. Glomerular filtration rate as determined by the endogenous creatinine clearance was measured in 90 patients with type 2 diabetes mellitus and 60 controls at the Jos University Teaching Hospital, Jos. Twelve subjects (13.3% ) in the diabetic group had hyperfiltration (GFR > 125 ml/min) compared to 3 (5% ) in the control group, although the mean glomerular filtration rates were similar in the two groups (96.19 +/- 29.14 ml/min and 88.38 +/- 24.13 ml/min respectively, p > 0.05). All the subjects with hyperfiltration had been diabetic for less than 5 years. Only one of the diabetics had renal insufficiency (GFR < 50 ml/min). This study demonstrates that hyperfiltration is common in patients with type 2 diabetes mellitus and that it occurs early in the course of the disease.
Highland Medical Research Journal, 2018
Background -The implementation of insulin in the management of type 2 diabetes mellitus is often... more Background -The implementation of insulin in the management of type 2 diabetes mellitus is often necessary for better glycaemic control. However, many still consider insulin therapy as the last resort. Several factors come to play in the acceptance of insulin as a form of therapy by patients. This study evaluated the perception of insulin therapy among patients with type 2 diabetes mellitus. Methods - This was a descriptive cross-sectional study carried out at the Jos University Teaching Hospital (JUTH) Jos, North Central Nigeria. One hundred and eighty five persons (100 insulin naive persons and 85 persons on insulin) were recruited consecutively. The insulin treatment appraisal scale (ITAS) was used to evaluate the perception of insulin therapy among these patients Results - fifty five (64.7%) females were on insulin while 64 (64%) were insulin naive. The mean age was 52 ± 11 years and 59 ± 10 years in those on insulin and insulin naive persons respectively. Twenty one (24.7%)...
BMC Cardiovascular Disorders, 2020
Background Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amput... more Background Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amputation as well as coronary heart disease. It is more common in patients with diabetes mellitus (DM) and co-exists with peripheral neuropathy. Prevalence of PAD in type 2 DM patients in northern Nigeria is largely unknown. We investigated the occurrence and factors associated with PAD among patients with type 2 DM in a tertiary hospital in northern Nigeria. Methods This was a cross- sectional analytic study. We recruited 200 patients with type 2 DM consecutively from the diabetes clinic of the Jos University Teaching Hospital. Ankle brachial index was assessed for each participant. Clinical information, anthropometric indices and blood samples were collected for assay. Data was analysed using CDC Epi-Info and logistic regression analysis was used to determine independent correlates of PAD. RESULTS:PAD was present in 38.5%(n = 77) of subjects and it was associated with the female sex, age ≥...
Journal of Diabetology, 2020
Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of... more Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of developing impaired glucose metabolism is thought to be higher in first-degree relatives (FDRs) of those with T2DM. The aim of this study was to estimate the prevalence of impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) and its associated risk factors in FDRs of patients with T2DM. Materials and Methods: This is a cross-sectional descriptive study of 320 cases (FDRs of T2DM outpatients) aged ≥25 years (145 males and 175 females) and 160 controls (76 males, 84 females) who were age and sex matched. All subjects underwent anthropometric, physical activity, and laboratory assessments after an overnight fast. Oral glucose tolerance test with 75g anhydrous glucose was administered. Fasting plasma glucose of 6.1–6.9 mmol/L and 2-h post-fasting glucose value of 7.8–11.0 mmol/L were used to define IFG and IGT, respectively. Statistical analysis was carried out using the Statistical Package for the Social Sciences software, version 20 (SPSS, Chicago, Illinois), and P value of <0.05 was considered significant. Results: The mean (standard deviation) age of the cases and controls was 38.4 (12.3) and 38.9 (10.3) years, respectively, P = 0.66. The prevalence rates of both IGT and IFG in cases and controls were (28.1% vs. 18.1%, P = 0.019 and 10.3% vs. 5.6%, P = 0.0001). The prevalence of IGT and IFG was found to be higher among females, P < 0.05. Multivariate analysis revealed abnormal waist circumference, being FDR, and elevated systolic blood pressure as risk factors for both the IGT and IFG, P < 0.05. Conclusion: FDRs of patients with T2DM are at higher risk of IGT or IFG. The risk increases with the development of obesity and elevated blood pressure in them.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in hypertensive versus normotensive adults without cardiac symptoms. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty normotensive, age and sex matched adults (HTN-) were enrolled from the medical clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 23 males in each of the two groups. The mean ages were 49 ± 8 and 47 ± 7 years respectively (p=0.48). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+ group had a higher prevalence of LVD compared to the HTN- group (30% versus 14%, p = 0.05). In addition, the HTN+ group had worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors of LVD on regression analysis. In the HTN- group, older age and left atria diameter correlated significantly with systolic and diastolic parameters. They also emerged as independent predictors on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives without cardiac symptoms. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Annals of African Medicine, 2016
Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic setting... more Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization&amp;amp;amp;amp;amp;amp;amp;#39;s STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P&amp;amp;amp;amp;amp;amp;amp;lt; 0.05. A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities. The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in asymptomatic hypertensive patients with and without type 2 diabetes. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty with hypertension and type 2 diabetes mellitus (HTN+/DM+) were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 29 females in the HTN+ and HTN+/DM+ groups respectively. The mean ages were 49 ± 8 and 49 ± 7 years respectively (p = 0.95). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+/DM+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+/DM+ group had a higher prevalence of LVD compared to the HTN+ group (56% versus 30%, p < 0.01) and worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors on multivariate regression analysis. In the HTN+/DM+ group, duration of DM correlated significantly with systolic and diastolic parameters while duration of hypertension correlated significantly with systolic parameters. Both further emerged as independent predictor on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives; co-morbid diabetes mellitus worsens it. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Gynecology and Obstetrics, 2015
A thyroid storm is a major life threatening disorder and is more complicated when it happens in a... more A thyroid storm is a major life threatening disorder and is more complicated when it happens in an unsupported pregnant teenager where possible maternal and perinatal morbidity and mortality are additional concerns on account of medical and social issues. This patient who defaulted treatment for Graves ' disease for 18 months presented with cardiovascular, central nervous system, gastrointestinal, renal and obstetric complications as a medical emergency to the Labour Ward of the Jos University Teaching Hospital (JUTH). She was in cardiac failure, had anaemia and assessed to have a thyroid storm with intrauterine foetal death. She received intensive care from a multidisciplinary team with anti-thyroid and anti-heart failure drugs, oxygen, blood transfusion, antibiotics, supportive therapy, and subsequently went into labour and had forceps delivery of a macerated foetus and very proactive management that led to the aversion of a potential maternal mortality.
Sahel Medical Journal, 2015
Background: The prevalence of type 2 diabetes (T2DM) is on the increase in developing countries d... more Background: The prevalence of type 2 diabetes (T2DM) is on the increase in developing countries due to urbanization, ageing population, physical inactivity and the high prevalence of obesity. Identifying the risk factors for T2DM is a necessary step in the planning of preventive measures to reduce the burden of the disease. The aim of this study was to determine the socio-demographic and anthropometric risk factors for type 2 diabetes in Maiduguri, northeastern Nigeria. Methods: We randomly selected 242 subjects resident in the study location. Trained interviewers obtained socio-demographic data from each respondent using a pretested questionnaire. Physical measurements for anthropometric indices were carried out using standard methods. Fasting blood samples were collected for the determination of fasting plasma glucose and diagnosis of diabetes. Data were analyzed using SPSS version 16 for windows and a P < 0.05 was considered significant. Results: All the 242 subjects recruited for the study responded. The mean (SD) age of 96 (39.7%) males and 146 (60.3%) females was 40.0 (14.6) years and 41.5 (12.0) years respectively, P > 0.05.The crude prevalence of diabetes was 17 (7.0%). The prevalence was 10(10.4%) in males and 7(4.8%) in females (M: F = 2.1:1), P < 0.05. The independent risk factors for diabetes identified were increasing age (OR = 3.72, 95% CI = 0.83-16.7, P = 0.007) and waist circumference in both males (OR = 1.65, 95% CI = 0.75-3.63, P = 0.036). and females (OR = 1.63, 95% CI = 0.56-4.78, P = 0.025). Conclusion: We identified increasing age and waist circumference to be the independent risk factors for T2DM in Maiduguri, Northeastern Nigeria.
Journal of the National Medical Association, 2006
Studies of frequency of occurrence of diabetic neuropathy are few, and available studies were lim... more Studies of frequency of occurrence of diabetic neuropathy are few, and available studies were limited to the southern part of Nigeria. The objectives of the study were to determine the frequency of occurrence and grades of diabetes peripheral neuropathy using clinical measures. Consecutive patients with diabetes mellitus attending the Jos University Teaching Hospital were recruited as the study population, including 120 diabetics and 60 age-matched, nondiabetic controls. A standard proforma based on the Michigan Neuropathy Screening Instrument (MNSI) was employed to screen for diabetic neuropathy. The frequency of occurrence of diabetic peripheral neuropathy was 75%. For the specific types of peripheral neuropathy, sensorimotor neuropathy was the commonest (40.4%, chi(2)=29.1; p<0.001). There was no significant difference, with severity of peripheral neuropathy among diabetics, when compared by gender. (Chi square=3.03, P value=0.081). The frequency of occurrence of peripheral ne...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Diabetes mellitus is associated with derangements in the serum levels of several biochemical para... more Diabetes mellitus is associated with derangements in the serum levels of several biochemical parameters. This study was conducted in an attempt to obtain the biochemical profiles and their abnormalities in Nigerian type 2 diabetic patients in Jos, North Central Nigeria. Seventy-five (75) Nigerians with type 2 diabetes mellitus and 69 age and sex-matched non-diabetic controls were investigated. Each participant had fasting plasma glucose, plasma lipids, liver, renal function profiles as well as their clinical characteristics assessed. The clinical characteristics body mass index, waist hip ratio and blood pressures were significantly higher in diabetics than controls (p < 0.05). Renal and lipid profiles were also significantly higher in diabetics. There was no significant difference in the liver profile between diabetics and controls. Diabetics with good glycaemic control had lower frequencies of biochemical abnormalities compared to diabetics with poor control. Metabolic abnormal...
International Journal of Vascular Medicine, 2011
As part of a larger study of cardiovascular risk factors in nonhypertensive type 2 diabetes patie... more As part of a larger study of cardiovascular risk factors in nonhypertensive type 2 diabetes patients, we subjected a cohort of diabetics to B mode ultrasonography of the carotid artery to measure the intima media thickness (IMT) and compared it with values in hypertensives and apparently normal controls matched reasonably for gender and age. All groups were comparable in terms of age and gender representation. The mean (SD) of carotid IMT right and left was 0.94 mm (0.12), 0.94 mm (0.16); 0.93 mm (0.21), 0.93 mm (0.15); 0.91 mm (0.17), 0.91 mm (0.13) for diabetic, hypertensive, and normal groups, respectively. There was a nonsignificant tendency to raised IMT for the disease groups from the normal ones. Diabetic and hypertensive Nigerians are equally burdened by cardiovascular disease risk factors. Apparently normal subjects have a reasonable degree of burden suggesting the need to evaluate them for other traditional and emerging risk factors.
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Diabetes mellitus remains a high burden for individuals all over the world. Identification of adu... more Diabetes mellitus remains a high burden for individuals all over the world. Identification of adults at risk for diabetes mellitus provides potential opportunities for early diagnosis and prevention of diabetes mellitus. This study sought to determine the risk factors for diabetes mellitus among adults in a rural Nigerian community. A cross sectional descriptive study of 750 subjects age > or = 15 years using a systematic sampling technique. Data were collected with a structured questionnaire. Subjects were examined for weight, height, waist circumference and hip circumference; body mass index and waist-hip ratio were calculated. Blood samples were collected from subjects for estimation of plasma glucose concentration using the glucose oxidase method of Trinder. Diabetes mellitus was diagnosed according to standard WHO/IDF criteria. Subjects consisted of 385 (51.3%) males and 365 (48.7%) females (male: female 1.05:1) with mean age of 39.42 +/- 16.17 years. Physical inactivity and...
Atherosclerosis Supplements, 2009
S Afr J Diabetes …, 2012
... This observation is in line with that reported by Alebiosu et al.,53 who reported a prevalenc... more ... This observation is in line with that reported by Alebiosu et al.,53 who reported a prevalence of 25.3%, but contrasts with findings of other Nigerian investigators. Adedapo et al. ... Adesanya CO. Diabetes and the heart. 5. E Afr Med J 1977; 54: 417–420. ...
Nigerian Postgraduate Medical Journal
Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. To describ... more Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. To describe the pattern of glomerular filtration rate abnormalities and its clinical correlates in Nigerians with type 2 diabetes mellitus. Glomerular filtration rate as determined by the endogenous creatinine clearance was measured in 90 patients with type 2 diabetes mellitus and 60 controls at the Jos University Teaching Hospital, Jos. Twelve subjects (13.3% ) in the diabetic group had hyperfiltration (GFR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 125 ml/min) compared to 3 (5% ) in the control group, although the mean glomerular filtration rates were similar in the two groups (96.19 +/- 29.14 ml/min and 88.38 +/- 24.13 ml/min respectively, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). All the subjects with hyperfiltration had been diabetic for less than 5 years. Only one of the diabetics had renal insufficiency (GFR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 50 ml/min). This study demonstrates that hyperfiltration is common in patients with type 2 diabetes mellitus and that it occurs early in the course of the disease.
Highland Medical Research Journal, 2018
Background -The implementation of insulin in the management of type 2 diabetes mellitus is often... more Background -The implementation of insulin in the management of type 2 diabetes mellitus is often necessary for better glycaemic control. However, many still consider insulin therapy as the last resort. Several factors come to play in the acceptance of insulin as a form of therapy by patients. This study evaluated the perception of insulin therapy among patients with type 2 diabetes mellitus. Methods - This was a descriptive cross-sectional study carried out at the Jos University Teaching Hospital (JUTH) Jos, North Central Nigeria. One hundred and eighty five persons (100 insulin naive persons and 85 persons on insulin) were recruited consecutively. The insulin treatment appraisal scale (ITAS) was used to evaluate the perception of insulin therapy among these patients Results - fifty five (64.7%) females were on insulin while 64 (64%) were insulin naive. The mean age was 52 ± 11 years and 59 ± 10 years in those on insulin and insulin naive persons respectively. Twenty one (24.7%)...
BMC Cardiovascular Disorders, 2020
Background Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amput... more Background Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amputation as well as coronary heart disease. It is more common in patients with diabetes mellitus (DM) and co-exists with peripheral neuropathy. Prevalence of PAD in type 2 DM patients in northern Nigeria is largely unknown. We investigated the occurrence and factors associated with PAD among patients with type 2 DM in a tertiary hospital in northern Nigeria. Methods This was a cross- sectional analytic study. We recruited 200 patients with type 2 DM consecutively from the diabetes clinic of the Jos University Teaching Hospital. Ankle brachial index was assessed for each participant. Clinical information, anthropometric indices and blood samples were collected for assay. Data was analysed using CDC Epi-Info and logistic regression analysis was used to determine independent correlates of PAD. RESULTS:PAD was present in 38.5%(n = 77) of subjects and it was associated with the female sex, age ≥...
Journal of Diabetology, 2020
Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of... more Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of developing impaired glucose metabolism is thought to be higher in first-degree relatives (FDRs) of those with T2DM. The aim of this study was to estimate the prevalence of impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) and its associated risk factors in FDRs of patients with T2DM. Materials and Methods: This is a cross-sectional descriptive study of 320 cases (FDRs of T2DM outpatients) aged ≥25 years (145 males and 175 females) and 160 controls (76 males, 84 females) who were age and sex matched. All subjects underwent anthropometric, physical activity, and laboratory assessments after an overnight fast. Oral glucose tolerance test with 75g anhydrous glucose was administered. Fasting plasma glucose of 6.1–6.9 mmol/L and 2-h post-fasting glucose value of 7.8–11.0 mmol/L were used to define IFG and IGT, respectively. Statistical analysis was carried out using the Statistical Package for the Social Sciences software, version 20 (SPSS, Chicago, Illinois), and P value of <0.05 was considered significant. Results: The mean (standard deviation) age of the cases and controls was 38.4 (12.3) and 38.9 (10.3) years, respectively, P = 0.66. The prevalence rates of both IGT and IFG in cases and controls were (28.1% vs. 18.1%, P = 0.019 and 10.3% vs. 5.6%, P = 0.0001). The prevalence of IGT and IFG was found to be higher among females, P < 0.05. Multivariate analysis revealed abnormal waist circumference, being FDR, and elevated systolic blood pressure as risk factors for both the IGT and IFG, P < 0.05. Conclusion: FDRs of patients with T2DM are at higher risk of IGT or IFG. The risk increases with the development of obesity and elevated blood pressure in them.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in hypertensive versus normotensive adults without cardiac symptoms. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty normotensive, age and sex matched adults (HTN-) were enrolled from the medical clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 23 males in each of the two groups. The mean ages were 49 ± 8 and 47 ± 7 years respectively (p=0.48). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+ group had a higher prevalence of LVD compared to the HTN- group (30% versus 14%, p = 0.05). In addition, the HTN+ group had worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors of LVD on regression analysis. In the HTN- group, older age and left atria diameter correlated significantly with systolic and diastolic parameters. They also emerged as independent predictors on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives without cardiac symptoms. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Annals of African Medicine, 2016
Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic setting... more Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization&amp;amp;amp;amp;amp;amp;amp;#39;s STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P&amp;amp;amp;amp;amp;amp;amp;lt; 0.05. A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities. The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in asymptomatic hypertensive patients with and without type 2 diabetes. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty with hypertension and type 2 diabetes mellitus (HTN+/DM+) were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 29 females in the HTN+ and HTN+/DM+ groups respectively. The mean ages were 49 ± 8 and 49 ± 7 years respectively (p = 0.95). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+/DM+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+/DM+ group had a higher prevalence of LVD compared to the HTN+ group (56% versus 30%, p < 0.01) and worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors on multivariate regression analysis. In the HTN+/DM+ group, duration of DM correlated significantly with systolic and diastolic parameters while duration of hypertension correlated significantly with systolic parameters. Both further emerged as independent predictor on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives; co-morbid diabetes mellitus worsens it. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Gynecology and Obstetrics, 2015
A thyroid storm is a major life threatening disorder and is more complicated when it happens in a... more A thyroid storm is a major life threatening disorder and is more complicated when it happens in an unsupported pregnant teenager where possible maternal and perinatal morbidity and mortality are additional concerns on account of medical and social issues. This patient who defaulted treatment for Graves ' disease for 18 months presented with cardiovascular, central nervous system, gastrointestinal, renal and obstetric complications as a medical emergency to the Labour Ward of the Jos University Teaching Hospital (JUTH). She was in cardiac failure, had anaemia and assessed to have a thyroid storm with intrauterine foetal death. She received intensive care from a multidisciplinary team with anti-thyroid and anti-heart failure drugs, oxygen, blood transfusion, antibiotics, supportive therapy, and subsequently went into labour and had forceps delivery of a macerated foetus and very proactive management that led to the aversion of a potential maternal mortality.
Sahel Medical Journal, 2015
Background: The prevalence of type 2 diabetes (T2DM) is on the increase in developing countries d... more Background: The prevalence of type 2 diabetes (T2DM) is on the increase in developing countries due to urbanization, ageing population, physical inactivity and the high prevalence of obesity. Identifying the risk factors for T2DM is a necessary step in the planning of preventive measures to reduce the burden of the disease. The aim of this study was to determine the socio-demographic and anthropometric risk factors for type 2 diabetes in Maiduguri, northeastern Nigeria. Methods: We randomly selected 242 subjects resident in the study location. Trained interviewers obtained socio-demographic data from each respondent using a pretested questionnaire. Physical measurements for anthropometric indices were carried out using standard methods. Fasting blood samples were collected for the determination of fasting plasma glucose and diagnosis of diabetes. Data were analyzed using SPSS version 16 for windows and a P < 0.05 was considered significant. Results: All the 242 subjects recruited for the study responded. The mean (SD) age of 96 (39.7%) males and 146 (60.3%) females was 40.0 (14.6) years and 41.5 (12.0) years respectively, P > 0.05.The crude prevalence of diabetes was 17 (7.0%). The prevalence was 10(10.4%) in males and 7(4.8%) in females (M: F = 2.1:1), P < 0.05. The independent risk factors for diabetes identified were increasing age (OR = 3.72, 95% CI = 0.83-16.7, P = 0.007) and waist circumference in both males (OR = 1.65, 95% CI = 0.75-3.63, P = 0.036). and females (OR = 1.63, 95% CI = 0.56-4.78, P = 0.025). Conclusion: We identified increasing age and waist circumference to be the independent risk factors for T2DM in Maiduguri, Northeastern Nigeria.
Journal of the National Medical Association, 2006
Studies of frequency of occurrence of diabetic neuropathy are few, and available studies were lim... more Studies of frequency of occurrence of diabetic neuropathy are few, and available studies were limited to the southern part of Nigeria. The objectives of the study were to determine the frequency of occurrence and grades of diabetes peripheral neuropathy using clinical measures. Consecutive patients with diabetes mellitus attending the Jos University Teaching Hospital were recruited as the study population, including 120 diabetics and 60 age-matched, nondiabetic controls. A standard proforma based on the Michigan Neuropathy Screening Instrument (MNSI) was employed to screen for diabetic neuropathy. The frequency of occurrence of diabetic peripheral neuropathy was 75%. For the specific types of peripheral neuropathy, sensorimotor neuropathy was the commonest (40.4%, chi(2)=29.1; p<0.001). There was no significant difference, with severity of peripheral neuropathy among diabetics, when compared by gender. (Chi square=3.03, P value=0.081). The frequency of occurrence of peripheral ne...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Diabetes mellitus is associated with derangements in the serum levels of several biochemical para... more Diabetes mellitus is associated with derangements in the serum levels of several biochemical parameters. This study was conducted in an attempt to obtain the biochemical profiles and their abnormalities in Nigerian type 2 diabetic patients in Jos, North Central Nigeria. Seventy-five (75) Nigerians with type 2 diabetes mellitus and 69 age and sex-matched non-diabetic controls were investigated. Each participant had fasting plasma glucose, plasma lipids, liver, renal function profiles as well as their clinical characteristics assessed. The clinical characteristics body mass index, waist hip ratio and blood pressures were significantly higher in diabetics than controls (p < 0.05). Renal and lipid profiles were also significantly higher in diabetics. There was no significant difference in the liver profile between diabetics and controls. Diabetics with good glycaemic control had lower frequencies of biochemical abnormalities compared to diabetics with poor control. Metabolic abnormal...
International Journal of Vascular Medicine, 2011
As part of a larger study of cardiovascular risk factors in nonhypertensive type 2 diabetes patie... more As part of a larger study of cardiovascular risk factors in nonhypertensive type 2 diabetes patients, we subjected a cohort of diabetics to B mode ultrasonography of the carotid artery to measure the intima media thickness (IMT) and compared it with values in hypertensives and apparently normal controls matched reasonably for gender and age. All groups were comparable in terms of age and gender representation. The mean (SD) of carotid IMT right and left was 0.94 mm (0.12), 0.94 mm (0.16); 0.93 mm (0.21), 0.93 mm (0.15); 0.91 mm (0.17), 0.91 mm (0.13) for diabetic, hypertensive, and normal groups, respectively. There was a nonsignificant tendency to raised IMT for the disease groups from the normal ones. Diabetic and hypertensive Nigerians are equally burdened by cardiovascular disease risk factors. Apparently normal subjects have a reasonable degree of burden suggesting the need to evaluate them for other traditional and emerging risk factors.
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Diabetes mellitus remains a high burden for individuals all over the world. Identification of adu... more Diabetes mellitus remains a high burden for individuals all over the world. Identification of adults at risk for diabetes mellitus provides potential opportunities for early diagnosis and prevention of diabetes mellitus. This study sought to determine the risk factors for diabetes mellitus among adults in a rural Nigerian community. A cross sectional descriptive study of 750 subjects age > or = 15 years using a systematic sampling technique. Data were collected with a structured questionnaire. Subjects were examined for weight, height, waist circumference and hip circumference; body mass index and waist-hip ratio were calculated. Blood samples were collected from subjects for estimation of plasma glucose concentration using the glucose oxidase method of Trinder. Diabetes mellitus was diagnosed according to standard WHO/IDF criteria. Subjects consisted of 385 (51.3%) males and 365 (48.7%) females (male: female 1.05:1) with mean age of 39.42 +/- 16.17 years. Physical inactivity and...
Atherosclerosis Supplements, 2009
S Afr J Diabetes …, 2012
... This observation is in line with that reported by Alebiosu et al.,53 who reported a prevalenc... more ... This observation is in line with that reported by Alebiosu et al.,53 who reported a prevalence of 25.3%, but contrasts with findings of other Nigerian investigators. Adedapo et al. ... Adesanya CO. Diabetes and the heart. 5. E Afr Med J 1977; 54: 417–420. ...