Category Archives: Information

Pan-African Diabetic Foot Study Group Bi-annual Scientific Meeting.

 Pan-African Diabetic Foot Study Group Biannual Scientific Meeting.
Pan-African Diabetic Foot Study Group Biannual Scientific Meeting.

The 2nd Pan-African Diabetic Foot Study Group Bi-annual Scientific Meeting.

This Bi-annual meeting being the first of its kind in Africa, took place at the conference room of the Blue Pearl Hotel Morogoro Road, Ubungo Plaza, Dar-es-Salaam Tanzania between 24th to 26th August 2014.

It was aimed at providing updated information regarding the prevention and management of diabetic foot complications in Africa, by bringing together a group of international specialist who are well known for their work in the field of diabetic limb complication.

Delegates from 29 countries around the world, 19 African countries out of which 4 Nigerians were in attendance.The scientific conference was fully packaged with twenty-two lectures on diabetic foot by specialists, eight live workshops which focused on various aspect of clinical practice and management of diabetic foot complications, oral and poster presentations by selected delegates.

The PADFSG was created to promote an advancement of knowledge on all aspect of diabetic foot care through active cooperation and collaboration between diabetologist, podiatrist, specialist nurses, orthopaedics and vascular surgeons and all other specialist with an interest in caring for people living with diabetic foot problems.

This collaborative effort will be to bring together, researchers working in this fields to exchange experiences in research and clinical practice during regular meetings. In addition, the PADFSG may also work actively for the promotion of African collaborative studies and also act as a reference group for other groups in matters relating to foot problems, amputation etc.

Diabetes is a serious chronic disease that needs urgent attention. It affects rich and poor,young and old, and industrialized in equal measure. In 2013, the global prevalence of diabetes was estimated at 382 million (20-70yrs) of which 80% live in low and middle income countries. This figure is predicted globally to reach 592 million ( 55% increase) by 2035. In Africa, total number of diabetes was 19.8 million in 2013 and will increase to 41.4 million by 2035. At present, it is estimated that still 190 million people (55%) with diabetes are undiagnosed. At the same time, diabetic foot complication will increase.

Every 20 seconds a limb is lost due to diabetes somewhere in the world. Approximately 15% of all people with diabetes will be affected by a foot ulcer during their lifetime and up to 85% of amputations in relation to people with diabetes are preceded by a foot ulcer. 1 in 4 of diabetes patient with DM foot require immediate amputation and five years recurrence rates of ulcer is 70%.

Research studies have shown that people with one lower limb amputation as a result of uncontrolled diabetes have a 50% risk of developing a serious lesion in the second limb within 2 years. People with diabetes have a 50% mortality rate in the 5 years following the initial amputation. Across the globe, 40-60% of all lower extremity non-traumatic amputations is due to diabetic foot.

The prevalence of diabetic foot among people with diabetes in Nigeria is 55% and mortality is 12%. Globally, up to 70% of all leg amputations happens to people living with diabetes, lower extremely amputations in diabetes count over 1 million per year. Foot complications, especially serious ones like the septic limb can be serious and costly.
85% of all diabetic foot related problems are preventable.

In other to improve diabetic foot care, education and prevention of amputation in Africa, Dr. Z.G. Abass who doubled as the chairman PADFSG and also chairman organising committee of the conference, initiated the “Step by Step Foot Project” in Tanzania in 2004, which was the first in Africa and has due to the successful establishment of its model of diabetic foot care in Tanzania encouraged other countries to do likewise. To date, the model has been exported to various other countries in Africa, Pakistan, Saudi Arabia and the Caribbean.

As part of the step by step foot project, a book “Pocket guidelines of diabetic foot for health care worker” by Dr. Z.G. Abbas was launched on the first day of the conference to provide a broad sweep of current knowledge in the field of diabetic foot complications.

Thus, educating patients and health care workers which is the integral part of any prevention program. The pocket guideline is a useful tool for clinical practice aimed at managing the diabetic foot; it focuses on the key aspect of prevention and education through initiatives based on sharing of knowledge and guidelines for managing diabetic foot.

We want to profoundly appreciate the immense contribution of the PADFSG, particularly Dr Z.G. Abass for the sponsorship of the NGDOC representative to the conference.

Dr Foluke Ajose is a diabetes advocate, NGdoc DiabLink Cordinator interested in Diabetes Limb Salvage, she is currently in talks with Dr Abass towards inviting him to Nigeria and replicating the “Step by Step Foot Project” model in Nigeria.

Next PADFSG Conference holds Oct 14-15th 2016,in Cairo Egypt. Don’t Miss it!

PHOTO SPEAKS

Traditional Display at the Gala dinner

Traditional Display at the Gala dinner

BLUE PEARL HOTEL MAIN ENTRANCE

BLUE PEARL HOTEL MAIN ENTRANCE

DELEGATE REGISTRATION

DELEGATE REGISTRATION

Delegates at Lunch

Delegates at Lunch

Delegates from Nigeria

Delegates from Nigeria

Dr. Ajose Foluke with Dr. Z.G. Abbass(chairman PADFSG)

Dr. Ajose Foluke with Dr. Z.G. Abbass(chairman PADFSG)

Dr. Arun Bal,Founder President Diabetic Foot Sosiety of India

Dr. Arun Bal,Founder President Diabetic Foot Society of India

Launching of Book and Opening of the Meeting

Launching of Book and Opening of the Meeting

Overview of Delegates at the Conference

Overview of Delegates at the Conference

Prof Andrew Bolton, Founding Chair Diabetic Foot Study Group Of EASD 1998

Prof Andrew Bolton, Founding Chair Diabetic Foot Study Group Of EASD 1998

TANZANIAN MINISTER FOR HEALTH

TANZANIAN MINISTER FOR HEALTH – Dr Seif S. Rashid

The Blue Pearl Hotel

The Blue Pearl Hotel

 

 

DIABLINK… A platform for children living with Type 1 Diabetes in Nigeria

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Someone once told me our children are dying, our future is dying and Type 1 diabetes mellitus is the killer!

Type 1 diabetes mellitus formerly known as “juvenile-onset” diabetes because it was thought to develop mostly in children or young adults but now has been known to affect people of any age.

Prevention they say is better than cure. The most devastating part of type 1 diabetes is that it’s neither preventable nor curable and it affects children more. As a chronic disease with serious consequences, if left untreated, can result in death.

Type 1 diabetes is most likely a polygenic condition with a number of potential environmental risk factors being implicated to include dietary factors, initiation of bovine milk in babies, infectious agents (for example viruses like enterovirus, rotavirus, rubella), chemicals and toxins, —but results have however been inconclusive.

Type 1 diabetes is usually caused by an auto-immune reaction where the body’s defense system attacks the pancreatic cells that produce insulin.

Children with Type 1 diabetes produce little or no insulin- the hormone that. converts sugar, starch and other food into energy needed for daily life which makes them require daily insulin in order to control blood glucose. Consequently lack of access to insulin will result in complications and might eventually lead to death.

Most children with diabetes may end up developing debilitating complications such as blindness, kidney failure, heart disease, diabetes ketoacidosis – a common presentation at the emergency centers in hospitals. All these complications from Type 1 diabetes are devastating for these children, their family, and the health system.

Besides physical problems, children with Type 1 diabetes can experience anxiety and depression from living a restricted lifestyle. They may lose productivity due to school absences because of the development of complications. Changing personal routines can also affect other family members. The physical, social, economic and emotional burden of Type 1 diabetes can’t be underestimated.

Even though diabetes is a serious problem, it is manageable and requires appropriate and timely intervention. Diabetes can be managed as insulin replacement through lifelong insulin injections everyday, following a healthy diet and eating plan, taking regular exercises and monitoring of blood glucose levels regularly.

The management of children living with Type 1 diabetes poses a huge financial burden on their families especially in the developing world. Most families can not afford a continuous availability of insulin for these children resulting in most complications and death.

In view of these challenges, Diablink was created as a platform for advocating for the welfare of Type1 diabetes children and is embedded in and developed from The Nigeria Diabetes Online Community (NGDoc) as a response to the realization of the problems children living with diabetes face or will face upon diagnosis.

Diablink is aimed at the management of emergency cases of Type 1 diabetes where parents can’t afford treatment and subsequently linking Nigerian children living with Type 1 diabetes with others globally, creating pen pal relationships among them, thus creating social peer empowerment for them.

For more information on Type 1 diabetes mellitus in Nigeria you can read our piece on “Type 1 Diabetes Mellitus in Nigeria: rare or not obvious” – here

Until recently funds for the availability of insulin as well as building supportive communities for children with Type 1 diabetes have been generated internally by NGdoc volunteers but we look forward to partnering with interested individuals, corporate organizations and NGOs to help us make this life changing endeavor.

Health is a right not a privilege; let’s build a world that is fit for all children because every child matters.

Foluke Ajose

Partner with us today and together let’s touch lives of those living with diabetes in Nigeria. We can be reached on +234 703 885 5224; +234 812 616 2561 or t1diablink@ngdoc.com for further discussions.

Dr Foluke Ajose is an NGdoc volunteer and is currently the coordinator of Diablink.

References

http://www.mayoclinic.org

http://www.ngdocblog.com

Are you Obese?

Obesity represents a state of excess storage of body fat.

Obesity is a leading preventable cause of death worldwide with increasing rates in adults and children.

Authorities view it as one of the most serious public health problems of the 21st century.

Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely seen as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

In 2013, the American Medical Association classified obesity as a disease.

Obesity does not occur overnight. First we’re normal weight, then we put on some more weight and become overweight, some more weight again and obesity finally sets in.

The prevalence of overweight and obesity is on the rise in low and middle income countries, particularly in urban settings.
Many factors may contribute to the development of obesity, but unhealthy changes in lifestyle, such as poor exercise habit, sedentary lifestyle and intake of calorie dense food (such as fast food, alcoholic and non alcoholic beverages, etc) have been major contributing factors to the rising prevalence of overweight and obesity.

Obesity increases the risk of developing many other medical conditions, including Type 2 diabetes, hypertension and stroke to name a few.

How Do You Determine If You Are Obese Or Not?

There are many ways to estimate body fat, but the commonest and probably the easiest is the Body Mass Index (BMI)- and it’s simple math.

To calculate your BMI:

1. Measure your weight in kilogram (kg)
2. Measure your height in metres (m)
3. Use the formula
BMI= weight (kg)/ (Height in metres)2

If for instance a 75kg man is 1.6m tall, his BMI would be:
75/(1.6 X1.6)= 29.3kg/m 2

How To Interpret Your Result

18.5 – 24.9 – Normal

25 – 29.9 – Overweight

At this point you need to watch it. Regular exercise as well as eating healthier meals would be of great help and may even help you revert to a normal BMI.

30 – 39.9 – Obesity

>/= 40 – Morbid obesity

Obese and morbidly obese people may in addition to living healthier lifestyles, require other medical or surgical interventions to help with weight control.

Get those calculators out today and do some simple math. Remember to also spread the knowledge.
Feel free to share your result using the hash tag #ngdoc eg 22 #ngdoc.

Dr Odewale Halimat is a diabetes advocate and director of Research for NGdoc, we can be reached on thengdoc@gmail.com.

THE AFRICA DIABETES CONGRESS (YAOUNDE 2014)

The Africa Diabetes Congress of the International Diabetes Federation took place at the Palaise de Congress in Yaounde Cameroun from the 25th to the 28 February 2014.

Palaise de Congress
Palaise de Congress

 

The 2nd African Diabetes Congress appropriately themed: “Diabetes: Challenges and opportunities in Africa” provided an ideal opportunity for researchers, health care providers, practitioners, students, people living with diabetes to cross fertilize with colleagues from Africa and mingle with international renowned experts in the field of diabetes.

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About 1,000  participants from about 45 countries were there to raise awareness on diabetes and its impact by convening at the IDF Africa diabetes congress to exchange research and best practices on diabetes prevention, treatment and management.

NGdoc ADC2014

 Cross section of Participants at the ADC2014

The international Diabetes Federation (I.D.F) is the umbrella body organization of over 200 national diabetes associations in over 160 countries. It represents the interests and the growing numbers of people with diabetes and those at risk. The Federation has been leading the global diabetes community since 1950.

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Cross-section of participants at the pre-congress post graduate course on Research Methodology/Scientific writing

 A Pre-congress update course on Research Methodology/Scientific writing where about 30 young researchers from all over Africa were trained and updated on recent trends in research methodologies and scientific writing.

According to the Chairman organizing committee and former International Diabetes Federation, President Professor Mbanya the young scientists are expected to through the training received translate diabetes research and care in Africa to meet up to global standard. 

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 Discussing the challenges facing diabetes care in Africa over lunch

Simultaneously, a pre-conference update course on Advocacy was running where selected individuals from different countries attended and were trained on how to advocate, engage the government and ensure right policies are effected in their respective countries .

Policy advocacy is one of the most effective ways to achieve public health goals by ensuring that necessary resources, policies and political will are available to support, scale up, and sustain diabetes efforts within broader NCD programs.

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 Mobolaji Dauda from Nigeria and Pamela Donggo from Uganda at the Update course

We strongly believe that this congress will be one that wont be quickly forgotten as it laid a solid foundation not just for subsequent congresses but also diabetes research, prevention and care in Africa generally.

The 2nd Africa Diabetes Congress was made bilingual through an impressive translation efforts of the Medical Students of the University of Yaounde (a feat that was very professional and commendable).

The Organizers through the efforts of the platinum sponsors were able to sponsor about 600 participants for the congress, a remarkable and great achievement.

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With recent announcement of the startoff of the Africa Diabetes Study Group and Africa Diabetes Journal we are rest assured that IDF Africa through the ADC is positioning itself for the task of curbing the diabetes epidermic in the continent.

We wish to appreciate the congress organizers who through the support of El-Lilly were able to fully sponsor 2 members of The Nigeria Diabetes Online Community for the pre-congress update course and congress and also through Servier provided accommodation for 4 members of The Nigeria diabetes online community for the period of the congress.

We believe supports like this is important in not just building young researchers but also inspiring more youths into diabetes care and prevention in their respective communities all over africa.

PHOTO SPEAKS

NgdocADC2014POST GRADUATE COURSE IN RESEARCH METHODS AND SCIENTIFIC WRITING

 

IMG_0882SHOWCASING THE RICH TRADITIONAL CULTURE OF CAMEROON

 

NGdocADC2014THE OPENING CEREMONY OF THE 2ND AFRICA DIABETES CONGRESS

IMG_0856OPENING CEREMONY WITH THE MINISTER OF PUBLIC HEALTH OF CAMEROON

IMG_0857GUEST LECTURE BY GEORGE ALBERTI (UK)

 

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IMG_0851ONE OF THE SCIENTIFIC SESSIONS

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PROF MBANYA ADMONISHING THE NGDOC TEAM AT THE LILLY DIABETES CONVERSATION MAP STAND

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DIABETES WALK

 

20140226_230203-1NIGERIAN DELEGATES TO THE ADC WITH PROF TOM JOHNSON (4TH FROM THE LEFT)

 

DSC03850YOUNG RESEARCHERS FROM AFRICA

 

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LILLY HOSTED US TO A DINNER

 

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GALA NIGHT

 

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The next Africa diabetes congress will be hosted by Uganda. UGANDA 2016

Diabetes care in Nigeria- My Personal Experience

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Mrs Audifferen and her son Ayomide

My family moved to Nigeria in 2003, when my husband received a job posting to his home country Nigeria. My son, Ayomide, was 18 months at the time. He had been diagnosed with Type 1 diabetes only six months earlier.

Had I fully known the state of medical care in Nigeria then, I may not have agreed to come. My naivety and sense of adventure seemed to overshadow rational thinking at the time.

His paediatric endocrinologist in the US attempted to help us locate an endocrinologist in Nigeria, but was unsuccessful. He did suggest a paediatric endocrinologist at Cambridge University in the UK, in case we didn’t find a doctor in Nigeria, but I remained optimistic.

In the meantime, I spent the few months prior to our relocation buying and reading as many books as I could on caring for a child with diabetes. This proved to be the wisest thing I ever did. I could count carbs, calculate correction factors, determine and administer insulin–all essential skills. With a suitcase filled with a 6-month supply of syringes and insulin we headed to Nigeria.

Once we settled in Lagos, I set out to look for a paediatrician who could refer me to an endocrinologist, preferably a paediatric endocrinologist. The doctors I did see were unable to provide a referral and seemed more familiar with Type 2 diabetes.
Eventually, during a casual conversation with an expatriate nurse who worked in the clinic of an oil company, I learned of a paediatric endocrinologist at a hospital on Lagos mainland.

Although this doctor came highly recommended, I did not receive the level of care I expected. I was kept waiting for my appointment and the staff were rude.

My only option now was seeing the doctor at Cambridge University for regular check-ups. We did this for one year. During this time my son became ill which caused his blood sugars to spike. I called Cambridge for assistance. After speaking with a diabetes nurse who prescribed a course of action, I realized that relying upon Cambridge for emergency care wasn’t the best option, so I resumed my search locally.

I found a wonderful expatriate doctor In Victoria Island, Lagos, who was knowledgeable and provided great care. However, when he informed me that he was leaving Nigeria I was devastated. He didn’t know who else might help me. My knowledge was going to come in handy now as I had to rely on myself to manage Ayomide’s diabetes care.

During the school break in summer, I went back to the US to find an endocrinologist who would agree to treat my son on a long distance basis. One did agree, and that relationship lasted for 7 years.

This, however, didn’t solve emergency diabetic issues, which did occur. During one such occasion, my son experienced a seizure due to a very low blood sugar at 3:00 am.

We had switched to an insulin pump only a few months before and were still trying to figure out boluses for local foods. I suspect we overcompensated for the amount of carbs eaten. We went to an expatriate clinic to get him stabilized after which he was medical evacuated to Paris.

On another occasion, he vomited due to DKA. At the hospital I had to instruct the emergency room staff that what Ayomide needed was to be immediately put on a saline drip, after explaining the DKA issues, instead of running unneeded tests.

But the real work began when Ayomide started primary school. We endured many stares and questions. People couldn’t understand how a child so young contracted such a disease. I refused to hide anything. I performed blood sugar checks and injections right in front of them.

I answered each and every question from parents, teachers and classmates. I felt compelled to make them aware of my son’s illness as a life-saving measure. I also explained to nurses and teachers on the signs of hypo- and hyper-glycaemia and how to log information. My nanny was well informed and could perform checks and injections.

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Ayomide seemed to be adjusting, but there were restrictions. He couldn’t participate in class parties, unless I or the nanny was present.

He also couldn’t spend long periods of time at a friend’s home, and he definitely couldn’t spend the night anywhere without me.

He understood all this, but it would have been better if he could have interacted with other diabetic children. We didn’t know where to turn for this.

Ayomide is 12 now and I’ve trained him on how to care for himself. He can weigh and calculate carbs and boluses. He’s even spent the night at a friend’s home–with a cell phone beside his ear waiting for me to call to remind him to check his blood sugar.

This journey of diabetes care in Nigeria has indeed been an adventure. I’ve discovered that parental knowledge about diabetes care is essential, particularly in this environment. Most importantly, parents must be their child’s best advocate.

Educate yourself and don’t allow cultural misconceptions and ignorance to prevent you from seeking care for your child.

There are more clinics and universities that specialize in diabetes care, as well as advocacy groups, than when I arrived ten years ago. I’m encouraged and confident that this progress will create more awareness, less stigmatization, and better access to care that will save the lives of all diabetics in Nigeria.

Mrs Audifferen (Mummy Ayo)

Mrs. Audifferen is the mother of Ayo a Type 1 Nigerian child who through her experience is passionate about networking with other Nigerian Type 1 mothers towards achieving peer support for one another.

She can be reached on her twitter handle @naijabeticmama

We encourage mothers of Type 1 Children in Nigeria to key into The International Diabetes Federation Life for a child program for ease of access to insulin. For more information about IDF Life for a child in Nigeria visit here

DIABETES MELLITUS AND TUBERCULOSIS

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TUBERCULOSIS: THE ISSUE IN DIABETES 

Tuberculosis (TB) is an airborne disease caused by infection with Mycobacterium tuberculosis complex (M. tuberculosis, M. bovis, and M. africanum).

Tuberculosis is a major public health problem in many low- and middle-income countries, where the number of people with diabetes is also rising rapidly. Regions, such as Africa and Asia that are most heavily affected by tuberculosis are also those that have some of the highest numbers of people with diabetes, and will experience the biggest increases by 2030.

GROWING DOUBLE BURDEN 

Clinicians have observed an association between Diabetes Mellitus (DM) and TB for centuries, as far back as the ancient Roman times, even though they were unable to determine whether DM caused TB or whether TB led to the clinical manifestations of DM.

The growing prevalence of diabetes poses a challenge for TB control as uncontrolled diabetes leads to a greater risk of developing TB. A recent study showed that countries that saw an increase in diabetes prevalence also had a significant increase in the number of people with TB. This suggests that increasing diabetes prevalence could make attainment of the Millennium Development Goals on tuberculosis more difficult to achieve.

These trends reflect the important links between the diseases. Several studies have looked at the association between diabetes and tuberculosis in developed countries and found that people with diabetes are almost 3 times more likely to develop tuberculosis. These findings were also true of developing regions including Africa where one study found that the prevalence (%) of diabetes was twice as high in people with tuberculosis than in people without tuberculosis.

TUBERCULOSIS

Experimental studies investigating the relationship between Tuberculosis and Diabetes have demonstrated that DM is indeed positively associated with TB.  Studies revealed consistent evidence for an increased risk of TB among people with diabetes despite heterogeneity in study design, geographic area, underlying burden of TB, assessment of exposure and outcome, and control of potential confounders. In addition, DM patients have a significantly increased risk of developing active TB, three times higher than in persons without DM.

BATTLE AGAINST TWO

The relationship between DM and TB is bidirectional. These diseases often coexist. Suboptimal control of diabetes predisposes the patient to tuberculosis, and is one of the common causes of poor response to anti-Tuberculosis treatment. Diabetes impacts TB by:

  1. Tripling the rate of developing active TB from latent TB infection
  2. Increasing mortality and severity of disease
  3. Slowing the response to effective TB treatment.

TB and its treatment can worsen glycemic control and diabetes-related neuropathy. Tuberculosis also affects diabetes by causing hyperglycemia and causing impaired glucose tolerance. Impaired glucose tolerance is one of the major risk factors for developing diabetes.

THE DUO TO WORRY ABOUT

At the individual level, the risk of developing TB is considerably lower in persons with DM than in HIV patients. However, the much larger and rapidly growing pool of DM patients makes the global population of persons with TB and DM very similar to that seen with HIV.

In a study conducted on the United States-Mexico border, it was shown prospectively that DM contributed to 25% of TB cases whereas HIV infection contributed to ≤5%; hence as with TB-HIV, we must adapt and apply similar methods of preventing, screening and treating DM-TB patients, and ensure that we have a secure pipeline for drugs that will improve the efficacy of treatment.

WISDOM WAY OUT

The Pacific Standards for Management of Tuberculosis and Diabetes lay out a framework for the bi-directional screening for each disease when one is present, as well as provides guidance on testing, patient support, active and preventive TB treatment. This framework may be useful for other regions, and should be considered for the proper management of TB and DM.

Suggested screening for M. tuberculosis infection can be  achieved using QuantiFERON®-TB Gold In-Tube test (QFT®), along with a symptom review for prompt diagnosis and treatment of TB or latent TB infection (LTBI).  QFT has been shown to be significantly more accurate than the skin test, only requires one visit, and does not cross-react with the BCG vaccine. However QFT or the skin test do not distinguish between Latent TB Infection  and active disease, hence active TB must be excluded before starting preventive therapy.

QFT, like the skin test is an  indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography and other medical and diagnostic evaluations.  (QuantiFERON-TB Gold ELISA Package Insert, 2013).  Clinical assessment is always needed. Hence, active or latent TB should never be diagnosed or excluded on the sole basis of the QFT or skin test result.

This write-up was put together by Akinpelu Akintunde, a final year medical student of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.

REFERENCES

  1. The International Diabetes Federation
  2. Banyai A (1931) Diabetes and pulmonary tuberculosis. Am Rev Tuberc 24: 650-667.
  3. Root H (1934) The association of diabetes and tuberculosis. New Engl J Med 210: 1-13.
  4. Boucot KR, Dillon ES, Cooper DA, Meier P, Richardson R (1952) Tuberculosis among diabetics: the Philadelphia survey. Am Rev Tuberc 65: 1-50.
  5. Nichols GP (1957) Diabetes among young tuberculosis patients; a review of the association of the two diseases. Am Rev Tuberc 76: 1016-1030.
  6. Silwer H, Oscarsson PN (1958) Incidence and coincidence of diabetes mellitus and pulmonary tuberculosis in a Swedish county. Acta Med Scand Suppl 335: 1-48.
  7. Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG (1995) Incidence of pulmonary tuberculosis among diabetics. Tuber Lung Dis 76: 529-533.
  8. Pablos-Mendez A, Blustein J, Knirsch CA (1997) The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics. Am J Public Health 87: 574-579.
  9. Ponce-De-Leon A, Garcia-Garcia Md Mde I., Garcia-Sancho MC, Gomez-Perez FJ, Valdespino-Gomez JL., et al. (2004) Tuberculosis and diabetes in southern Mexico. Diabetes Care 27: 1584-1590.
  10. Alisjahbana B, van Crevel R, Sahiratmadja F, den Heijer M, Maya A (2006) Diabetes mellitus is strongly associated with tuberculosis in Indonesia. Int J Tuberc Lung Dis 10: 696-700.

10. Perez A, Brown HS 3rd, Restrepo BI (2006) Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas. Am J Trop Med Hyg 74: 604-611.

11. Christie Y Jeon, Megan B. Murray (2008) Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med 5(7): e152.

12. Asfandyar Khan Niazi and Sanjay Kalra (2012) Diabetes and tuberculosis: a review of the role of optimal glycemic control. Journal of Diabetes & Metabolic Disorders 2012, 11:28.

13. Pacific Island TB Control Association (2013) USA Pacific Standards for the Management of Tuberculosis and Diabetes. http://www.currytbcenter.ucsf.edu/abouttb/TB_DM_USAPI_Standards_document_12_01_2010.pdf.

14. QuantiFERON-TB Gold (QFT) ELISA Package Insert. July 2013.

 

OUR RIGHTS AND RESPONSIBILITIES AS PEOPLE LIVING WITH DIABETES

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Goodday Nigeria, we are excited at our planned activities for the year as we present to the board this Month.

We strongly believe in the rights and responsibility of people living with diabetes most especially in Nigeria.

Hence we will be sharing excerpts from the International Diabetes Federation International charter of Rights & responsibility of People Living with Diabetes (#PWD).

The Vision of the Charter is to optimize the health & quality of life of People Living with Diabetes (#PWD) and enable PWD to live as normally as possible.

People Living with Diabetes (#PWD) have the right to early diagnosis, affordable & equitable access to care and treatment including access to care and support.

People Living with Diabetes (#PWD have a right to benefit from proactive health sector community outreach, education & preventive campaign in every healthcare settings

People Living with Diabetes (#PWD) have the right to appropriate transitional care, addressing the progression of the disease & changes that occur with age.

People Living with Diabetes (#PWD) have the right to advocate for improvement in diabetes care & service.

WE HAVE A RIGHT TO BE INVOLVED IN ASSESSING, PLANNING & IMPLEMENTING AS WELL AS MONITORING OUR OWN CARE AND HEALTH GOALS.

People Living with Diabetes (#PWD) have a right to social justice. we have a right to AFFORDABLE MEDICINES and MONITORING TECHNOLOGIES.

People Living with Diabetes (#PWD) have the right to not be discriminated against in the form of insurance cover.

People Living with Diabetes (#PWD) have the responsibility to adopt, implement & monitor healthy lifestyle behaviors as part of our self management of #diabetes.

People Living with Diabetes (#PWD) have the responsibility to share info with our health care providers on our current health, drugs, allergies etc

Importantly, every Nigerian living with diabetes deserves to live a healthy life.

Do you live with #diabetes or you have or know someone with #diabetes. Let’s connect.

Send us an email on thengdoc@gmail.com or Mobile on 2347038855224

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SPARE A ROSE AND SAVE A CHILD

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Image credit @ConnectInMotion

Valentine is a season of love but for children around the world with type 1 diabetes, lack of access to insulin is
the most common cause of death.

And in some areas of the world, most children with diabetes can expect to live less than a year past their diagnosis date – if they’re diagnosed at all.

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This Valentine’s day, our community can help change that.

Under the Spare a Rose, Save a Child campaign, (a Diabetes Hand Foundation Campaign) we will help create awareness and gain donations and awareness for Life for a Child, an International Diabetes Federation program aiming to fund the continuous medical care, access to supplies and medication, and diabetes education that children in developing nations need to stay alive.

Spare a Rose, Save a Child
is simple:

You buy one less rose this Valentine’s Day and share the value of that flower
with a child with diabetes in the developing world.

Your loved one at home still receives flowers and you both give help to a child with diabetes who desperately
needs it.

A rose is about 5 bucks, for that one rose, IDF can give a child one month of life.

A dozen roses, a year of life for a child with diabetes. You can watch the video of how Lives have been saved by the International Diabetes Federation here

Click here to donate

Please note that all funds goes directly to the International Diabetes Federation Life For A Child Program.
Thank you.

For more information contact us on thengdoc@gmail.com

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DIABETES AND PREGNANCY

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Pregnant women who have never had diabetes before but have high blood glucose (sugar) level during pregnancy are said to have Gestational Diabetes.

It is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy (especially 3rd trimester).

Gestational diabetes (GDM) affects about 3-10% of pregnancies. After delivery about 50-60% of women with GDM are found to develop Type 2 diabetes within 10-20 years.

Gestational diabetes is caused when insulin receptors do not function properly.
This is likely due to pregnancy related factors such as Human Placenta Lactogen (HPL) that interferes with susceptible insulin receptors(insulin resistance) ,thereby increasing blood sugar.

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Pregnancy itself is stressful and diabetogenic due to increased production of pregnancy hormones that are insulin antagonists e.g cortisol, placenta insulinase, estrogen, progesterone, etc.

Some identified risk factors for Gestational Diabetes includes:

Previous Gestational diabetes, impaired glucose tolerance, Impaired fasting glucose.
Family history revealing a first degree relative with type 2.
Maternal age >35yrs
Overweight, obese or being severely obese increases risk.
Previous pregnancy resulting in a child with macrosomia.
Previous poor obstetric history.

Symptoms:

Typically, women with GDM exhibit little or NO symptoms (another good reason for universal screening) but some can demonstrate the well known diabetes symptoms such as:

increased thirst (polydipsia), increased urination (polyuria) , polyphagia, fatigue , nausea, vomiting etc.
Some also have urinary tract infections, history of repeated abortions, stillbirth(s), or delivery of oversized babies.

How Gestational Diabetes Affects You And Your Baby.

GDM poses a significant risk to mother and child. This risk is largely related to uncontrolled high blood glucose levels and its consequences.

Prompt recognition and care results in better control of these sugar levels and will reduce some of the risks considerably.

Fetal Risks:

Abortions, polyhydramnios-due to large placenta, fetal size and its sequelae.

Macrosomia (fetal weight>4kg), which in turn increase risk of instrumental deliveries (forceps,ventouse) or problems during vagina delivery(shoulder dystocia).
Preterm labour.

Intrauterine fetal death in the last 4wks due to ketosis, hypoglycemia, placenta insufficiency.

Neonatal morbidity and mortality due to respiratory distress syndrome, jaundice, hypoglycaemia,hyperviscosity,hypocalcemia.

Maternal Risks:

Pregnancy induced hypertension,Urinary tract infections and puerperal sepsis,obstructed labour,deficient lactation.

How can Gestational Diabetes be managed?

SIMPLY CONTROL YOUR BLOOD SUGAR

This can be achieved by using special meal plans (diabetic diet), scheduled physical activities (Exercise).

Dietary modifications are extremely important as a total of 1800calories/day and restriction of carbohydrate to 200g/day with less fat, more proteins and vitamins is advised.

Carbohydrate intake should be limited in the morning because of high blood glucose levels between 3-9am resulting from diurnal variant in plasma cortisol and glucagon levels.
Though,there are individual variations, endeavor to discuss your meal plan with your dietician and endocrinologist who will prescribe the appropriate insulin regimen.

The goal of treatment is to reduce blood sugar within normal limits thereby improving perinatal outcomes.

Frequent antenatal visits and foetal monitoring is strongly advised.


You don’t have to lose that pregnancy or suffer morbidities, though it might be true that after child birth you are free of gestational diabetes but while you still carry that baby———CONTROL YOUR DIABETES !!!

Ojo Oluwatosin

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It is generally advisable that all pregnant women be screened for gestational diabetes at health facilities.
For more information kindly send us an email thengdoc(at)gmail.com.

The Second African Diabetes Congress Yaounde 2014 “Diabetes: Challenges and Opportunities in Africa”

The Second African Diabetes Congress  Yaounde 2014

“Diabetes: Challenges and Opportunities in Africa”


The Second African Diabetes Congress Yaounde-Cameroon:25th-28th February 2014 “Diabetes: Challenges and Opportunities in Africa”


The 2nd African Diabetes Congress will promote excellence in the field of diabetes.

The congress has been appropriately themed: “Diabetes: Challenges and opportunities in Africa”. The Congress will provide an ideal opportunity to cross fertilize with colleagues from Africa and mingle with international renowned experts in the field of diabetes.
The conference organizers are putting together an exciting scientific programme of the most recent diabetes evidence and best practice that will underpin the improvement in diabetes care, treatment and prevention adapted to the African region.
The congress will be held at the Palais des Congres Yaoundé -Cameroon from the 25th–28th February 2014. We look forward to welcoming you to Cameroon, Africa in Miniature!
More information can be gotten here