Clinical, biophysical and biochemical variables from African-heritage subjects with type 2 diabetes.
We compared the metabolic profile of two ethnic populations with type 2 diabetes, one from Bantu (n = 23; Ban) and the other from Belgian (n = 314) extraction followed at St Luc Hospital. Further comparison with a Belgian sub-cohort (n = 64; Be) matched for age (52 yrs) and sex distribution (M/F: 61/39%) showed no significant difference between Belgian and Bantu subjects with regards to diabetes duration (9 and 11 yrs; Ban and Be respectively), age at diabetes diagnosis (43 and 42 yrs), HbA1c (8.1 +/- 1.9 vs. 8.5 +/- 1.9%; NS), and achieved education level. BMI was lower in Ban (29 +/- 4 vs. 32 +/- 7 in Be; p < 0.02), as were body fat (33 +/- 12 vs. 37 +/- 11 kg; NS) and waist diameter (99 +/- 9 vs. 106 +/- 16 cm; p < 0.02). Forty-eight and 72% of Ban and Be were on metformin (p < 0.05), while insulin was given to 39 and 34%. Daily insulin dose was lower in Ban (0.31 +/- 0.20 vs. 0.47 +/- 0.18 IU.kg-1.24 h-1; p < 0.001). There was no difference in beta-cell function (% beta; normal: 100%) or insulin sensitivity (%S; normal: 100%) as determined with HOMA between groups. % beta (median [perc 25-75]) was 51 [23-119] and 67 [45-84] in Ban and Be, while %S was 32 [29-37] and 37 [27-45]. Smoking (past & current) prevalence was 5 and 47% in Ban and Be (p < 0.0001). Prevalence of micro- and macroangiopathy did not differ between groups, although Ban had more macroalbuminuria (29 vs. 9%; p < 0.05), and were more often treated with Ca(2+)-channel- and beta-blockers than Be subjects (36 and 39% vs. 16 and 8%; p = 0.07 and < 0.05, respectively). Fasting (F) and interprandial (IP) triglycerides (TG) were lower in Ban: 115 [81-149] vs. 189 [155-325] mg.dL-1 for F-TG and 127 [81-160] vs. 170 [128-305] mg.dL-1 for IP-TG (p < 0.0001), as was total cholesterol (201 +/- 53 vs. 223 +/- 40 mg.dL-1 (p < 0.05), despite lower use of hypolipidaemic drug (13 vs. 44%; p < 0.01). African-heritage subjects with type 2 diabetes have similar degree of diabetes control and complications, in the presence of leaner biophysical status, minimal tobacco exposure and lower fasting and interprandial triglycerides.
Hermans
M P
MP
Service d'Endocrinologie et Nutrition, Cliniques Universitaires St Luc, UCL-DIAB 54.74, Avenue Hippocrate 54, B-1200 Brussels, Belgium.
Dumont
C
C
Buysschaert
M
M
D000349:Africa / Q000208:ethnology; D017668:Age of Onset; D001530:Belgium / Q000208:ethnology; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000503:physiopathology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides