A survey of the management, control, and complications of diabetes mellitus in patients attending a diabetes clinic in Blantyre, Malawi, an area of high HIV prevalence.
The aim of this study was to describe the current status of diabetes care in an urban diabetes clinic in Malawi and the prevalence of human immunodeficiency virus (HIV) in this population, investigating possible associations between HIV and diabetes. A systematic prospective survey of patients attending the diabetes clinic at a teaching hospital in Blantyre, Malawi was conducted. Six hundred twenty patients were assessed. Seventy-four percent had glycosylated hemoglobin (HbA1C) > 7.5%. Systolic blood pressure was > 140 mm Hg in 52% of patients. Hypertension was more common in patients with raised creatinine (P < 0.003), retinopathy (P = 0.01), and stroke (P < 0.0002). Microvascular complication rates were high, specifically nephropathy (34.7%), retinopathy (34.7%), and neuropathy (46.4%). HIV seroprevalence was 13.7%. HIV-positive subjects had a lower body mass index (BMI) and lower fasting blood sugar, and they were more likely to have albuminuria (48.0% versus 33.3%; P < 0.05). Control of glycemia and hypertension were poor, and microvascular complications were common. Nephropathy in diabetic patients may be affected by HIV status.
Cohen
Danielle B
DB
Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi. danbcohen@yahoo.com
Allain
Theresa J
TJ
Glover
Simon
S
Chimbayo
Daniel
D
Dzamalala
Helen
H
Hofland
Helma W C
HW
Banda
Ndaziona P K
NP
Zijlstra
Eduard E
EE
D000293:Adolescent; D000328:Adult; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015658:HIV Infections / Q000150:complications*; D015528:HIV Seroprevalence; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
D006442:Glycated Hemoglobin
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