Prevalence of diabetic foot amongst adults with diabetes mellitus in northern Sudan: A cross-sectional study

Serum 25-Hydroxyvitamin D Concentrations in Patients with Type 2 Diabetes Mellitus in Eastern Sudan: A Case-Control Study

Introduction

Diabetes mellitus (DM) is one of the world's major public health problems. There are few published data on 25-hydroxyvitamin D (25[OH]D) concentrations and DM, and these studies showed different results.

Objectives

The current study aimed to compare 25[OH]D concentrations between patients with type 2 DM (T2DM) and healthy controls in eastern Sudan.

Methods

A case-control study of two groups matched for age and gender (88 in each group) was conducted in eastern Sudan from March to May 2022. The cases were patients with T2DM, and the controls were healthy participants. Sociodemographic data were collected, and serum 25(OH)D levels were assessed. A univariate analysis was performed.

Results

Of the total 176, 82 (47%) were males, and 94 (53%) were females; the median (interquartile range [IQR]) of age, body mass index (BMI), and 25(OH)D concentration were 55 (50-61) years, 27 (23-31) kg/m2, and 13 (10-19) ng/mL, respectively. Of the 176, 137 (78%) were vitamin D deficiency cases. Compared with the controls, age, gender, educational level, marital status, or BMI were not different in the circumstances. Moreover, the median (IQR) for serum 25(OH)D concentrations showed no difference between patients with T2DM and the healthy controls (12 [10-18] ng/mL vs. 13 [10-20] ng/mL). The prevalence of vitamin D deficiency (25(OH)D level < 20 ng/mL) was not different between patients with T2DM and the healthy controls (66/88 [75%] vs. 71/88 [81%]). There was no association in the serum 25(OH)D levels between diabetic and nondiabetic participants (OR = 1.01, 95% CI 0.97-1.06) or in vitamin D deficiency between diabetic and nondiabetic participants (OR = 0.72, 95% CI 0.35-1.47).

Conclusion

There was no significant difference in 25(OH)D levels between diabetic and nondiabetic participants in this study. Further studies investigating the mechanisms of association between 25(OH)D levels and DM are needed.

Assessment of Glycemic Control in Patients With Diabetes in Northern Sudan Using Calculated HbA1c

BACKGROUND

Diabetes mellitus (DM) significantly burdens health services worldwide. As a simple and cost-effective method, the mathematical calculation of HbA1c is coming to be of value in areas with scarce resources. This study aimed to use calculated HbA1c to ascertain the prevalence of uncontrolled DM and correlate it with the risk factors for DM.

METHODS

In the River Nile State of northern Sudan, a cross-sectional study was conducted in five leading cities from May to August 2021. Patients diagnosed and recorded as having type 2 or type 1 DM were included in this study. Enzymatic methods were used to assess fasting blood glucose (FBG). We used the mean of three FBG readings for three months to calculate HbA1c using the equation {HbA1c = (FBG mg/dl) x 0.03+2.6}, which was used to compute the estimated mediocre blood sugar over the course of three months.

RESULTS

A total of 2047 diabetic patients from northern Sudan were studied for their DM control. Nearly two-thirds (65.2%) had uncontrolled DM. Of the patients studied, uncontrolled DM was significantly positively associated with older age, history of ischemic heart disease, and being a housewife. Multivariate regression analysis showed significant correlations between uncontrolled DM, an inactive lifestyle, and obesity.

CONCLUSION

The prevalence of uncontrolled DM among known patients with diabetic in northern Sudan is high (65.2%). The inactive lifestyles of housewives and freelance workers, having type 1 DM, and being hypertensive and obese are risk factors significantly associated with uncontrolled DM and its related complications.

Mid-upper arm circumference as a substitute for body mass index in the assessment of nutritional status among adults in eastern Sudan

Background

Body mass index (BMI) remains the most used indicator of nutritional status despite the presence of a potentially credible alternative. Mid-upper arm circumference (MUAC) is an anthropometric measure that requires simple equipment and minimal training. The aim of this study was to compare MUAC with BMI and propose a MUAC cut-off point corresponding to a BMI of < 18.5 kg/m² (underweight) and ≥ 30.0 kg/m² (obesity) among Sudanese adults.

Methods

A cross-sectional study using multistage cluster sampling was conducted in New-Halfa, eastern Sudan. Participants’ age and sex were recorded and their MUAC, weight and height were measured using the standard procedures. The MUAC (cm) cut-offs corresponding to < 18.5 kg/m² and ≥ 30.0 kg/m² were calculated and determined using receiver operating characteristic (ROC) curve analysis

Results

Five hundreds and fifty-two adults were enrolled in the study. The median (interquartile range, IQR) of the participants age was 31.0 (24.0 – 40.0) years and 331 (60.0%) of them were females. The medians (IQR) of BMI and MUAC were 22.4 (19.1 – 26.3) kg/m² and 25.0 (23.0 – 28.0) cm, respectively.

There was a significant positive correlation between MUAC and BMI (r = 0.673, p < 0.001).

Of the 552 enrolled participants, 104 (18.8%), 282 (51.1%), 89 (16.1%) and 77 (13.9%) were normal weight, underweight, overweight and obese, respectively. Best statistically derived MUAC cut-off corresponding to a BMI < 18.5 kg/m² (underweight) was ≤ 25.5 cm in both males and females (Youden’s Index, YI = 0.51; sensitivity = 96.0%; specificity = 54.0%), with a good predictive value (AUROCC = 0.82). Best statistically derived MUAC cut-off corresponding to a BMI ≥ 30.0 kg/m² (obesity) was ≥ 29.5 cm in both males and females (YI = 0.62, sensitivity = 70.3%, specificity = 92.0%), with a good predictive value (AUROCC = 0.86, 95.0% CI = 0.76 – 0.95).

Conclusion

The results suggest that the cut-offs based on MUAC can be used for community-based screening of underweight and obesity