Metabolic Syndrome in Native African Type-2 Diabetic Patients: DISCUSSION
This report describes clustering of cardiovascular risk factors consistent with the metabolic syndrome found among Nigerian type-2 diabetic (generic Actos is used to treat type II of diabetes) patients. The prevalence of the syndrome is lower than values ranging from 70-80% among Caucasians with type-2 diabetes mellitus. It is, however, higher compared to the recently reported prevalence of 25.2% among type-2 diabetic (Drug Avandia controlling blood sugar levels in patients with type 2 diabetes) patients in southern Nigeria but similar to the data from Zimbabwean urban type-2 diabetic patients. Disparities in the prevalence of metabolic syndrome are largely due to differences in lifestyles, age of the study populations and nonapplication of uniform diagnostic criteria.
In the present report, metabolic syndrome is not associated with HDL hypochlolesterolemia, and ischemic heart disease is a relative rarity. These findings are strikingly at variance with the Caucasians but consistent with previous reports on African diabetics and hypertensives. Normal or elevated HDL cholesterol in diabetes mellitus and a direct relationship between obesity (cheap phentrimine medicine increases energy, stimulates metabolism for quicker weight loss, suppresses appetite) and HDL cholesterol are well-documented among Africans. Obesity is diet-related among Africans. Obese Africans, therefore, tend to consume correspondingly high amounts of fiber. Epidemiological studies have linked high fiber-rich food consumption with reduced risk of coronary artery disease. In diabetes mellitus (Starlix 120mg is used to control blood glucose levels in type 2 diabetes), HDL hypocholesterolemia is due to a reduction of HDL2 subfraction of HDL cholesterol arising from increased HDL cholesterol catabolism. It is not known if fiber reduces catabolism of HDL cholesterol in type-2 diabetics.
Two types of type-2 diabetic (Canadian Actoplus Met is a combination of two oral diabetes medicines that help control blood sugar levels) populations have been described in blacks: one with insulin resistance and increased risk of cardiovascular mortality and morbidity, and the other that is insulin sensitive with no increased risk of cardiovascular disease. Insulin resistance is genetically determined and underlies the pathogenic mechanism of the metabolic syndrome. Family history of hypertension, type-2 diabetes mellitus (Drug Glucophage treating type 2 diabetes) and obesity (buy rimonabant online is an appetite suppressant diet pill) are recognized markers of genetic predisposition to the syndrome. The present study demonstrated that genetic predisposition to the metabolic syndrome is not increased in type-2 diabetics with a family history of concomitant hypertension and diabetes mellitus, compared to those with a family history of either of the two conditions occurring in isolation.
In addition to insulin resistance, suitable environmental factors are an important prerequisite for the clinical expression of the metabolic syndrome. Variations in these factors partly explain the population differences in the frequency of the syndrome. We recorded a significantly higher percentage of metabolic syndrome among type-2 diabetics (Generic Prandin managing type 2 diabetes) in the upper/middle socioeconomic class compared to the lower class. Differences in dietary habits largely account for socioeconomic class-related variations in the prevalence of the metabolic syndrome. In the Chennai Indian population, for example, individuals in the middle class had significantly higher monthly income, calorie and fat intake and increased prevalence of metabolic syndrome, compared to those in the lower class.
A rural-urban difference in the prevalence of metabolic syndrome has also been documented in the Palestinian West Bank community. Affluent and sedentary lifestyles, characterized by high calorie and fat intake, are more likely among the urban population than the rural population. In the developing nations, the prevalence of hypertension and diabetes is higher in the urban areas than in rural areas. It is, therefore, not surprising that the percentage of occurrence of metabolic syndrome is significantly higher among urban- rather than rural-dwelling type-2 diabetes mellitus (Generic Glucophage is used to treat a type of diabetes mellitus) patients. Given the increasing urbanization in developing nations, an association of urbanization with the increased clustering of cardiovascular risk factors among type-2 diabetics should be a major public health concern.
The effect of gender on the prevalence of metabolic syndrome is uncertain. While some reports showed a higher value among females than males, others showed no such relationship. The higher percentage of the syndrome among female type-2 diabetes mellitus (Avandamet medication is used for improving blood sugar levels, with diet and exercise) patients in the present report with an Islam-dominated population may be explained by the sedentary lifestyle arising from the practice of purdah, a religious obligation that restricts women to their homes.
Data on the specific effects of occupation on the metabolic syndrome are lacking. It is, however, well-documented that type-2 diabetics that are engaged in physical exercise have decreased clustering of cardiovascular risk factors. Peasant farming is the predominant occupation in the developing nations. It is manual and physically demanding. This probably accounts for the inverse relationship between the metabolic syndrome and physical activities of individuals in the current report.
We were constrained by the lack of facilities for the determination of insulin sensitivity. The high drop-out rate of patients from the clinic in the setting where this work was carried out compelled us to screen for microalbuminuria over a four-week period instead of the recommended three-to-six month period.
In conclusion, the occurrence of metabolic syndrome in type-2 diabetes mellitus (Avandia drug is an with a proper diet and exercise program to control high blood sugar in patients with type 2 diabetes) patients is affected by clinical and demographic variables that could be potentially modified to favorably alter the prevalence of the syndrome in this population.