Air scattering in neutron capture cross section measurements

Abstract

Type 1 diabetes (T1DM) in sub-Saharan Africans is rare and is associated with high mortality from nephropathy. We studied the prevalence and potential risk factors for microalbuminuria (MA) in African and in age-of-onset matched white patients with T1DM. Risk factors for MA were evaluated prospectively in an African cohort.68 African and 134 white patients, age at diagnosis 10–40 years, duration of diabetes > 2 years, were evaluated for MA; 48 Africans were followed prospectively.Africans had shorter duration of diabetes (median, 8 years vs 11 years), higher HbA1c (10.62(SD 2.52)%, vs 9.02(2.44)%, lower cholesterol (4.45(1.04) vs 5.45(1.16)mmol/l), and fewer (23.5% vs 54.5%) had adolescent diabetes onset (p 0.0030 for each); the prevalence of MA was 39.7% and 24.6% respectively (p = 0.0155). In multiple regression analysis MA was associated with mean HbA1c (p < 0.0001), younger age at diagnosis (p = 0.0060), SBP (p = 0.0012) and African race (p = 0.0287). Prospectively, Africans developing MA (45%) had higher mean HbA1c levels (p = 0.0001), were more likely to have had adolescent onset of DM (33.3% vs 8.0%, p = 0.0310) and lower BMI (p = 0.0340); logistic regression revealed that higher HbA1c and SBP, and lower BMI predicted MA. Nine of 16 African subjects progressed to macroalbuminuria; they were characterised only by extremely poor glycaemic control (mean HbA1c, 13.49(2.00)%).Microalbuminuria, and severe hyperglycaemia, are common in diabetic Africans with short duration TIDM; MA may rapidly progress to macroalbumiuria. African race may be associated with increased susceptibility to diabetic nephropathy.