Abstract
Aim : To study the seasonal characteristics of hyperglycemic decompensations in the endocrinology department of the CNHU-HKM of Cotonou. Materials and methods :It was a cross-sectional, descriptive, and study of diabetic patients hospitalized from January 1, 2010 to December 31, 2019. Diabetic patients hospitalized for ketosis decompensation and/or hyperglycemic hyperosmolar syndrome were included in this study. The meteorological data used were obtained from the climate observation network of the Direction de la Météorologie Nationale (DMN) du Bénin. We have considered the means of rainfall and temperature per month and per year. Results : A total of 613 patients were included during the study period. The mean age of the patients was 46.77±15.84 years. The frequency of hyperglycemic hyperosmolar syndrome and ketoacidosis was 14.7% and 69.5% respectively. Hyperglycemic crises were more frequent during the rainy season and periods of low temperature. The main precipitating factors were infections and non-adherence to treatment. The main infectious sites involved in hyperglycemic crises were pulmonary (19%), urogenital (21.3%) and malaria (26.8%). The frequency of these different infections was higher during the rainy season with a statistically significant difference (p=0.02) for malaria. Conclusion : The frequency of hyperglycemic crises was high and had a seasonal distribution. The most frequent precipitating factors were infections and non-adherence to treatment. Those factors were more frequent in the rainy season.
Highlights
Diabetes mellitus is a public health problem that concerns every continent
Its course can lead to complications such as hyperglycemic crises including diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome [2]
The current study found that the prevalence of hyperglycemic crises was higher during rainy seasons and periods of cold weather
Summary
Diabetes mellitus is a public health problem that concerns every continent. According to the International Diabetes Federation (IDF), the number of people living with diabetes will rise from 19 million in 2019 to 47 million by 2045 [1] in Africa region. Its course can lead to complications such as hyperglycemic crises including diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome [2]. In West Africa, the prevalence of ketoacidosis is high and ranges from 28.99% to 59.1% depending on the studies [2-4]. Many factors are involved in these acute complications; the most frequent are infections, non-adherence to treatment and lack of recognition of the disease [2, 5, 6]. The seasonal period for each acute infectious disease is determined by geographical locations [9]. Kalliora et al [10] and Mianowska et al [11] in 2011 reported the lowest values of glycated hemoglobin (A1C) in summer and the highest values in winter in their studies studies involving children and adults with T1DM. In 2013, a study of 8020 children in Sweden had reported that 53% of new cases of type 1 diabetes were diagnosed during the autumn and winter months [12]. In a recent study in Cameroon, a slight increase in the incidence of diabetes
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