Type 1 Diabetes in Bobo-Dioulasso: Clinical Features and Treatment Issues

ABSTRACTBackground. Type 1 diabetes in Africa poses a problem of diagnostic and therapeutic delay related to poverty and insufficient technical facilities in health services. The objective was to determine the clinical characteristics and therapeutic difficulties related to the management of type 1 diabetes in Bobo-Dioulasso. Materials and Methods. This was a cross-sectional study of type 1 diabetic patients followed as outpatients in the internal medicine department of the CHU-SS over a 2-year period. All diabetic patients aged less than 35 years at the time of discovery of diabetes, whose diagnosis of diabetes mellitus was retained based on the WHO criteria for the diagnosis of diabetes mellitus and who met the clinical criteria for type 1 diabetes were included. Results. A total of 55 patients with type 1 diabetes were included. The sex ratio was 1.75. The mean age of the patients was 21.5 years. Leanness and overweight were noted in 27.3% and 14.5% of patients, respectively. Microangiopathy was present in 5.45% of patients. Diabetes was unbalanced in 74.4% of patients. Therapeutic difficulties were dominated by poor insulin storage (12.7%), therapeutic breakthrough (10.9%) and break in follow-up (25.5%). Death was noted in 3.6% of patients. Conclusion. Type 1 diabetes in Bobo has a male and adult face and difficulties marked by poor insulin conservation, therapeutic and follow-up failure. RESUME Introduction. Le diabete de type 1 en Afrique pose un probleme de retard diagnostique et therapeutique lie a la pauvrete et au plateau technique insuffisant des services de sante. L’objectif de ce travail etait de determiner les caracteristiques cliniques et les difficultes therapeutiques liees a la prise en charge du diabete de type 1 a Bobo-Dioulasso. Materiels et Methodes. Il s’est agi d’une etude transversale chez des patients diabetiques de type 1 suivis en ambulatoire dans le service de medecine interne du CHU-SS sur une periode de 2 ans. Etait inclus tout patient diabetique âge de moins de 35 ans a la decouverte du diabete, dont le diagnostic de diabete sucre a ete retenu sur les criteres OMS du diagnostic du diabete sucre et satisfaisant aux criteres cliniques du diabete de type1. Resultats. Au total, 55 patients diabetiques de type 1 etaient inclus. Le sex ratio etait de 1,75. L’âge moyen des patients etait de 21,5 ans. Une maigreur et une surcharge ponderale ont ete notees respectivement chez 27,3% et 14,5% des patients. Une microangiopathie etait presente chez 5,45% des patients. Le diabete etait desequilibre chez 74,4% des patients. Les difficultes therapeutiques ont ete dominees par la mauvaise conservation de l’insuline (12,7%), la rupture therapeutique (10,9%) et la rupture de suivi (25,5%). Un deces a ete constate chez 3,6% des patients. Conclusion. Le diabete de type 1 a bobo a un visage masculin et adulte. Les difficultes de traitement etaient souvent liees ar la mauvaise conservation de l’insuline, la rupture therapeutique et de suivi.