Journal of Cardio-diabetes and metabolic disorders

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Background: Metabolic syndrome is associated with increased cardiovascular death. The objectives of this study were to find the frequency of metabolic syndrome among Nigerians with type 2 diabetes and to compare the modified National Cholesterol Education Program on the detection, evaluation, and treatment of high blood cholesterol in adults—Adults Treatment Panel III (NCEP ATP III) criteria and the International Diabetes Federation (IDF) criteria. Materials and Methods: The study involved 134 participants. Sixty-seven were cases with type 2 diabetes, whereas the rest were the controls without type 2 diabetes. Ethical approval was granted by the Institutional Ethics Review Committee. Anthropometric, clinical, and laboratory parameters were obtained using standard protocols. Data were analyzed with SPSS version 22. Means were compared with Student’s t-test, whereas proportions were compared with Pearson’s χ² test. Point biserial correlation was used to determine the association between the dichotomous variables and interval variables. Agreement between the criteria was tested with Cohen’s kappa test. Results: Type 2 diabetes was associated with a higher prevalence of hypertension and truncal obesity. The frequency of metabolic syndrome was lower with the IDF criteria compared with the modified NCEP criteria (65.7% vs. 71.6%). Although there was a strong agreement between the IDF and the modified NCEP criteria (κ=0.862; P<0.0001), the IDF criteria missed 8.3% of diabetic individuals diagnosed with metabolic syndrome by the modified NCEP criteria. Cardiovascular risk is better predicted when the modified NCEP criteria were used to diagnose metabolic syndrome. Conclusion: Metabolic syndrome is very common among Nigerians with type 2 diabetes, and it is better diagnosed with the modified NCEP ATP III criteria.

Immune-mediated musculoskeletal (MSK) manifestation is one of the most prevalent phenotypes of rheumatic disorders. Diabetes Mellitus (DM), the modern epidemic, acts as a great mimicker of rheumatic diseases in terms of MSK involvement. Numerous attempts have been made in various strands of scientific research to identify the level of association of these disorders with DM but unfortunately, the results are not uniform. In daily clinical practice, it is sometimes difficult to differentiate diabetes-related joint and muscle problems from pure rheumatic disorders without proper background knowledge. Rheumatic manifestations often amplify the magnitude of diabetes-related morbidities. In the modern era, treating the primary disease is often not sufficient; we need to go further ahead to tackle its long-term complications also to mitigate the suffering of patients. The identification and management of diabetes-related rheumatic problems in the ocean of rheumatology needs sufficient evidence-based knowledge, expertise, as well as clinical experience. In our article, we intend to discuss various MSK problems related to diabetes, their pathogenesis, clinical features, important clues for diagnosis, and overall management strategies.

Online since 8^th September 2020