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- ItemOpen Access3- year efficacy and safety for liraglitude 3.0mg in adults with obesity/overweight, prediabetes and baseline BMI <35 vs >/=35kg/m2 in the SCALE obesity and and pore diabetes, double-blind, placebo-controlled trial(Endocrine and Metabolism Society of Nigeria, 2007-09) Fasanmade, O; Greenway, F; Le Roux, C.W; McGowan, B; Pi-Sunyer, X; Cancino, A.P
- ItemOpen AccessAccess to basic endocrine care where there's no endocrinologist(2019-03) Fasanmade, O.AThere are few endocrinologists in many African countries including Nigeria when compared with the number in other regions of the world. There are many people with endocrine diseases and often these overwhelm the few endocrinologists. There is an urgent need to recruit other health care workers in the management of these patients to serve them better. The other healthcare providers need to be trained in basic endocrine care so that the endocrinologists can focus on the more serious or more technical endocrine problems. The shortage of endocrinologists should not reduce the quality/quantity of care for our patients with endocrine diseases and the endocrinologists need to think of innovative ways to cover this deficiency. Countries with one or 2 endocrinologists have explored and utilized other allied health workers to cover this gap, a lesson that Nigeria can learn from.
- ItemOpen AccessThe Adrenal Gland and the Patient with Pulmonary Tuberculosis Infected with HIV(2016-06-08) Odeniyi, I.A; Fasanmade, O.A; Ohwovoriole, A.EBook of abstracts attached.
- ItemOpen AccessAge at diagnosis of diabetes type 2 diabetes mellitus patients attending LUTH diabetes clinic(Endocrine and Metabolism Society of Nigeria, 2013-09) Fasanmade, O.O; Fasanmade, O.A; Odeniyi, I.A; Iwuala, S.O; Ohwovoriole, A.EBackground: The prevalence of diabetes is increasing worldwide. This is coincident with increases in the prevalence of obesity and sedentary lifestyle. There is also concern that diabetes may be occurring at a greater frequency in youth and in young adults. The mean age at diagnosis of type 2 diabetes mellitus in the United States has decreased from 52 years, reported in the years 1988 to 1994, to 46 years, reported in the years 1999 to 2000. This change may represent earlier onset of type 2 diabetes or earlier detection or a combination of both. Objectives: The purpose of the study was to determine the self-reported age of diagnosis of diabetes of type 2 diabetes patients attending LUTH clinic Methods: The diabetes clinic Register of patients attending the Lagos University Teaching Hospital (a tertiary hospital) , Nigeria was analyzed. Information such as; date of Birth, sex, year of diagnosis was extracted. Data collected was analyzed using SPSS version 17. Results: Data of 347 patients seen in the month of March 2013 were used. Of these, 35.7% were males, 64.3% females. Mean age of the cohort was 60.72 ±11.01. Mean age at diagnosis was 50.31 ± 11.52. 32.3% of these patients were diagnosed with DM at age 51-60yrs, 30.3% at age 41-50yrs, 15.9% at age 31-40yrs. 14.1% at age 61-70yrs,3.5% at age 71-80yrs, 2.9% at age 21-30yrs, 0.9% at age 11-20yrs, 0.3% at age 81-90yrs. Conclusion: A large number of our patients (i.e 32.3%) were diagnosed in the 6th decade of life followed by 5th decade. This may imply that most of our patients are still not being screened and diagnosed early enough.
- ItemOpen AccessAnkle brachial index abnormalities in Nigerian patients with diabetic foot ulceration(International diabetes federation, 2009) Iwuala, S.O; Fadahunsi, O.O; Fasanmade, O.A; Ohwovoriole, A.EBackground: Foot ulceration is a major cause of morbidity and mortality in diabetes mellitus patients worldwide. It often occurs in a background of neuropathy and peripheral arterial disease (PAD). The peripheral arterial disease can be assessed clinically or more accurately with the use of simple devices such as a mini-doppler which unfortunately is not readily available in resource-poor settings. Aim: To determine the prevalence of peripheral arterial disease in patients with diabetes mellitus foot syndrome in a tertiary health care centre in Nigeria using mini-doppler. Methods: An analysis of the mini-doppler findings of patients with diabetes mellitus foot syndrome (DMFS) was done. The data retrieved from the minidoppler report included the age, gender, presence of hypertension, smoking history and ankle-brachial pressure index (ABPI). Peripheral arterial disease was defined as the presence of ABPI of < 0.9. Results: There were 64 patients, 28 (43.8%) females and 36 (56.3%) males. The mean age of the study participants was 63.9 (10.9) years. Hypertension was present in 56% of the patients and 15.7% had a significant smoking history. The mean ABPI was 0.9 (0.4) with no significant difference in APBI in the males and females (p=0.12). Decreased ABPI indicating PAD was present in 27 (42.2%) patients, 14 (51.9%) males and 13 (48.1%) females. There was no difference in the frequency of PAD in the males and females (p=0.32). PAD was not significantly associated with a significant smoking history or presence of hypertension (p=0.19 and p=0.47 respectively) or with age in the study population (r=0.2, p=0.20). Conclusion: The contribution of PAD to the development of diabetic foot ulceration appears high in this population of Africans with diabetes. It can be reliably detected with the use of simple devices like the mini-doppler. Such devices should be made available at least in major hospitals in resource-poor settings for better management of DMFS.
- ItemOpen AccessAnthropometric indices of the elderly attending a diabetes clinic in Lagos(Endocrine and Metabolism Society of Nigeria, 2009-09) Enang, O.E; Olamoyegun, M.Y; Akinlade, A.T; Kushimo, W.A; Odusi, T.A; Fasanmade, O.AOBJECTIVE Obesity is one of the greatest challenges among patients with diabetes. The aim of the present study to assess the prevalence of overweight, obesity and an increased and high waist circumference in the elderly attending the diabetes clinic in a tertiary institution in Lagos and to describe the associations of both measures. METHODS This was a point prevalence study with 31 patients aged 60years and above attending the diabetes clinic between July and August 2009. Bodyweight, height, waist circumference, and blood pressure was measured, while the fasting blood glucose, glycosylated haemoglobin (HbA1c), duration of diabetes and complications were recorded from the patients’ case notes. We calculated rate ratios stratified for age and gender. RESULTS There were 21 (67.7%) females and 10 (32.3%) males. The mean age of female subjects was 68±7years and 68±5years for males (P=0.4). The mean duration of diabetes for males was 14±11 years and for females 11±8years (P=0.4). Of the 31 subjects, 7 (25%) of the study subjects were obese while 12 (43%) were overweight. Of the female subjects, 5 (26%) were obese while 8 (42%) were overweight. Of the male subjects, 2 (22%) were obese, while 4 (44%) were overweight.The mean WC for male subjects was 95± 12 cm and the mean WC for female subjects was 98±13cm. The difference was not statistically significant (P=0.53) CONCLUSION There is a high prevalence of obesity (22% of males and 44% of females) and, in particular, abdominal obesity (60% of males and 81% of females) in elderly patients attending the diabetes clinic. A high WC identifies high risk patients from within the overweight group.
- ItemOpen AccessAssessment of Group versus Individual Diabetes Education(Endocrine and Metabolism Society of Nigeria, 2019) Fasanmade, O.O; Odeniyi, I.A; Fasanmade, O.A; Olopade, O.B; Chimah, P.O; Ohwovoriole, A.EAssessment of Groups versus Individual Diabetes Education Background: Diabetes education (DE) has been shown to improve diabetes knowledge, attitudes, self-care behaviours, metabolic control and quality of life in persons living with DM. It can be delivered in group or individual setting and both have been shown to be effective. Objectives: The purpose of this study was to determine the effectiveness of individual and group interventions on anthropometric indices, blood pressure, glycaemic control and quality of life (QoL) of type 2 diabetes mellitus (T2DM) patients attending the Lagos University Teaching Hospital. Methodology: This was a prospective randomized intervention trial using a structured DE programme. One hundred and fifty-three subjects with T2DM were randomised into 3 groups namely: group diabetes education (GDE), individual diabetes education (IDE) and control groups. Subjects were seen over a period of 16 weeks: at weeks 0,1,2,3,10 and 16. Intervention groups had 4 sessions of DE at weeks 0,1,2 and 3. Data collected at baseline and end of study included HbA1c, FPG, QoL, anthropometric indices and blood pressure. Analysis was performed with IBM SPSS 22. P-value < 0.05 was considered statistically significant. Results: The GDE arm had the following mean (95% CI) changes: MBI -0.07(-0.22,0.36)kg/m2, Hba1C -0.91(0.49,1.33)%, QoL -14.20 (9.96,18.43). While the IDE arm had the following mean changes: BMI -0.07(-0.24,0.39)kg/m2 , HbA1c -1.09(0.61,1.57)% and QoL -11.91(7.94,15.88). Mean changes were similar between the two arms (P>0.05). Conclusion: Diabetes Education delivered in either group or individual formats are equally effective in improving glycaemic control and QoL of T2DM Nigerians
- ItemOpen AccessAtherogenic profile in diabetes mellitus - a Nigerian report(International diabetes federation, 2009-10) Ogbera, A; Fasanmade, O; Chinenye, S; Akinlade, AAims: Diabetes mellitus (DM) is a disorder that is often associated with cardiovascular events and underlying lipid abnormalities. This report seeks to determine the atherogenic profile of DM. Methods: A total of 600 patients with DM aged between 22 – 79 years were evaluated for lipid abnormalities. The anthropometric indices, glycosylated haemoglobin, and pattern of DM treatment were noted. Total cholesterol (TCHOL), triglyceride (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol were measured. Test statistics used included student’s t test and X2 . Results: The mean (SD) age and age range of the study subjects was 58 (10) years and 22-79 years respectively. The ratio of subjects with type 1 to 2 DM was 15:565. The prevalence of lipid abnormalities was 89%. The prevalence of elevated LDL-C reduced HDL, and elevated TG were 74%, 53%, and 13% respectively. The prevalence of elevated TCHOL/HDL ratio was 56% with a female preponderance. There were notable gender, type of DM and BMI impact on TCHOL and LDL, TG and HDL respectively. Conclusions: The prevalence of lipid abnormalities of Nigerian patients with DM is high and the pattern of abnormalities differ from what obtained elsewhere
- ItemOpen AccessAudit of clinical processes among patients with type 2 diabetes in Lagos, Nigeria(Endocrine and Metabolism Society of Nigeria, 2018-09) Nwaukwa, P.C; Fasanmade, O.A; Ohwovoriole, A.Eabstracts attached
- ItemOpen AccessBariatric/Metabolic Surgery in Nigeria: prospects and challenges – A Case Series and Discussion(Endocrinology and metabolism society of Nigeria, 2012-09) Fasanmade, O.A; Okaro, AIntroduction Obesity is an “epidemic” with associated life-threatening co-morbidities including diabetes, hypercholesterolemia, hypertension, and cancer. The real proportion of adult Nigerians with obesity is unknown; there is however a large and growing number of Nigerians affected by complicated hypertension and diabetes. Obesity is now considered one of the leading preventable causes of death worldwide Aim To open up a platform for engagement and discussions on the opportunities and challenges facing the development of Bariatric surgery in Nigeria Case Series We report these landmark cases. The first case is of a middle-aged retired nurse, otherwise, fit and well, who weighed 148kg (BMI – 55kg/m2) when 1st seen in the Weight loss clinic. Following careful discussions and preparation, she underwent a laparoscopic sleeve gastrectomy in a Lagos minimally invasive unit. There were 10 cases of Intra-Gastric Balloon-assisted weight loss with an average Weight loss of 24kg over 6 months. One of the patients was thought to be a type 1 diabetes patient. Results The procedures and recovery were uneventful. The sleeve gastrectomy case was discharged home on the 3rd postoperative day on a liquid diet for 2 weeks and a long-term daily vitamin supplement. Her weight in the clinic 1 year after her surgery was 108kg (BMI – 39kg/m2), a loss of nearly 60% of excess body weight. All balloon cases spent on average 1.5 hours in our unit after balloon insertion. The type 1 DM case had full resolution of his diabetes by 2 months into the treatment Conclusion Safe minimally invasive bariatric surgery can be performed in Nigeria. The patient selection and choice of surgical procedure in terms of early and late complications need to be carefully considered and discussed with the patient and relatives. A multi-disciplinary team approach for the delivery of such highly specialised and high-risk services cannot be overemphasised. The future demand for bariatric/metabolic surgery in Nigeria is likely to increase as international organisations like WHO increasingly highlight the long-term health benefits of these types of procedures
- ItemOpen AccessBasal and postglucagon C-peptide levels in Nigerians with type 2 diabetes mellitus(Nigerian Society of Endocrinology and Metabolism, 2007-09) Coker, A.O; Fasanmade, O.A; Ohwovoriole, A.EObjective To study basal C-peptide (BCP) and post glucagon C-peptide (PGCP) levels in Nigerians with type 2 diabetes mellitus. Methods A total of 40 subjects with type 2 diabetes and 20 control subjects were recruited from the Lagos University Teaching Hospital. BCP and PGCP were determined in all subjects. Results Mean+SEM BCP of 2.0+1.1ng/ml and 1.8+0.7 ng /ml in controls and subjects with diabetes was comparable. Mean +SEM post glucagon C-peptide (PGCP) and increment in C-peptide from basal was lower in subjects with diabetes compared with the control subjects (2.9 + 0.22 versus 5.6 + 0.5 and 1.14 +0.2 versus 3.6+0.32 respectively) p<0.05 and p<0.01. Among the subjects with diabetes, 2 had PGCP levels less than 1 ng/ml, and the mean increment in C-peptide was 0.03 and —0.06 ng/ml while 10(25%) had PGCP < 1.8ng/ml. Conclusion Post glucagon C-peptide levels are useful in reclassifying subjects Clinically defined as type 2 diabetes mellitus.
- ItemOpen AccessBurden of diabetes mellitus foot ulcer in a Nigerian tertiary hospital(Nigerian chapter of American Association of Clinical Endocrinologists, 2017-04) Okunowo, B.O; Odeniyi, I.A; Fasanmade, O.A; Iwuala, S.O; Ohwovoriole, A.EBackground Foot complications in people living with diabetes mellitus can present in a variety of ways. It is responsible for major economic and financial burdens both to the patient, and the community at large. Objective The objective of this study was to assess the burden and outcomes of diabetic foot ulcerations in Nigerians admitted into a tertiary hospital. Method Two years, 2014 and 2015 inpatient records of diabetes mellitus (DM) patients admitted into the medical wards of the Lagos University Teaching Hospital (LUTH) in south-western Nigeria were reviewed. The following data were obtained from the records - age and sex of patients, indication for admission, duration of stay in the hospital, and outcome of inpatient management. Regarding outcome, 143 (56.7%) of the patients had complete data for analysis and these constituted a group for sub-analysis. Data management and statistical analyses were entered into Microsoft excel and cleaned up. Analyses were carried out using SPSS 22. Descriptive statistics were presented as mean and standard deviation while inferential statistics as student t-test. Results were presented as tables, figures, and tests. Results During the period under review, 2232 patients were admitted into the medical wards of the hospital. Out of these, 252 (11.3%) were diabetic patients of which 108(42.9%) were males and 144(57.1%) were females. Of the 252 patients, 143 had full data and they are further analyzed for the outcome of admission. The average ages of the males and females were similar. Seventy-five (52.4%) patients were admitted on account of diabetic foot ulcers. The mean duration of admission for DMFS was 65days. Diabetes mellitus foot ulceration accounted for the highest case fatality and discharged against medical advice in the two-year period. Conclusion Diabetic foot ulcers are preventable complications of diabetes mellitus, which appear to constitute the main indications for admission of DM patients in LUTH. Case fatality rate associated with diabetic foot ulceration admissions was unacceptably high. There is a need for more advocacy on foot care.
- ItemOpen AccessCardiovascular outcomes in long-term testosterone replacement therapy among men with late-onset hypogonadism and functional hypogonadism: systematic review.(Association of Clinical Endocrinologists of Nigeria, 2023-04-29) Olopade, O.B.; Odeniyi, I.A.; Adejumobi, S.; Ijeh, I.N.; Fasanmade, Olufemi Adetola; Kalhan, A.There is a worldwide increase in the prescription and use of Testosterone replacement therapy (TRT) in managing cases of hypogonadism with the dearth of evidence on long-term cardiovascular safety on the use of TRT in men with Late-Onset and functional hypogonadism. This systematic review seeks to establish whether long-term use of TRT is safe. METHODS An extensive systematic review was done using the preferred reporting items for systematic reviews and meta-analysis (PRISMA 2020) set of standard checklists. Six databases which are Embase, Wiley Library. Scopus, PubMed, Google Scholar and Cochrane Database of Systematic Reviews were the sites used for the journal retrieval. Distiller-SR software program was employed to screen the journal titles and abstracts, remove journal duplicates, and data extraction for the articles that met the eligibility criteria. RESULTS Twenty-three publications (10 RCTs and 13 cohort studies) that met the eligibility criteria were included in the review with a total of 102,139 participants involved. Only seven of the included Journal articles reported Major Adverse Cardiovascular Events (MACE), which is a composite of nonfatal stroke, nonfatal myocardial infarction and cardiovascular death as part of their outcome measures but many had measures on cardiovascular risk factors benefits and/or adverse effects. CONCLUSION Long-term use of TRT seems to have some cardiovascular benefits in men with LOH and FH when safe practices are followed. Testosterone therapy should be used with caution in hypogonadal men with underlying or established cardiovascular disease.
- ItemOpen AccessCase Report: Paget's disease of bone, an atypical presentation in a Nigerian(Nigerian chapter of American Association of Clinical endocrinologists, 2007-10) Iwuala, S.O; Fasanmade, O.A; Ohwovoriole, A.E
- ItemOpen AccessChallenges in managing invasive fungal sinusitis in type 2 DM: a case report(Endocrine and Metabolism Society of Nigeria, 2018-09) Obieli, J.I; Hassan, A.A; Olopade, O.B; Odeniyi, I.A; Fasanmade, O.AAbstracts attached
- ItemOpen AccessCharacterization of newly registered patients with diabetes mellitus in an out patient facility in Nigeria(Nigerian Society of Endocrinology and Metabolism, 2007-09) Ogbera, A; Onyekwere, A; Fasanmade, O.A; Olayode, B.MBackground Diabetes mellitus (DM) is a non-communicable disorder that is of public health significance. The burden associated with this all-important disease is unacceptably high. This is more so in developing countries where there are limited health resources. There is a dearth of unpublished data on DM from Nigeria thus this report attempts to bridge this gap. Methods This study was carried out at the Medical outpatient department of the Lagos State University Teaching hospital for a 21month period (April 2004 - December 2005). The subjects recruited for the study were those that were referred to diabetes outpatient of the hospital. These referrals include those with longstanding and recently diagnosed diabetes mellitus. The demographic data, anthropometric indices, biochemical parameters, complications, co-morbidities, and other associated clinical features of DM were documented. Results A total of 419 referrals with diabetes mellitus were seen at the Medical outpatient of the Lagos State University Teaching hospital during the period of the study. The Male: Female ratio was 1:1.2. The mean age of the study subjects was 54.3412years and their ages ranged from 17-89 years. Patients with Type 1 DM made up 36 (8.6%) of the study subjects. Chronic complications of DM were with varying rates of occurrence. Hypertension was seen in a third of all the subjects. Eye complications and erectile dysfunction were the commonest chronic DM complications noted. Few of the patients were on herbal medications for the treatment of their DM. Conclusions Proper auditing of DM cases is necessary for data generation purposes as this will make policymakers and caregivers involved in DM care to be sensitized to the peculiarities of DM.
- ItemOpen AccessClinical and aetiologic profile of patients with chronic urticaria at the outpatient clinic of a tertiary hospital in Lagos, Nigeria: a cross-sectional observational study(Pan African Medical Journal, 2021-11) Ayanlowo, O.; Gold-Olufadi, S.; Akinkugbe, A.O.; Otrofanowei, E.Chronic urticaria is a condition characterized by recurrent wheals associated with itching lasting longer than six weeks. The condition tends to run a chronic course with significant morbidity. Several factors have been explored in the cause, yet the aetiology is still uncertain. We documented the clinical profile and assessed the possible aetiologic factors in patients with chronic urticaria. Clinical profile of sixty consecutive patients with chronic spontaneous urticaria was assessed with possible precipitants identified using a structured questionnaire. The complete blood count with erythrocyte sedimentation rate, antithyroid peroxidase (antiTPO), hepatitis B surface antigen (HBsAg), antihepatitis C virus screening (AntiHCV), stool for ova and parasites and helicobacter pylori were carried out. Controls without a history of urticaria were recruited in a 1: 1 ratio for stool for parasites and H. pylori because of the high prevalence rates reported in this environment. Data analysis was carried out with Statistical Packages for Social Sciences (SPSS) version 22. Sixty patients with chronic urticaria and sixty age and sex matched controls were enrolled in the study. Females presented more often with urticaria with a M: F ratio of 1: 2.5. The mean age of onset of urticaria was in the third decade of life. Precipitants were identified in close to a third of patients. The investigated antigenic aetiology was not found to play a role. The presentation and clinical profile of patients in this environment is similar to previously documented studies. History still remains the cornerstone of management as precipitants and triggers may be identified. Management of patients should therefore be individualized.
- ItemOpen AccessClinical audit of the process of diabetes mellitus foot syndrome prevention in Lagos, Nigeria(Endocrine and Metabolism Society of Nigeria, 2010-09) Adigun, A; Okunromade, L; Ohwovoriole, A; Fasanmade, O; Onung, SBACKGROUND: Diabetes mellitus foot syndrome (DMFS), places a great burden on the patient. If the right preventive measures are put in place, this burden can be reduced to the barest minimum. It is in line with this goal that this clinical audit was conducted with emphasis on process of preventing DMFS in LUTH Nigeria. OBJECTIVE: To determine if the process of preventing DMFS in LUTH is adequate. SUBJECTS, MATERIALS AND METHODS This is a clinical audit involving patients living with diabetes mellitus who are attending the diabetic clinic of LUTH Nigeria. Subjects were selected from consecutive weekly diabetic clinics and interviewed using a questionnaire prepared by the investigator. Data collected was analyzed using Epi-info version 3.5.1. A total of thirty-seven (37) patients have so far been recruited in this pilot study. RESULTS: 88.9% of the patients were found to have had formal education on diabetes mellitus and its complications. In the past one year 33.3% of the patients have had their feet examined by a doctor while 94.4% have never had a Doppler done in the past. 88% of the patients have never had a monofilament test done on them and 97.2% have never been examined for vibration sense CONCLUSION: There is need for more efforts to be channeled towards the clinical examination of our diabetic patients with the sole aim of reducing the burden of diabetes mellitus foot syndrome in Lagos. Efforts directed at diabetic education appear adequate.
- ItemOpen AccessClinical profile of 1267 Nigerians with diabetes mellitus(Endocrine and Metabolism society of Nigeria, 2004) Fasanmade, O.A; Okubadejo, N.U.Abstracts attached
- ItemOpen AccessA Comparison of Patients With Diabetes Mellitus Hand And Foot Syndromes(2018) Ijeoma, A.R; Okunowo, B.O; Odeniyi, I.A; Olopade, O.B; Fasanmade, O.A; Ohwovoriole, A.EThis paper examines the similarities and peculiarities between diabetes hand syndrome and diabetic foot ulcers in LUTH Nigeria