Swai A B, Lutale J, McLarty D G
Department of Medicine, Muhimbili Medical Centre, Dar es Salaam, Tanzania.
BMJ. 1990 Apr 28;300(6732):1103-6. doi: 10.1136/bmj.300.6732.1103.
To study the clinical characteristics of newly diagnosed diabetic patients in tropical Africa.
Prospective study of all newly diagnosed diabetic patients registered at a major urban hospital between 1 June 1981 and 31 May 1987.
Muhimbili Medical Centre, Dar es Salaam, Tanzania.
1250 Patients: 874 men, 376 women.
272 (21.8%) Patients had diabetes requiring insulin, 825 (66.0%) had diabetes not requiring insulin, and 153 (12.2%) had diabetes of uncertain type. Most patients (1103, 88.2%) presented with the classic symptoms of diabetes. The peak time of presentation of diabetic patients requiring insulin was at age 15 to 19 years. Male manual workers and peasant farmers with diabetes not requiring insulin presented at a significantly older age and had a lower body mass index than sedentary office workers. Forty six (18.1%) of the patients requiring insulin diabetes and 111 (14.4%) not requiring insulin had first degree relative with diabetes. Twenty seven per cent of patients were underweight (body mass index less than 20 kg/m2) and 14.6% were obese (body mass index greater than 30 kg/m2). Hypertension was diagnosed in 211 (26.7%) of 791 patients not requiring insulin. Nine (3.3%) of those requiring insulin may have had the protein deficient type of diabetes related to malnutrition. The fibrocalculous variety of diabetes related to malnutrition was not observed.
Newly presenting diabetic patients in Tanzania with diabetes requiring insulin are older at presentation than those in Britain; most diabetic patients present with diabetes not requiring insulin and a smaller proportion of Tanzanian patients are obese. Most have a lower socioeconomic state than diabetic patients in Britain. There are often delays in diagnosis in Tanzania, and there is a higher incidence of death shortly after presentation.
研究热带非洲新诊断糖尿病患者的临床特征。
对1981年6月1日至1987年5月31日在一家大型城市医院登记的所有新诊断糖尿病患者进行前瞻性研究。
坦桑尼亚达累斯萨拉姆的穆希姆比利医疗中心。
1250例患者，其中男性874例，女性376例。
272例（21.8%）患者患有需胰岛素治疗的糖尿病，825例（66.0%）患有无需胰岛素治疗的糖尿病，153例（12.2%）患有类型不明的糖尿病。大多数患者（1103例，88.2%）表现出糖尿病的典型症状。需胰岛素治疗的糖尿病患者就诊的高峰年龄为15至19岁。患有无需胰岛素治疗糖尿病的男性体力劳动者和农民就诊时年龄明显较大，且体重指数低于久坐的办公室职员。46例（18.1%）需胰岛素治疗的糖尿病患者和111例（14.4%）无需胰岛素治疗的糖尿病患者有糖尿病一级亲属。27%的患者体重过轻（体重指数低于20kg/m²），14.6%的患者肥胖（体重指数高于30kg/m²）。在791例无需胰岛素治疗的患者中，211例（26.7%）被诊断为高血压。9例（3.3%）需胰岛素治疗的患者可能患有与营养不良相关的蛋白质缺乏型糖尿病。未观察到与营养不良相关的纤维钙化型糖尿病。
坦桑尼亚新诊断的需胰岛素治疗的糖尿病患者就诊时年龄比英国患者大；大多数糖尿病患者患的是无需胰岛素治疗的糖尿病，坦桑尼亚肥胖患者的比例较小。大多数患者的社会经济状况低于英国的糖尿病患者。坦桑尼亚经常存在诊断延误的情况，且就诊后不久死亡率较高。
