Katte Jean Claude, Gwan Emmanuel, Feuatsap Christiale Kenne, Kamdem Liliane, Chetcha Adele, Dehayem Mesmin Yefou
Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, United Kingdom.
National Obesity Centre and The Endocrinology and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
Pan Afr Med J. 2025 Feb 26;50:62. doi: 10.11604/pamj.2025.50.62.46186. eCollection 2025.
Type 1 diabetes-associated mortality in Africa remains high despite several coordinated international initiatives. Therefore, understanding the causes of death will guide context-specific public health interventions. This descriptive case series examined the number and causes of death among children and young people (CYP) with type 1 diabetes (T1D) in the young-onset diabetes in sub-Saharan Africa (YODA) study in Cameroon. Among 313 CYP recruited between 2019 and 2022, 23 deaths were recorded (56.5% male). At recruitment, the median (IQR) age at diagnosis was 16 (13-18) years, BMI 21.5 (18.9-24.7) kg/m, and plasma C-peptide concentration 116 (37-210) pmol/L, respectively. Causes of death included hypoglycaemia (7 cases), diabetic ketoacidosis (5 cases), infections (4 cases), undefined causes (4 cases), chronic liver disease (2 cases), and chronic kidney disease (1 case). Most deaths (17/23, 73.9%) occurred in individuals with significantly low plasma C-peptide levels (<200 pmol/L), signifying severe insulin deficiency. Hypoglycaemia deaths (85.7%, 6/7) were also common at significantly low C-peptide levels (<200 pmol/L). Nearly half (11/23, 47.8%) of the deaths occurred outside the hospital setting. These findings describe a possible relationship between low C-peptide and mortality for CYP living with T1D in Cameroon which should be investigated thoroughly prospectively.
尽管有多项国际协调举措，但非洲1型糖尿病相关死亡率仍然很高。因此，了解死亡原因将为因地制宜的公共卫生干预措施提供指导。本描述性病例系列研究了喀麦隆撒哈拉以南非洲青少年糖尿病（YODA）研究中1型糖尿病（T1D）儿童和青少年（CYP）的死亡人数和原因。在2019年至2022年招募的313名CYP中，记录了23例死亡（男性占56.5%）。招募时，诊断时的中位（IQR）年龄为16（13 - 18）岁，BMI为21.5（18.9 - 24.7）kg/m，血浆C肽浓度分别为116（37 - 210）pmol/L。死亡原因包括低血糖（7例）、糖尿病酮症酸中毒（5例）、感染（4例）、不明原因（4例）、慢性肝病（2例）和慢性肾病（1例）。大多数死亡（17/23，73.9%）发生在血浆C肽水平显著较低（<200 pmol/L）的个体中，这表明严重胰岛素缺乏。低血糖死亡（85.7%，6/7）在C肽水平显著较低（<200 pmol/L）时也很常见。近一半（11/23，47.8%）的死亡发生在医院外。这些发现描述了喀麦隆T1D患儿和青少年中低C肽与死亡率之间可能存在的关系，应进行前瞻性深入调查。
