Abstract
Background: Essential hypertension is associated with an increased incidence of glucose intolerance (prediabetes and type 2 diabetes mellitus) but many persons with glucose intolerance remain undiagnosed for many years.
Aims: To determine the frequency of undiagnosed diabetes and prediabetes in a group of hypertensives and normotensives.
Methods: Anthropometry, blood pressure and standard oral glucose tolerance test (OGTT) were done in adult participants (hypertensive and normotensive controls) newly presenting to a General Outpatient Clinic of the University College Hospital, Ibadan.
Results: Using the OGTT, the frequency of undiagnosed diabetes was 10.4% and 4.3% in hypertensives andnormotensives respectively (p=0.031) but was 5.2% and 2.6% in hypertensives and normotensives respectively using fasting plasma glucose (FPG) alone (p=0.308).Using the OGTT, impaired glucose tolerance (IGT) was diagnosed in 32.2% of hypertensives compared to 14.8% of normotensives (p=0.002) while impaired fasting glucose (IFG) was diagnosed in 5.2% of hypertensive and 2.6% of the normotensives (p=0.288). After adjusting for hypertension, age, level of education, body mass index and waist circumference, hypertensives and persons with a higher waist circumference had statistically significantly increased odds of having glucose intolerance: hypertension (OR 2.915; 95% CI 1.526-5.556) and waist circumference (OR 1.050; 95%CI 1.010-1.090).
Conclusion: Diabetes and prediabetes are commoner in hypertensive persons and such persons require close andfrequent monitoring for the development of this disease. Screening with both fasting plasma glucose and post glucose load plasma glucose (OGTT) identifies more persons with glucose intolerance than fasting plasma glucose alone.
Keywords: Hypertension, diabetes mellitus, impaired fasting glucose, impaired glucose tolerance, prediabetes, glucose intolerance
Résumé
Contexte: L’hypertension essentielle est liée à une incidence accrue de l’intolérance au glucose (prédiabète et de diabète de type 2), mais beaucoup de personnes souffrant d’intolérance au glucose ne sont toujours pas diagnostiquées pendant plusieurs années.
Objectifs: Déterminer la fréquence du diabète non diagnostiqué et le pré diabète parmi un groupe de patients hypertendus et normotendus.
Méthodes: L’anthropométrie, la pression artérielle et le test de tolérance au glucose oral standard (HGPO) ont été réalisées chez les participants adultes (le contrôle des hypertendus et des normotendus) nouvellement présentés à une policlinique du centre hospitalier universitaire d’Ibadan.
Résultats: En se servant du test HGPO, la fréquence du diabète non diagnostiqué était de 10,4% et de 4,3% chez les hypertendus et les normotendus respectivement (p = 0,031), mais elle était de 5,2% et de 2,6% chez les hypertendus et normotendus en utilisant respectivement la glycémie (p = 0,308). Avec l’usage du test HGPO, la tolérance au glucose (IGT) a été diagnostiqué chez 32,2% des hypertendus comparativement à 14,8% des sujets normotendus (p = 0,002), tandis que la glycémie (IFG) a été diagnostiqué chez 5,2% des hypertendus et 2,6% des sujets normotendus (p = 0,288). Après le contrôle de l’hypertension, l’âge, le niveau d’éducation, l’indice de masse corporelle et la largeur de la hanche, les hypertendus et les personnes ayant de plus large hanche a augmenté de façon statistiquement importante la chance de n’être probablement pas victime d’intolérance au glucose: l’hypertension (OR 2,915, IC 95% 1,526 à 5,556) et la largeur (OR 1,050, IC 95% 1,010 à 1,090).
Conclusion: Le diabète et le prédiabète sont plus fréquents chez les personnes hypertendues et ont donc besoin de fréquents contrôles afin d’éviter la gravité de cette maladie. Le dépistage à la fois par la glycémie et par le test HGPO identifie plus le nombre de personnes souffrant d’intolérance au glucose que par la glycémie seule.
Correspondence: Dr. Temilola O. Akande, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail- fumkande@yahoo.com
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