D I A B E T E S R E S E A R C H A N D C L I N I C A L P R A C T I C E 1 0 3 S ( 2 0 1 4 ) S 1 – S 6 1 S47

P=0.047). In multivariate analysis, strong significant independentpredictors of type 2 diabetes were belonging to a traditionalreligion (HR 2.1, 95% CI 1.1–4.2; P=0.036) and a relative increasein nadir CD4 cell count (beta coefficient 0.003; P<0.0001).

Conclusion: ART-related obesity and type 2 diabetes arebecoming increasing problems in Central Africans with HIVdisease. A relative increase in nadir CD4 count and traditionalreligion status appear to be the strongest independent predictorsof type 2 diabetes.

P46Survey of patients in primary care for diabetes healthcentres in Kinshasa, DR Congo

J.C. Kalobu a, E. Bewa b, C. Darras b, M. De Clerck c, J. Van Olmen a,G. Kegels c, B. Criel a. aMemisa Kinshasa, DR. Congo; bInstitute ofTropical Medicine Antwerp, Belgium cRéseau de soins de santé primaire

Introduction: Diabetes prevalence in Kinshasa is estimated at5%, resulting in a caseload of about 200,000 Type 2 diabetics. Thestudy context is a “network” of 60 first line health care facilitiesand 4 referral centres in Kinshasa, offering a standardisedpackage of diabetes care to approximately 7000 patients. Ourresearch questions were: 1) how did the health status of patientsin the 4 targeted sanitary formations develop over the threeyears of follow-up? 2) How can the use of routine data improvethe follow-up of patients?

Methods: Based upon predefined criteria, we included inour research 4 health centres belonging to the network. A 3years observational study was conducted: annual cross-sectionalsurvey that included all diabetics routinely followed up. Datawere retrieved from the central network register and individualpatient records. Analysis was done at aggregate level and foreach centre separately. We also analysed the differences betweeneach year and discussed them with program staff, in other tounderstand the impact of monitoring on care.

Results: 351 patients are registered in the 4 facilities in 2010,535 in 2011, and 561 in 2012. Out of them more than 50% areregular attendants. In the 3 years, the median BMI is 25.61 (2010),25.7 (2011) and 25.7 (2012). 39% had normal glucose levels duringtheir last visit in 2010, 41.9% in 2011 and 39.8% in 2012. 1.6%were treated for a diabetic foot in the last year, 12% in 2011 and10% in 2012. 64% also receive anti-hypertensive medication in2010, 52% in 2011 and 51% in 2012. 14% on diet only, 9.15% in2011 and 7.3% in 2012. People on insulin had less well controlledglucose levels: 41% (2010), 23% (2011, 2012). More than 70% of thepatients come from an area outside of the health district.

P47Effects of type 2 diabetes on the quality of sleep in patientswith sleep apnea syndrome

J. Kamgang a, C. Kuate b, E. Sobngwi c, M. Azabji c, J.C. Mbanya c.aHôpital régional de Garoua, Cameroon; bHôpital général de Douala,FMSB, Cameroon; cHôpital central de Yaoundé, FMSB, Cameroon

Introduction: Sleep apnea syndrome (SAS) is more frequentin diabetic patients. Some authors think that sleep-inducedrespiratory disturbances can be the basis of the pathogenesisof type 2 diabetes in some patients. We aimed to compare thesleep quality of patients with sleep apnea, having the presenceof diabetes as comparative factor.

Methods: The study included 9 patients with SAS aged 30to 62 years. The patients underwent electroencephalographicrecording, concomitantly with the recording of heart rate andpulse oximetry. Analyzing EEG recording made us able todetermine the rate of sleep efficiency, and the proportions of thedifferent stages of sleep. The data analysis was performed usingSPSS® 17.0.

Results: 4 out of 9 patients had type 2 diabetes. There wereno significant difference between the age, and the morphologicparameters of the two groups. The Oxygen Desaturation Indexseemed to be higher in diabetic patient, but that was notsignificant (47.7±33.3 �= 20.7±15.2, p=0.19). Total duration of sleepwas similar for the 2 groups (p=0.56). But the efficiency ofthe sleep was diminished in patients with diabetes (74.5±11.2�= 91.5±3.9, p=0.05). Similarly, we found that diabetic patientsexperienced about two time more arousal than non-diabeticpatients (p=0.02). Although no diabetic reached the 4th stage ofsleep, the proportions of deep sleep and REM sleep were notsignificantly different between the 2 groups. However, micro-arousals seemed to be more frequent among patients withdiabetes, but that was not significant (p=0.35).

Conclusion: SAS is also associated with impaired sleepquality in obese patients in our region. But sleep parametersseem to be worse in diabetic patients with SAS than in non-diabetic. Thought to be associated to the pathogenesis andcomplications of diabetes, and being more severe in this groupof patients, SAS must therefore be aggressively sought andvigorously treated in diabetic patients.

P48Phénotype des patients reçus à l’hôpital de jour dediabétologie au CHU de Conakry

M.C. Diallo, N.M. Baldé, A. Kaké, T.O. Barry, M.O. Barry,J.S. Bangoura, O.B. Diallo, M.A. Diallo. Hôpital Universitaire(Guinée-Conakry)

Objectif : Décrire les caractéristiques de patients suivis à l’HDJ dediabétologie et présenter les thèmes d’éducation abordés.

Méthodes : Cette étude a concerné les patients suivis au Ser-vice d’endocrinologie et à l’unité de diabétologie pédiatrique duCHU de Donka. Les patients avaient été présélectionnés par lesmédecins en consultation de routine et inclus de façon aléatoire.

Résultats : Un total de 89 patients ont été interrogés etexaminés. La fréquence des facteurs de risque cardiovasculairesétait la suivante : 29,9 % étaient tabagiques, 12,2 % obèses, 55,5 %hypertendus, 23,59 % avaient une hypertriglycéridémie et 30,3 %une hypercholestérolémie. Le taux d’HbA1c était inferieur à7 % pour 31,5 % des patients. En terme de bilan pour le suivi,41,5 % des patients avaient réalisé l’ECG, 34,8 % avaient réaliséun examen ophtalmologique et une rétinopathie diabétiqueétait présente chez 1,1 % chez ces derniers, 14,6 % étaient eninsuffisance rénale modérée (Clairance de 30 à 59 ml/min). 24patients (26,9 %) avaient une lésion au pied. Sur 20 séancesd’éducation, les thèmes éducatifs abordés étaient : les valeurscibles du traitement (20 fois), la prévention des lésions dupied (11 fois), l’adaptation du traitement du diabète (n=16), del’hypertension (n=4) et de dyslipidémie (n=8).

Conclusion : Les patients recrutés en HDJ ont une grandefréquence de facteurs de risque, un équilibre glycémique in-suffisant et un faible niveau d’évaluation des complications.L’éducation qui leur est proposée semble adaptée.

P49Profils socio-démographiques, cliniques, biologiques etthérapeuthiques des patients diabétiques suivis a l’hôpitalde district de la Cité-verte. Yaoundé-Cameroun

N.J. Mandeng, J.M. Mendimi Nkodo, M.A. Mbang. Hôpital de districtde la Cité-Verte. Yaoundé-Cameroun

Objectif : La décentralisation du suivi du patient diabétique està vitesse variable dans le microcosme sanitaire du Cameroun.Dans le but de préciser les caractéristiques sociodémogra-phiques, cliniques, biologiques et thérapeutiques des patientsdiabétiques dans une structure décentralisée, la clinique du