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Abstract
RÉSUMÉ
Introduction. Le pèlerinage à La Mecque expose les pèlerins diabétiques à des risques accrus de décompensation métabolique, un sujet peu documenté au Burkina Faso. Cette étude décrit les profils cliniques et métaboliques des pèlerins diabétiques évalués en consultation pré-pèlerinage à Bobo Dioulasso. Méthodologie. Une étude observationnelle prospective a été menée de janvier à avril 2025 au service de médecine interne du Centre Hospitalier Universitaire Sourô Sanou. Les pèlerins diabétiques adultes (≥18 ans) consultant pour une évaluation pré-pèlerinage ont été inclus. Les données sociodémographiques, cliniques, métaboliques (HbA1c, lipides, fonction rénale) et thérapeutiques ont été analysées. Résultats. Parmi 28 participants (âge moyen 58,8 ± 9,3 ans ; 64% hommes), 96% présentaient un diabète de type 2 (ancienneté moyenne 9,6 ± 6,8 ans). Les comorbidités prévalentes incluaient l’HTA (66%), la dyslipidémie (42%), le surpoids/obésité (90%) et l’obésité abdominale (70%). Le contrôle glycémique était inadéquat (HbA1c moyenne 9,1 ± 1,9%) : 16% des patients avaient une HbA1c <7% contre 44% >9%. On observait une hypertriglycéridémie (46%), un HDL-cholestérol bas (58%) et une insuffisance rénale (DFGe <60 ml/min/1,73m² ; 18%). Les traitements incluaient les antidiabétiques oraux seuls (58%), l’insuline seule (22%) et les associations (16%). Conclusion. Les pèlerins diabétiques burkinabés présentent un risque cardiométabolique élevé et un contrôle glycémique insuffisant avant le pèlerinage. Une optimisation thérapeutique et une éducation structurée sont impératives pour prévenir les complications durant le pèlerinage.
ABSTRACT
Introduction. The Hajj pilgrimage poses significant metabolic risks for diabetic pilgrims, with limited data available from Burkina Faso. This study describes the clinical and metabolic profiles of diabetic pilgrims during pre-Hajj assessments in Bobo Dioulasso. Methodology. A prospective observational study was conducted from January to April 2025 at the Internal Medicine Department of Centre Hospitalier Universitaire Sourô Sanou. Adult diabetic pilgrims (≥18 years) attending pre-Hajj consultations were included. Sociodemographic, clinical, metabolic (HbA1c, lipids, renal function), and therapeutic data were analyzed. Results. Among 28 participants (mean age 58.8 ± 9.3 years; 64% male), 96% had type 2 diabetes (mean duration 9.6 ± 6.8 years). Prevalent comorbidities included hypertension (66%), dyslipidemia (42%), overweight/obesity (90%), and abdominal obesity (70%). Glycemic control was suboptimal (mean HbA1c 9.1 ± 1.9%): 16% achieved HbA1c <7%, while 44% exceeded >9%. Hypertriglyceridemia (46%), low HDL-cholesterol (58%), and renal impairment (eGFR <60 ml/min/1.73m²; 18%) were observed. Treatments included oral antidiabetics alone (58%), insulin monotherapy (22%), and combination therapy (16%). Conclusion. Diabetic pilgrims from Burkina Faso exhibit high cardiometabolic risk and inadequate glycemic control pre-Hajj. Therapeutic optimization and structured education are critical to mitigate pilgrimage-related complications.
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References
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References
1. Thomas GN, Ho SY, Janus ED, et al; Hong Kong Cardiovascular Risk Factor Prevalence Study Steering Committee. The US National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) prevalence of the metabolic syndrome in a Chinese population. Diabetes Res Clin Pract 2005;67:251-7.
2. Osuji CU, Nzerem BA, Dioka CE, Onwubuya EI. Metabolic syndrome in newly diagnosed type 2 diabetes mellitus using NCEP-ATP III, the Nnewi experience. Nigerian J Clin Pract 2012;15:475-80.
3. Bruno G, Merletti F, Biggeri A, et al. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study. Diabetes Care 2004;27:2689-94.
4. Steichen O, Plouin PF. Prise en charge actuelle de l’hypertension artérielle. Rev Med Interne 2014;35:235-42.
5. Kumar SV, Nagesh A, Leena M, et al. Incidence of metabolic syndrome and its characteristics of patients attending a diabetic outpatient clinic in a tertiary care hospital. J Nat Sci Biol Med 2013;4:57-6.
6. Tamang HK, Timilsina U, Thapa S, et al. Prevalence of metabolic syndrome among Nepalese type 2 diabetic patients. Nepal Med Coll J 2013;15:50-5.
7. Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494–7.
8. Yaméogo TM, Sombié I, Ouédraogo SM, et al. Obésité versus obésité abdominale chez les diabétiques à Bobo-Dioulasso au Burkina Faso. J Soc Biol Clin 2014;20:44-5.
9. Nolin B. Intensité de pratique d’activité physique : définitions et commentaires. Infokine 2006;16:5-10.
10. Udenze IC, Azinge EC, Arikawe AP, et al. The prevalence of metabolic syndrome in persons with type 2 diabetes at the Lagos University Teaching Hospital, Lagos, Nigeria. West Afr J Med 2013;32:126-32.
11. Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among U.S. adults. Diabetes Care 2004;27:2444–9.
12. Tan MC, Wong TW, Ng OC, et al. Metabolic syndrome components and prevalence of cardiovascular disease among type 2 diabetic patients in Malaysia. Southeast Asian J Trop Med Public Health 2014;45:226-35.
13. Titty FK. Glycaemic control, dyslipidaemia and metabolic syndrome among recently diagnosed diabetes mellitus patients in Tamale Teaching Hospital, Ghana. West Afr J Med 2010;29:8-11.
14. Mogre V, Salifu ZS, Abedandi R. Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus. J Diabetes Metab Disord 2014;13:80.
15. Yanogo RDA, Sagna Y, Tiéno H, et al. Prevalence of diabetes and cardiovascular risk factors in Ouagadougou (Burkina-Faso). Open Access Library Journal 2014;1:e595. http://dx.doi.org/10.4236/oalib.1100595
16. Chung HS, Seo JA, Kim SG, et al. Relationship between metabolic syndrome and risk of chronic complications in Koreans with type 2 diabetes. Korean Diabetes J 2009;33:392-400.
17. James PT, Rigby N, Leach R. The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil 2004;11:3–8.