Recherche en endocrinologie et diabète

A Random Plasma Glucose in Gynecologic Patients

Tandu-Umba Barthelemy, Tsangu Phuati Joseph and Mbangama Muela Andy

Objective: To determine gynecologic pathologies associated with abnormal plasma glucose in order to provide clinicians with an opportunity to achieve prevention or early detection of diabetes and better control of co-morbidities linked to hyperglycemia.
Methods: This is a cross-sectional study including all adult gynecologic non pregnant patients admitted for routine consultation between 1st and 30th August 2012 at the university clinics of Kinshasa, DR Congo, irrespective of their clinical status. Information generated by their charts was used for extensive identification of general characteristics. Random venous blood glucose was assayed upon recruitment by use of One Touch Profile Meters (Lifescan, Johnson & Johnson, High Wycombe, U.K.). Using Odds ratios and logistic regression calculation we assessed risk for abnormal glucose concentration.
Results: This study recruited 99 participants whose general characteristics are (mean ± SD): 34.3 ± 13.0 years, 1.7 ± 2.7 and 2.3 ± 1.2 for age, parity and gravidity, respectively. The five major complaints were: pelvic/back pain (33.3%), vaginal discharge with/without pruritus (10.1%), mastodynia (8.1%), amenorrhea (7.1%), infertility and abnormal uterine bleeding (6.1% each). The major diagnoses were myoma (13.1%), urinary infection (11.1%), polycystic ovaries syndrome (9.1%), breast cancer 9.1%), infertility (9.1%), cervicitis (7.1%), vaginitis (5.1%) and ovarian cyst (4%). The mean plasma glucose concentrations of the sample was 123.7 ± 51.6 mg/dL, and none of the 11 (11.1%) who qualified as diabetic patients (having >200 mg/dL) presented with symptoms of marked hyperglycemia. Micropolycystic ovaries syndrome and cervical cancer significantly raised the risk for pathologic glucose concentration (OR 9.8; CI 1.1-86.8 and OR 35.1; CI 1.6-75.1, respectively), mostly when patients were either ≥ 35 years old or overweight/obese or both.
Conclusions: Ignored hyperglycemia that can be present in certain gynecological situations years before the development of overt diabetes could be regarded as missed opportunity for early detection of diabetes. In turn, better glycemic control is expected to improve the situations concerned.