Literature Review on the Particularities of Dysmetabolism and T2DM in Libreville: Perspectives on Postprandial Glucido-Lipid Exposure

Dysmetabolism and T2DM are common in Libreville. Based on a literature review of study data, the aim was to identify the various salient findings and analyze these dysmetabolisms from the point of view of clinico-metabolic particularities, and to propose reinforcing their significance by postprandial dynamic explorations. In Gabon, all dyslipidemias are present in the population (moderate to severe hypercholesterolemia, high or low high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)). In connection with the studies by Ngou (1997) [1] on reference values for lipids in the population. Polymorphism of the low-density lipoprotein (LDL)-oxidizing enzyme paraoxonase-1 (PON-1) is associated with lower protective HDL in diabetics. Qualitative abnormalities in LDL with atherogenic potential, expressed as conjugated diene onset latency or PON-1 activity, were associated with chronic complications (hypertension, retinopathy, etc.). In Gabon, the interaction between metabolism and Plasmodium falciparum malaria leads to particularities of expression, given the endemic nature of the disease. These include the classic hypertriglyceridemia associated with malaria, high levels of free fatty acids (FAs) and hypoglycemia dissociated from high lactate levels. In Gabon, postprandial glycemia is used to diagnose pre-diabetic states. It may then be accompanied by a postprandial hyperinsulinism syndrome prefiguring insulin resistance. We had the opportunity to compare the results of T2DM patients in Libreville with those of Caucasians in Marseille, through the work we co-directed. Modalities of insulin resistance and morphotype are not always the same in the two races. Finally, an inadequacy in the monitoring of T2DM treatment by HbA1c (glycated haemoglobin) was highlighted in Libreville. In view of these numerous particularities of T2DM in African subjects, it has become necessary to conduct technical studies on the methodology and metabolic aspects of the postprandial space. Research into improving diagnosis and therapeutic strategy must be built today around specific knowledge of postprandial dyslipidemia and the dietary context.