SAJDVD: VOLUME 10, ISSUE 3, SEPTEMBER 2013
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  1. The diet - central in the treatment of diabetes and polycystic ovarian syndrome : editorial
    Authors: Lombard, Landi; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 83
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    Abstract: The diet is a topic discussed and written about extensively. It plays a pivotal role in the management of diabetes, both type 1 and type 2, as well as in polycystic ovarian syndrome (PCOS). PCOS can be seen as a major risk factor and probably a marker of future risk for the development of diabetes.
     
  2. The tolerability and safety of DPP-4 inhibitors for the treatment of older people with type 2 diabetes mellitus : an observational study : research article
    Authors: Viljoen, Adie; Meek, Claire L.; Gadsby, Roger; Viljoen, Sumarie; Langerman, Haya; Sinclair, Alan J.; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 84-87
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    Abstract: Aims/introduction: Despite type 2 diabetes mellitus being up to five times more prevalent in patients aged ≥ 65 years compared with patients < 65 years of age, this population is surprisingly less well studied. Dipeptidyl peptidase (DPP)-4 inhibitor treatment is an option for this older patient group, but clinical practice data for this drug class are sparse in this population. The study examined the efficacy and tolerability of DPP-4 inhibitors in older patients with type 2 diabetes whilst focusing on particular pertinent aspects relevant to care of older persons.
    Materials and methods: The medical records of 431 randomly selected patients (median age 74 years) were reviewed and two cohorts (DPP-4-inhibitor-treated and non-DPP-4-inhibitor-treated) were compared.
    Results: Both groups had a similar duration of diabetes (8 years) and comparable glycated haemoglobin A1C concentrations (7.4% and 7.2%). Hypoglycaemia was less common in the DPP-4 inhibitor group (3%) compared with the medically treated non-DPP-4 inhibitor group (8%), p < 0.02. Despite significantly more patients in the non-DPP-4 inhibitor group living in cared accommodation (9 vs 2%) this group received significantly more insulin (30 vs 7%).
    Conclusion: Clinicians need to consider the specific clinical issues relevant to older diabetic patients when taking complex treatment decisions.

  3. Is there an optimal diet for patients with type 2 diabetes? Yes, the one that works for them! : review
    Authors: Krebs, Jeremy D.; Parry-Strong, Amber; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 88-92
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    Abstract: Diet is fundamental in the aetiology and management of type 2 diabetes. The optimal diet remains unclear and the EASD and ADA have recently adopted increased flexibility with dietary composition, whilst maintaining a focus on reduced energy, reduced saturated fat and increased dietary fibre. This review draws three conclusions on the current evidence for three dietary approaches; high protein diets, very low carbohydrate diets and the Mediterranean diet, specifically for the management of weight, glycaemic control and cardiovascular risk in patients with type 2 diabetes. First, unless energy intake is reduced below energy expenditure over a sustained period of time, weight loss will not occur. Second, weight loss achieved with any dietary approach over the long-term is modest, though compared with the natural history of weight gain in obesity is clinically important. Third, the evidence supports flexibility in dietary composition with no approach superior to another for weight loss, glycaemic control or cardiovascular risk management. Most importantly there is evidence that adherence to any given dietary approach is more important than the macronutrient prescription. So the best diet for those with type 2 diabetes is the one that works for them, and critically the one that they can maintain in the long term.

  4. Screening for diabetes and cardiometabolic disease in women with polycystic ovary syndrome : review
    Authors: Tomlinson, Julie A.; Pinkney, Jonathan H.; Evans, Phil; Millward, Ann; Stenhouse, Elizabeth; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 93-99
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    Abstract: Polycystic ovary syndrome (PCOS) is a significant risk factor for developing type 2 diabetes and increased cardiovascular disease risk (together referred to as 'cardiometabolic disease', CMD). Primary prevention of CMD may be possible in women with PCOS but the diagnostic criteria for PCOS are controversial and this often hampers optimal clinical management. PCOS affects as many as 18% of women of reproductive age, and at least 70% remain undiagnosed in primary care. Screening women with PCOS for diabetes is seldom undertaken, largely through difficulties in diagnosis due to identification and management of PCOS continuing to focus on treatment of infertility and hirsutism. This article focuses on the diagnostic challenges of making the initial diagnosis of PCOS and considers how screening, detection and prevention of CMD might become routine clinical practice. It explores the unique challenges associated with PCOS and highlights the need for better evidence to justify screening and intervention. Finally, a pragmatic approach to assessing women with PCOS is suggested for use within primary care.

  5. Intermittent fasting : a dietary intervention for prevention of diabetes and cardiovascular disease? : review
    Authors: Brown, James E.; Mosley, Michael; Aldred, Sarah; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 100-102
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    Abstract: Intermittent fasting, in which individuals fast on consecutive or alternate days, has been reported to facilitate weight loss and improve cardiovascular risk. This review evaluates the various approaches to intermittent fasting and examines the advantages and limitations for use of this approach in the treatment of obesity and type 2 diabetes.
     
  6. Burnout : a critical problem among healthcare workers : diabetes educators' focus
    Authors: Wagenaar, P.; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 103-104
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    Abstract: An online survey has revealed that 60% of healthcare workers experience burnout, with 21% always or often feeling burned out, according to an article published earlier this year on the website, Health IT News. Heavy patient loads, smaller staff complements and higher stress levels are responsible, according to the survey by the American recruiting firm, CareerBuilder, which was conducted between 11 February and 6 March 2013. It involved more than 500 US healthcare workers and more than 240 employers.
     
  7. Making good nutritional choices : patient information leaflet
    Authors: Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 105-108
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    Abstract: Good nutrition is important throughout life, to help with feeling your best and staying strong. Good nutrition can also prevent the risk of developing some diseases and help to manage the symptoms of existing health issues. Although understanding our nutritional needs may seem complicated, food labelling legislation helps us to know what the nutrient content of packaged foodstuffs is. Fortunately, vegetables and fruit don't come with nutrition facts stamped into their skins. For the nutrient content of fresh fruit and vegetables, see Tables 1 and 2.
     
  8. ADA Watch summaries
    Authors: Hardy, G.; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 109-110 Full text: Click here to order »
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    Abstract: ADA Watch summaries
    2013 Update from Chicago, USA
    21-25 June 2013

  9. EASD Watch summaries
    Authors: Hardy, G.; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 111-112
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    Abstract: EASD Watch summaries
    2013 Update from Barcelona, Spain
    23-27 September 2013

  10. Novo Nordisk Incretin and Cardiovascular summit : drug trends
    Authors: Wagenaar, P.; Published: 2013
    From: South African Journal of Diabetes and Vascular Disease, Vol 10, Issue 3, Sep, Pages: 114-116
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    Abstract: A number of consistent key messages came through at Novo Nordisk's Incretin and Cardiovascular summit, which took place in Durban on 29 June 2013. Despite some superficially conflicting evidence in clinical studies, early intensive therapy has long-term cardiovascular benefit in diabetes patients, consequent on a legacy effect or 'metabolic memory', even though these benefits may take years and even decades to manifest.
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