SAJDVD: VOLUME 11, ISSUE 3, SEPTEMBER 2014
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  1. The role of allied health practitioners in diabetes care and more : editorial
    Authors: Mahomed, F.A.
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: This edition examines the important role of allied health practitioners in the management of diabetes and also looks at potential risks associated with medication.

  2. Incretins : harmful to the pancreas or not? : review
    Authors: Ramsunder, Nikash
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Naturally occurring incretins are intestinal hormones that are released in response to food ingestion in order to potentiate the glucose-induced insulin response, and account for 50 to 70% of the total insulin secretion after meal ingestion. Their effects are mediated through binding with specific receptors as well as neural modulation.

  3. The effects of systemic medication on diabetic retinopathy : review
    Authors: Kruse, Carl-Heinz
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Of all the complications of diabetes mellitus, diabetic retinopathy (DR) is feared most by patients. These fears are well founded since DR is the third leading cause of irreversible blindness in the world and the leading cause among working-age adults. As a matter of fact, a diabetic patient is more likely to go blind in the next 14 years than die of a motor vehicle accident in his/her lifetime.

  4. An overview of the role of physiotherapy in managing diabetes and diabetes-associated conditions : review
    Authors: Shanahan, Heidi
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Although physiotherapists usually encounter diabetes as a secondary condition in patients during the evaluation and treatment of movement, functional and musculoskeletal disorders, physiotherapy is both a curative and preventative discipline that employs a holistic approach to healthcare.

  5. Paediatric diabetes with a focus on the adolescent : review
    Authors: Dhada, Barnesh; Blackbeard, David; Adams, Gayle
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Both type 1 and type 2 diabetes mellitus in children and adolescents is increasing worldwide. While new cases are diagnosed in South Africa annually, the true incidence is not known. The International Society for Paediatric and Adolescent Diabetes (ISPAD) in conjunction with the International Diabetes Federation (IDF) set out a comprehensive, evidence-based standard of care guideline in 2011. The goal of diabetes care is to achieve optimal glycaemic control in order to achieve good quality of life by preventing and treating complications. However, successful implementation of all aspects of care is complex.

  6. A review of the literature on multidisciplinary interventions in cardiac rehabilitation : review
    Authors: Rabilal, Melisha
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Cardiovascular disease (CVD) is a worldwide problem, with an increased prevalence in sub-Saharan Africa. Rheumatic heart disease, hypertension and cardiomyopathy are already prevalent, and coronary heart disease is assuming growing significance. It is vital that in developing countries, rehabilitative care be incorporated into the existing healthcare system.

  7. The effects of medicinal plants on renal function and blood pressure in diabetes mellitus : review
    Authors: Musabayane, C.T.
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Diabetes mellitus is one of the most common chronic global diseases affecting children and adolescents in both the developed and developing nations. The major types of diabetes mellitus are type 1 and type 2, the former arising from inadequate production of insulin due to pancreatic β-cell dysfunction, and the latter from reduced sensitivity to insulin in the target tissues and/or inadequate insulin secretion. Sustained hyperglycaemia is a common result of uncontrolled diabetes and, over time, can damage the heart, eyes, kidneys and nerves, mainly through deteriorating blood vessels supplying the organs. Microvascular (retinopathy and nephropathy) and macrovascular (atherosclerotic) disorders are the leading causes of morbidity and mortality in diabetic patients. Therefore, emphasis on diabetes care and management is on optimal blood glucose control to avert these adverse outcomes.
    Studies have demonstrated that diabetic nephropathy is associated with increased cardiovascular mortality. In general, about one in three patients with diabetes develops end-stage renal disease (ESRD) which proceeds to diabetic nephropathy (DN), the principal cause of significant morbidity and mortality in diabetes. Hypertension, a well-established major risk factor for cardiovascular disease contributes to ESRD in diabetes. Clinical evidence suggests that there is no effective treatment for diabetic nephropathy and prevention of the progression of diabetic nephropathy. However, biomedical evidence indicates that some plant extracts have beneficial effects on certain processes associated with reduced renal function in diabetes mellitus. On the other hand, other plant extracts may be hazardous in diabetes, as reports indicate impairment of renal function. This article outlines therapeutic and pharmacological evidence supporting the potential of some medicinal plants to control or compensate for diabetes-associated complications, with particular emphasis on kidney function and hypertension.

  8. The ADVANCE cardiovascular risk model and current strategies for cardiovascular disease risk evaluation in people with diabetes : review
    Authors: Kengne, Andre Pascal
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Purpose: To critically examine existing approaches to cardiovascular disease (CVD) risk evaluation in people with diabetes, and discuss the use of accurate and validated absolute CVD risk tools as an appropriate basis for CVD prevention in people with diabetes.
    Methods: This was a narrative review using evidence from the ADVANCE study and all relevant publications identified via PubMed MEDLINE.
    Results: There is sufficient evidence that diabetes does not confer a CVD risk equivalent to that in non-diabetic people with existing CVD in all circumstances. In people with diabetes, CVD risk follows a gradient. Reliably capturing this gradient depends on an adequate combination of several risk factors. Many global CVD risk tools applicable to people with diabetes have been developed. Those derived from older cohorts are less accurate in contemporary populations and many newer tools have not been tested. The ADVANCE risk engine, recently developed from the large multinational ADVANCE study, showed acceptable performance on the ADVANCE population and largely outperformed the popular Framingham risk equation when tested on the multinational DIAB-HYCAR cohort of people with type 2 diabetes.
    Conclusions: The high-risk status conferred by diabetes does not preclude estimation of absolute CVD risk using tools such as the ADVANCE risk engine and its use as the basis for initiating and intensifying CVD preventative measures. Adopting such an accurate and validated tool will likely improve prescriptions and outcomes of diabetes care.
     
  9. Prevalence and determinants of electrocardiographic abnormalities in sub-Saharan African individuals with type 2 diabetes : research article
    Authors: Dzudie, Anastase; Choukem, Simeon-Pierre; Adam, Abdoul Kadir; Kengne, Andre Pascal; Gouking, Patricia; Dehayem, Mesmin; Kamdem, Felicite; Doualla, Marie Solange; Joko, Henry Achu; Lobe, Marielle Epacka Ewane; Mbouende, Yves Monkam; Luma, Henry; Mbanya, Jean Claude; Kingue, Samuel
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Aim: This study assessed the prevalence and determinants of electrocardiographic abnormalities in a group of type 2 diabetes patients recruited from two referral centres in Cameroon.
    Methods: A total of 420 patients (49% men) receiving chronic diabetes care at the Douala General and Yaoundé Central hospitals were included. Electrocardiographic abnormalities were investigated, identified and related to potential determinants, with logistic regressions.
    Results: The mean age and median duration of diagnosis were 56.7 years and four years, respectively. The main electro-cardiographic aberrations (prevalence %) were: T-wave abnormalities (20.9%), Cornell product left ventricular hypertrophy (16.4%), arrhythmia (16.2%), ischaemic heartdisease (13.6%), conduction defects (11.9%), QTc prolongation (10.2%) and ectopic beats (4.8%). Blood pressure variables were consistently associated with all electrocardiographic abnormalities. Diabetes-specific factors were associated with some abnormalities only.
    Conclusions: Electrocardiographic aberrations in this population were dominated by repolarisation, conduction defects and left ventricular hypertrophy, and were more related to blood pressure than diabetes-specific factors.
     
  10. Making a difference, one patient at a time : diabetes personality
    Authors: Wagenaar, P.
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Sr Hester Davel, a diabetes nurse educator at the Centre for Diabetes and Endocrinology (CDE) in Houghton, Johannesburg, has been involved in diabetes education for 18 years. Her interest in chronic disease, and diabetes in particular, began when she was working in a medical ward and encountered a young boy with type 1 diabetes. 'The other staff made sure he didn't have access to sweets. At night, however, he used to steal sweets from other patients while they were asleep, and the next day his diabetes would be uncontrolled. When I asked him why he did it, his answer was that because his own sweets were always taken away, "Nobody gives me a choice".'
     
  11. A single injection of FGF1 arrests type 2 diabetes in mice
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: In mice with diet-induced diabetes, the equivalent of type 2 diabetes in humans, a single injection of the protein FGF1 was enough to restore blood glucose levels to a healthy range for more than two days. The discovery by Salk scientists, published recently in the journal Nature, could lead to a new generation of safer, more effective diabetes drugs.
     
  12. Psychological considerations in the management of diabetes : patient information leaflet
    Authors: Brown, Ottilia
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Diabetes is a complex non-communicable disease requiring lifelong management and personal responsibility of the patient for every aspect of treatment. Inadequate metabolic control in diabetic patients is well documented. This article focuses on psychology and diabetes in terms of examining the role of psychology in management of the illness throughout its course, and the negative influence of psychological presentations on diabetes management. The article also highlights the prevalence of these presentations and emphasises the importance of identifying and treating these conditions, as this can significantly improve adherence and glycaemic control. In closing, some thoughts on the way forward are discussed.
     
  13. Glucose 'control switch' in the brain key to both types of diabetes
    From: South African Journal of Diabetes and Vascular Disease, Vol 11, Issue 3, Sept 2014
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    Abstract: Researchers at Yale School of Medicine have pinpointed a mechanism in part of the brain that is key to sensing glucose levels in the blood, linking it to both type 1 and type 2 diabetes. The findings were published in the July 28 issue of Proceedings of the National Academies of Sciences
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