SA Journal of Diabetes & Vascular Disease: Vol 3, Issue 4, November 2006

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SAJDVD: VOLUME 3, ISSUE 4, NOVEMBER 2006

Title: 1st All-Africa Conference on Heart Disease, Diabetes and Stroke, Nairobi, Kenya, 13-16 May 2007
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.162
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Title: The metabolic syndrome : an evolving concept : editorial
Authors: Mollentze, W.F.; Oosthuizen, G.M.
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.165-166
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Title: Insulin sensitivity in South Africa : living off the fat of the land; burning issues : editorial
Authors: Pillay, T.S.
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.168-171
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Title: Diabetes management in Africa - challenges and opportunities : review
Authors: Kengne, Andre Pascal; Mbanya, Jean Claude
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.172-178
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Abstract: Background: The translation into practice of the results of observational studies and clinical trials accumulated in the field of diabetes over the past few decades has resulted in better management and improved outcomes for people living with diabetes in most developed countries. How this situation has evolved in Africa, where access to basic care is a challenge, is not well known. This review examines the current challenges and opportunities for better management of diabetes in Africa.
Methods: A Medline search of published literature on diabetes in Africa, complemented by a manual survey of references of indexed articles, and consultation of relevant experts and websites was carried out.
Data synthesis: Of the 1 728 entries obtained from Medline, using the key words 'diabetes' and 'Africa', 254 entries derived from most African countries had some applications to the field of management of diabetes. In addition, numerous websites and a number of secondary websites were visited.
Results: The estimated number of those suffering from diabetes in Africa in 2003 was 35 100 (type 1) and 7 million (type 2). A 100% increase in the magnitude is projected for the year 2025, and there is a high rate of under-diagnosis. Acute and chronic complications are frequent and are associated with a poor prognosis. Overall access to diagnosis and basic care for diabetes in Africa is not available to most of those who need it. When and where available, the cost is regularly a limiting factor. In addition, the social context, a misconception about diabetes, and parallel medicine create an unfavourable milieu for the optimal management of diabetes in Africa. There is ample scope for improvement in the management of diabetes in Africa.
Conclusions: Diabetes mellitus presents particular challenges in Africa. Opportunities for better management exist and require coordinated efforts from all stakeholders.
Title: Chronic diseases of lifestyle in South Africa : the role of public health nutrition in the promotion of health, and prevention and treatment of disease : review
Authors: Vorster, Hester H.; Kruger, Annamarie
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.179-181
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Title: Special report on South African Cardiovascular Risk Management Symposium : special report
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.183, 185-190
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Title: PREDICTIVE TM : relevance of phase 4/observational studies: new information on use of insulin detemir : special report
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.191
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Title: DREAM - a diabetes prevention study : current topic
Authors: Conlon, Deane
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.193-196
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Abstract: The Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) study reported in September 2006. This international, multicentre, randomised, double blind, placebo controlled, 2-by-2 factorial prospective three-year study examined the effect of rosiglitazone (8 mg/day) and/ or ramipril (15 mg/day) to prevent progression to type 2 diabetes in 5, 269 adults with impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or both. The primary end point (incidence of diabetes or death) was reduced by 60% on rosiglitazone (11.6% on rosiglitazone vs. 26.0% on placebo, p<0.0001), and more subjects regained normoglycaemia on rosiglitazone (50.5%) than placebo (30.3%, p<0.0001). Ramipril did not alter the incidence of diabetes or death (18.1% on ramipril vs. 19.5% on placebo) but more subjects regained normoglycaemia on ramipril (42.5%) than placebo (38.2%, p=0.001). There were no apparent interactions between ramipril and rosiglitazone. Although overall cardiovascular event rates were not significantly different between rosiglitazone and placebo there was an increase in heart failure (0.5% on rosiglitazone vs. 0.1% on placebo, p<0.01) and more oedema on rosiglitazone (6.8%) than placebo (4.9%, p<0.003).
Title: 15th Biennial Congress of the Southern African Hypertension Society
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.196
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Title: The role of metformin and pioglitazone in early combination treatment of type 2 diabetes mellitus : achieving best practice
Authors: Campbell, Ian W.
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.197-203
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Abstract: Metformin will celebrate 50 years of clinical use in 2007. Pioglitazone was introduced into clinical practice in 1999. Both metformin and pioglitazone have positive effects on components of the metabolic syndrome, namely: insulin resistance, hyperinsulinaemia, visceral obesity, hyperglycaemia, dyslipidaemia and hypertension and risk factors involved in endothelial dysfunction, inflammation and atherosclerosis. Improvements in cardiovascular outcomes have been demonstrated in patients at high risk of macrovascular events with pioglitazone (PROactive) and in overweight patients with metformin (UKPDS 34). Pioglitazone may also help to sustain beta-cell function. Introduction of combination therapy using two differently acting oral antidiabetic agents at the time of diagnosis or early thereafter is becoming increasingly common in order to reach glycaemic targets (e.g. HbA1C <7.0%). The combination of metformin and pioglitazone in an early stage of type 2 diabetes enables greater likelihood that these targets can be attained without the risk of hypoglycaemia associated with insulin secretagogues.
Title: Pioglitazone reduces risk of secondary stroke in high-risk type 2 diabetes patients : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.204
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Title: Canadian-led study shows that diabetes can be prevented with drug therapy : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.204-205
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Title: Delaying the incubation phase from obesity to diabetes and cardiovascular disease :drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.205-207
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Title: Support for wider metformin use in type 2 diabetes : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.207-208
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Title: Kids and Care, a diabetes education programme to benefit from Sanofi-Aventis grant : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 3, Issue 4, Oct / Nov
Published: 2006
Pages: p.208
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