SA Journal of Diabetes & Vascular Disease: Vol 5, Issue 3, September 2008

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SAJDVD: VOLUME 5, ISSUE 3, SEPTEMBER 2008

Title: Challenges facing the care of children and adolescents with diabetes in South Africa : life with diabetes can be sweet : editorial
Authors: Segal, David
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 103-106
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Abstract: Professor Martin Silink, president of the International Diabetes Federation (IDF), could not have more succinctly summarised the state of global diabetes when he wrote, 'It is a singular tragedy that, despite the emergence in recent years of increasingly effective strategies for the metabolic / glycaemic control of type 1 and 2 diabetes mellitus, this condition continues to exact a terrible toll. Perhaps no group better exemplifies the diabetes crisis gripping both developed and developing nations today than the child. Children and adolescents with diabetes represent society's most vulnerable population - and it is indeed a tragedy that young lives continue to be lost to a disease for which adequate management tools and knowledge exist.'
Title: New approaches to insulin therapy in children and adolescents with type 1 diabetes : review
Authors: Acerini, Carlo L.; Deeb, Asma
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 109-113
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Abstract: This article considers the problems associated with intensive glycaemic control in children and adolescents and how these may be circumvented. Use of insulin analogues, alternative insulin delivery methodologies and implementation of education programmes and other adjunctive strategies are discussed.
Title: Physical activity for the prevention and management of youth-onset type 2 diabetes mellitus : focus on cardiovascular complications : review
Authors: McGavock, Jonathan; Sellers, Elizabeth; Dean, Heather
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 114-119
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Abstract: With the growing prevalence of childhood obesity and type 2 diabetes mellitus (T2DM) in youth, the challenge of cardiovascular disease risk management has entered the paediatric realm, affecting specialists, family physicians and allied healthcare professionals alike. Currently, there is little evidence to support optimal strategies for management of T2DM in youth and the associated cardiovascular complications. Physical activity plays a powerful role in the prevention and management of T2DM and cardiovascular disease in adults.
This review will focus on the role of physical activity for the prevention of T2DM in youth and its associated cardiovascular complications. The first part describes the prevalence of cardiovascular risk factors in this cohort. The second part focuses on the role of physical activity in the prevention and management of T2DM in youth. Collectively, the limited intervention and observation studies published to date suggest that daily targets of 60-90 minutes of physical activity and less than 60 minutes of screen time (i.e. time spent in front of a television, computer or video games) are required for the prevention and management of T2DM in youth. Large-scale intervention studies are needed to determine the most effective physical activity strategies for the prevention and management of T2DM in youth.
Title: Exenatide : review of a novel agent for type 2 diabetes : diabetes prescriber
Authors: Decloedt, Eric; Blockman, Mark
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 121-124
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Abstract: Control of type 2 diabetes remains inadequate with current therapies. The incretin mimetics are a new class of drug with a novel mechanism of action that includes the enhancement of glucose-dependent insulin secretion and suppression of postprandial glucagon secretion. Exenatide is the first commercially available incretin mimetic and limited studies have demonstrated improved glycaemic control as add-on therapy to oral antidiabetic agents versus placebo. While sulfonylureas, thiazolidinediones and insulin treatment result in weight gain, exenatide promotes moderate but sustained weight loss. The drug is well tolerated, with limited adverse events identified at this stage. In a patient who requires further minimal reduction of HbA1c levels (less than 1%) and weight loss, can afford the medicine, and is prone to hypoglycaemic episodes, exenatide might be a suitable option. Its biggest drawback at present is its lack of long-term outcomes data.
Title: ISPAD watch : 2008 update from Durban : ISPAD watch
Authors: Koning, J.M.M.; Hallbauer, U.; Van Dyk, J.
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 125-128
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Abstract: International Society of Paediatric and Adolescent Diabetes
Goals of diabetes care
Poverty as a confounding factor in diabetes care
Workshop : parenting skills
Risk-taking behaviour in children and adolescents with diabetes
Risk of type 2 diabetes affects all socio-economic groups in an urbanised population : a prospective childhood study
Self-monitoring of blood glucose in CSII-treated adolescents with type 1 diabetes
Do more frequent visits at the outpatient clinic improve metabolic control in children and adolescents with high HbA1c? (poster)
Preventing hypoglycaemia
Exercise in type 1 diabetes mellitus
Acceleration
Early origins : foetal origins, thrifty phenotype and early protein hypotheses
Challenges to diabetes care : Costa Rica
Management of obesity
Teaching strategies for initiating CSII
Hyperglycaemia and the development of neurocognitive dysfunction in children and adolescents with diabetes
Title: First SA diabetic foot congress, Johannesburg 2008 : diabetes educator's focus
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 130-132
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Abstract: The first congress of the Diabetic Foot Working Group was held at the Wanderers Club in June and attended by an enthusiastic multidisciplinary group of specialists, including vascular surgeons, wound specialists, podiatrists, orthoticists and diabetes health educators from throughout the country.
Title: You and your treatment : starting on your medication for peripheral pain : pregabalin : patient information leaflet
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 133
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Abstract: Pregabalin is an effective new therapy used to relieve neuropathic pain (pain from damaged nerves), which can occur in your arms, hands, fingers, legs, feet or toes if you have diabetes, or in the area of the rash if you have had shingles (a painful rash that occurs after infection with herpes zoster). It is also used to treat fibromyalgia (a long-lasting condition that may cause pain, muscle stiffness and tenderness, tiredness and difficulty falling asleep or staying asleep).
Title: You and your treatment : hypoglycaemia (low blood glucose) in type 1 diabetes : patient information leaflet
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 135
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Abstract: Hypoglycaemia, also known as low blood sugar (or insulin reaction), occurs when levels of glucose (sugar) in the blood are too low. A person with symptoms and a blood glucose level below 3.3 mmol / l has hypoglycaemia. Some people with diabetes develop symptoms of hypoglycaemia at slightly higher levels, especially if blood glucose levels are high for long periods of time. Symptoms of low blood glucose may then become apparent as blood glucose levels decrease to 5.6 mmol / l.
Title: Novo Nordisk and LifeScan Diabetes Update Symposium : Centre for Diabetes and Endocrinology, Houghton, 8 August 2008 : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 136-138
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Abstract: Weighing the options in treatment regimens
Prescribing appropriate oral antidiabetic medication and insulin regimens that work synergistically with weight loss and exercise to retard diabetic disease progression is becoming a reality for clinicians.
Title: ADVANCE intensive glucose-lowering arm safely reduces microvascular complications, particularly nephropathy in type 2 diabetic patients : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 141, 143-144
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Abstract: The pragmatic and incremental strategy of intensive glucose lowering using modified-release gliclazide and other drugs as required is safe and provides significant protection for patients against major microvascular events. It may also provide longer-term benefit in cardiovascular event reduction, although this was not shown by the study, according to the leading investigators of the ADVANCE glucose-lowering arm of the study, which was released at the American Association of Diabetes (ADA) 2008 congress in San Francisco on Friday 6 June.
Title: Cardiometabolic risk-factor management : drug trends in diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 145-146
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Abstract: There is a linear relationship between increasing blood pressure (figure 1) and increasing risk for cardiovascular disease. However, when target-organ damage is present, this relationship is disturbed, causing the risk to increase rapidly. 'Hypertension is therefore about more than just blood pressure', Prof James Ker recently told a meeting hosted by Bayer-Schering Pharmaceuticals. 'We need to think of hypertension as having three components - blood pressure level, any sign of target-organ damage and any other cardiovascular risk factors.'
Title: Therapeutic substitution of antihypertensive drugs
From: South African Journal of Diabetes and Vascular Disease, Vol 5, Issue 3, Sep
Published: 2008
Pages: 146, 148
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Abstract: 'Generic substitution', which entails switching of a brand-name medication with an off-patent formulation of the identical molecule is a generally accepted practice. 'Therapeutic substitution', whereby a drug is exchanged for a different drug of the same class, is a far more contentious issue, especially as it is more often funder dictated than the result of a clinically based decision.

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