SAJDVD: VOLUME 6, ISSUE 4, NOVEMBER 2009
  1. Gestational diabetes : time to act : editorial
    Authors: Kramer, Brian D.; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 131-133
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    Abstract: Gestational diabetes (GDM) is defined as any glucose intolerance detected for the first time during pregnancy. Therefore this embraces a heterogeneous group of conditions categorised by any degree of hyperglycaemia, including type 1 diabetes (T1DM) and monogenic forms of diabetes. However, this is most often understood to mean a transient form of diabetes emerging during the second half of pregnancy and remitting post partum. Although this latter form of diabetes, including the attendant risk of producing large-for-gestational-age babies and conferring a higher risk of future maternal diabetes has long been recognised, it is only relatively recently that the true spectrum of risk associated with this has begun to emerge.

  2. C-reactive protein as a marker of cardiovascular risk. Chicken, egg or turkey? : editorial
    Authors: Karet, Brian; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 134-139
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    Abstract: In 2006 cardiovascular disease (CVD) cost the UK ₤14.4 billion in health care costs alone, of which ₤3.2 billion was attributable to coronary heart disease (CHD). Social costs including employment and community care were estimated to have cost another ₤12 billion. In 2004, there were about 216,000 deaths from CVD, about half of which were from CHD. However, death rates from CHD have been falling. Between 1997 and 2006 death rates for men between 55 and 64 years of age fell by almost 50% and it seems that half of this reduction is due to improvements in the management of risk factors. Lifestyle and therapeutic interventions are available for the major risk factors for CVD, namely smoking, high blood pressure, dyslipidaemia, obesity and diabetes. Given the cost implications, how to focus these interventions on the most appropriate groups and individuals is a challenge for all health economies.

  3. Should we measure C-reactive protein in risk assessment? : comment
    Authors: Dalby, Anthony J.; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 139-140
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    Abstract: In his review, Karet presents a critical discussion of the role of C-reactive protein (CRP) in the prediction of atherosclerotic cardiovascular disease (ASCVD). He points out that although the measurement of ultra-sensitive or high-sensitivity CRP has been put forward as a means of enhancing the predictive accuracy of our current risk-factor scoring systems, certain studies have called this proposal into question, finding no relationship between the CRP level and the risk of ASCVD. In general, he finds support for the view that CRP does not add to the accuracy of the usual risk-prediction tools because elevations of CRP, occurring as they frequently do in conjunction with recognised risk factors, turn out to be too non-specific. More recent studies also support this view. Furthermore, because CRP is an acute-phase reactant that may be elevated in a wide variety of inflammatory conditions and may vary with time, gender and ethnic origin, its accuracy in predicting ASCVD is further compromised.

  4. Smoking cessation 1 : choosing the right pharmacotherapy for each patient : review
    Authors: Aveyard, Paul; Parsons, Amanda; Begh, Rachna; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 141-142
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    Abstract: Most smokers want to stop smoking and intend to stop at some point, according to cross-sectional studies. Nearly half of all smokers expect not to be smoking in a year's time, but only two to three in every hundred actually stop smoking permanently each year. It is widely recognised that healthcare professionals have an important role to play in helping patients to stop smoking, but what is the best way to achieve this?

  5. Smoking cessation 2 : nicotine replacement therapy - new tricks with old drugs : review
    Authors: Aveyard, Paul; Parsons, Amanda; Begh, Rachna; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 143-146
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    Abstract: Mike Russell, who did much to create the current understanding of smoking as tobacco addiction said 'smokers smoke for the nicotine but die from the tar'. If this is so, it should be possible to provide enough nicotine replacement and keep smokers satisfied and thus help them to stop. Years later, we now have evidence that nicotine replacement is effective, but nicotine replacement therapy is, from this perspective, surprisingly ineffective. In this piece, we examine how primary care physicians can help smokers get more from nicotine replacement therapy (NRT).

  6. Clinical notes from 2009 EASD by attending clinician Dr Ahmed, Isipingo Hospital, Natal
    Authors: Zaleznik, D.F.; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 146, 155
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    Abstract: Glycaemic control in type 2 diabetes was better maintained with iraglutide than with the sulfonylurea drug, glimepiride, over two years and had a better side-effect profile.

  7. Starting on a statin to prevent heart and vascular disease and stroke : patient information leaflet
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 147
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    Abstract: Statins are a treatment to lower your cholesterol level. Cholesterol is a type of fat, or lipid, found in your blood.

  8. Cardiovascular and diabetes aspects of hypothyroidism : review
    Authors: Lazarus, John; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 149-150
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    Abstract: Hypothyroidism is common in adults and the prevalence of sub-clinical hypothyroidism is high in women, with various studies showing a range of 4 to 21% (average 7-10%) frequency in the population. 'The incidence of thyroid disease increases with age and impacts on cholesterol levels', said Prof John Lazarus at a recent CME meeting hosted by Merck Serono. 'We see a mean serum total cholesterol increase with increasing thyroid-stimulating hormone (TSH) levels.'

  9. More local news from the IDF conference
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 150
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    Abstract: Dr Areti Philotheou chaired the main session on diabetes in youth, with much-appreciated, heart-felt messages about the plight of children in the developing world. Dr Philotheou was one of the animated discussants, part of a very select psychopedagogic quartet, expounding for two hours to an enthralled audience what a Socratic dialogue on patient empowerment is all about.

  10. Diabetes and breastfeeding : diabetes educator's focus
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 152-155
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    Abstract: Worldwide, the race is finally on in earnest to meet the millennium development goals. Child survival is the key strategy. It has been shown that 13% of all deaths in children under five years old could be averted by successful breastfeeding alone. Other key interventions such as early mother-infant contact and skin-to-skin care can also save millions of lives.
     
  11. A primary care role model for diabetic patients : diabetes personality
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 156-157
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    Abstract: Providing quality care for diabetes mellitus patients in a resource-poor primary healthcare setting is fraught with challenges. But that doesn't stop dedicated, caring professionals like Sr Sesi Ramonotsi from doing everything possible to ensure that her patients get the best possible care at all times.
     
  12. EASD Watch - 2009 update from Vienna, Austria : summaries
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 158-163
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    Abstract: Cardiovascular disease and hypoglycaemia risk according to cognitive function in people with type 2 diabetes : ADVANCE study
    Diabetes and pregnancy: determinants of neonatal and maternal complications: HAPO study
    Melatonin : good morning to an unexpected culprit in type 2 diabetes
    Novel therapies for type 2 diabetes mellitus : Treatment with VI-0521 (phentermine and topiramate) leads to one-year durable glycaemic benefit and weight loss in subjects with type 2 diabetes mellitus
    Pregnancy outcomes in women with hyperinsulinaemia and impaired glucose tolerance, prophylactically treated with metformin: a case-control study
    To amputate or not?
    Diabetes education and management
    Diabetes in childhood
    Paradigms in metabolic disease
    Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding
    Colesevelam HCl improves glucose metabolism and increases plasma glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) concentrations in subjects with type 2 DM
    Hepatic steatosis does not result in hepatic insulin resistance in subjects with familial hypobetalipoproteinaemia.
     
  13. IDF Watch - 2009 update from Montreal : summaries
    Authors: Mollentze, W.F.; Aalbers, J.; Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 164-166
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    Abstract: Spotlight on the developing world
    Glucose-lowering agents and risk of malignancy
    Haemoglobin A1c as a diagnostic test for diabetes?
    The role of beta-cell mass and function in the pathogenesis of type 2 diabetes
    Where are we regarding the PPAR-agonists 10 years on?
    Progress in foot care
    New IDF study reveals that people in developing countries pay more for diabetes care and have poorer health results.
     
  14. Efficient and safe glucose control in type 2 diabetes : new ADVANCE results from IDF
    Comments from attending South African experts : drug trends
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 167-168, 170 Full text: Click here to order »
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    Abstract: The ADVANCE study on glucose lowering in type 2 diabetes patients continues to add to clinicians' understanding on the benefits of using a pragmatic and incremental approach to lowering glucose levels in these patients. In this study, a gliclazide MR-based treatment regimen was shown to be both safe and efficient.
     
  15. Diabetes care products
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 170
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    Abstract:
    Focus on Flora Pro-activ
    Equisweet with sucralose : all-round sweet treat
     
  16. It is now possible to improve symptoms and prognosis in angina patients : advertorial : drug trends
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 171-172
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    Abstract: Coronary artery disease (CAD) remains the leading cause of mortality and morbidity worldwide. Ischaemic heart disease, together with stroke and congestive heart failure, account for at least 80% of the burden of cardiovascular disease (CVD) in both high- and low-income regions. Although HIV / AIDS-related diseases are the leading cause of death in South Africa, CVD is second, and it is the number one killer in those over the age of 30. Despite recent advances, mainly in terms of secondary prevention, chronic CAD remains a major public health concern and its management continues to pose a serious challenge to contemporary cardiology. But do we actually see patients with angina in daily practice?
     
  17. Practical guidance on intensifying insulin therapy in type 2 diabetes using BIAsp 30 : drug trends
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 174
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    Abstract: The recently released consensus guidelines prepared by endocrinologists from the UK, the USA, Europe and the developing world (India, China and Turkey), focusing on how to introduce BIAsp 30 when intensifying insulin therapy in type 2 diabetes, fills an important gap in clinical guidelines. The international expert panel met at a Novo Nordisk-sponsored symposium in October last year with the specific purpose of providing practical guidance to general and specialist practitioners.
     
  18. Diabetes news
    Authors: Published: 2009
    From: South African Journal of Diabetes and Vascular Disease, Vol 6, Issue 4, Nov, Pages: 176
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    Abstract: The International Diabetes Federation (IDF) released new data recently showing that a staggering 285 million people worldwide have diabetes. The latest figures from the IDF Diabetes Atlas indicate that people in low- and middle-income countries (LMCs) are bearing the brunt of the epidemic, and that the disease is affecting far more people of working age than previously believed.
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