The SA Journal Diabetes & Vascular Disease Vol 13 No 1 (July 2016)

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DRUG TRENDS SA JOURNAL OF DIABETES & VASCULAR DISEASE
50 VOLUME 13 NUMBER 1 • JULY 2016
that no more than one-quarter of South
Africans with diabetes currently achieve and
maintain their glucose target levels, even
at tertiary care and university-associated
hospitals.7,8 These speakers highlighted the
importance of education for both patients
and healthcare providers and the need
for effective treatments that are easy to
administer with a low risk of side effects.
Endocrinologist Dr Zane Stevens and
renowned expert in clinical pharmacology,
Prof Jacques Snyman, reviewed highlights in
the history of insulin and the development
of novel molecules that have revolutionised
the lives of people with diabetes. These
treatments, which are easier to use,
require less frequent administration and
are less likely to cause serious side effects,
such as excessive drops in blood glucose
levels (hypoglycaemia) or weight gain, are
expected to go at least part of the way in
making glucose targets more achievable.
To close the meeting, Dr Manash Baruah,
director and consultant endocrinologist at
the Excel Centre, Guwahati, India, provided
some insight into clinical experience with
new diabetes treatments that are expected
to be available soon.
Novo Nordisk’s ongoing
commitment to diabetes care
The new-generation insulin summit forms
part of Novo Nordisk’s annual education
programme for healthcare professionals,
in addition to their incretin and diabetes
summits. Globally, only a minority of people
who receive diabetes care end up achieving
the desired health outcomes.1 This means
that millions of people worldwide do
not reach their goal of living a life free
of diabetes-related complications. Novo
Nordisk is committed to reducing this
number by providing ongoing education,
patient-friendly treatment solutions, and
supporting and encouraging patients in
effective self-management.
Dr Manash Baruah
For more information, please contact: Kerrin
Tessendorf on (011) 280-6679.
e-mail:
1. International Diabetes Federation. IDF Diabetes
Atlas, 7th edn. Brussels, Belgium: International
Diabetes Federation, 2015.
diabetesatlas. Accessed 11 May 2016.
2. Novo Nordisk. Diabetes is changing the world. How
can we change diabetes? Available at hyyp://www.
Accessed 12 May 2016.
3. Holman RR, Paul SK, Bethel MA, et al. 10-year
follow-up of intensive glucose control in type 2
diabetes. N Engl J Med 2008; 359: 1577–1589.
4. Chan JL, Abrahamson MJ. Pharmacological
management of type 2 diabetes mellitus: rationale
for rational use of insulin. Mayo Clinic Proc 2003;
78: 459–467.
5. Ross SA. Breaking down patient and physician
barriers to optimize glycaemic control in type 2
diabetes. Am J Med 2013; 126(9 Suppl 1): S38–
S48.
6. Nicolucci A, et al. Diabetes Attitudes, Wishes and
Needs second study (DAWN2™). Cross-national
benchmarking of diabetes-related psychosocial
outcomes for people with diabetes. Diabet Med
2013; 30: 767–777.
7. Pinchevsky Y, Butkow W, Raal FJ, et al. The
implementation of guidelines in a South African
population with type 2 diabetes.J Endocrinol Metab
Diabetes S Afr 2013; 18(3): 154–158.
8. Ngassa Piotie P, van Zyl DG, Rheeder P. Diabetic
nephropathy in a tertiary care clinic in South Africa:
a cross-sectional study. J Endocrinol Metab Diabetes
S Afr 2015; 20(1): 67–73.
Adjusted mean diastolic blood pressure
levels were found to be significantly
higher in women compared to men, but
other risk factors were almost the same
between genders, according to recent
research.
Williams and colleagues conducted a
cross-sectional study in which patients were
randomly recruited from three primary care
clinics in the south-eastern USA and asked
to complete a self-report survey yielding
data relevant to gender differences in
cardiovascular disease (CVD) risk-factor
control. The primary outcomes were
individual diabetes-related risks, which were
defined as not having an HbA1c level < 7%,
blood pressure of < 130/80mmHg, and low-
density lipoprotein (LDL) cholesterol level <
100 mg/dl (2.59 mmol/l), and composite
control defined as having all three outcomes
under control simultaneously.
Of the patients enrolled, 56% were
men, 67% were non-Hispanic black, and
Gender differences in the control of multiple cardiovascular disease
risk factors in type 2 diabetes patients
78% made less than $35 000 per year.
Unadjusted mean systolic blood pressure
(134 vs 13 mmHg, p = 0.005) and LDL
cholesterol levels [99.7 vs 87.6 mg/dl (2.58
vs 2.27 mmol/l), p < 0.001] were much
higher in women than in men; however,
after adjusting for relevant confounders,
differences in systolic blood pressure and
LDL cholesterol levels were not significant.
Adjusted mean diastolic blood pressure
levels were found to be significantly higher
in women compared to men (β = 3.09,
95% CI = 0.56–5.63).
Regarding the gender differences in
composite control, the results showed that
women had poorer control of multiple
CVD risk outcomes than men (β = 2.90,
95% CI = 1.37–6.13). Other primary
outcomes were not statistically significantly
different, including glycaemic control in
both genders.
Limitations of this study included the
fact that the cross-sectional study design
did not prove causal associations. Also,
confounders not controlled for included
diabetes knowledge, self-management
practices, medication adherence,
co-morbidity burden, social support,
duration of diabetes, medications used
to treat diabetes, and hypertension. In
addition, high triglyceride level was an
independent risk factor for coronary heart
disease, particularly for women.
In conclusion, further study is needed. In
the meantime, both genders, but especially
women, need to be encouraged to adopt
healthy lifestyle habits with a view to
modifying their risk factors and achieving
better outcomes.
1. Williams J, Lunch C, Winchester R, et al. Gender
differences in composite control of cardiovascular
risk factors among patients with type 2 diabetes.
Diabetes Technol Therapeut 2014; 16(7): 421–
427.
2.
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