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VOLUME 17 NUMBER 2 • NOVEMBER 2020
41
SA JOURNAL OF DIABETES & VASCULAR DISEASE
From the Editor’s Desk
Correspondence to: FA Mahomed
Head of Internal Medicine, Madadeni Hospital
Newcastle, KwaZulu-Natal
From the Editor’s Desk
T
his issue covers a range of topics, from stress hyperglycaemia
in an acute coronary syndrome (ACS) setting, the effects
of magnesium on cardiac contractility, and diabesity,
to the effect of weight loss on diabetes and the diabetogenic
associations of statins.
Yao
et al.
(page 42) examined the associations between initial
hyperglycaemia in the setting of ACS and various cardiovascular
outcomes in a study in Abidjan, Ivory Coast, and show similar
adverse associations to those seen in other studies.
1
Stress
hyperglycaemia also has an adverse association with acute stroke
outcomes,
2
and may be a marker of wider vascular dysfunction
and consequent poorer prognosis.
Aboalgasm and colleagues (page 48) studied the beneficial
effects of magnesium in rat cardiac contractility. Approximately
10% of hospitalised patients have hypomagnesaemia.
3
Magnesium is involved in over 300 known enzymatic reactions,
involving muscle, nerve and heart, and administration can
improve vascular tone, cardiac output and afterload. It can also
improve blood pressure
4
and insulin metabolism.
5
Perhaps wider
clinical trials may show great fundamental benefit for magnesium
supplementation in human health.
Dr Lombard discusses diabesity (page 56), especially focused
on drug causes and the rational use of drugs to reduce weight.
At a population level, governments need to assist with health
education (the promotion of healthy diet and exercise regimens)
and regulation of adverse dietary content of foods, especially
of so-called ‘junk food’, otherwise we will continue to see the
spiralling consequences of diabetes, hypertension and cardiac
disease.
6
Two articles from
Medical Brief
look at the effect of modest
weight loss on diabetes in the results of the Norfolk Diabetes
Prevention Study (page 63), and at the association between
statins and the increased risk of type 2 diabetes (page 64). Statins
have an undoubted beneficial effect on cardiac health, so risks
and benefits have to be weighed up when prescribing statins.
Patients also need to be counselled about these considerations.
New cholesterol-lowering drugs, such as the PCSK9 inhibitors,
may provide an alternative to statins and we eagerly await more
robust and detailed studies involving this new class of drugs.
This year, 2020, has been a difficult year for global health
due to the COVID-19 pandemic and we thank all our healthcare
workers for their dedication and selflessness during this period.
References
1. Al Jumaily T, Rose’meyer RB, Sweeny A, Jayasinghe R. Cardiac damage associated
with stress hyperglycaemia and acute coronary syndrome changes according to
level of presenting blood glucose.
Int J Cardiol
2015;
196
: 16–21.
2. Luitse MJA, Biessels GJ, Rutten GEHM, Kappelle LJ. Diabetes, hyperglycaemia,
and acute ischaemic stroke.
Lancet Neurol
2012;
11
(3): 261–271.
3. Swaminathan R. Magnesium metabolism and its disorders.
Clin Biochem Rev
2003;
24
(2): 47–66.
4. Houston M. The role of magnesium in hypertension and cardiovascular disease.
J Clin Hypertens
2011;
13
(11): 843–847.
5. Volpe SL. Magnesium and the athlete.
Curr Sports Med Rep
2015;
14
(4): 279–
283.
6. Farag YMK, Gaballa MR. Diabesity: An overview of a rising epidemic.
Nephrol
Dialysis Transplant
2011;
26
(1): 28–35.