VOLUME 9 NUMBER 3 • SEPTEMBER 2012
133
SA JOURNAL OF DIABETES & VASCULAR DISEASE
ADA WATCH
women who conceived after undergoing
bariatric surgery compared to women who
did not have bariatric surgery, suggesting
that bariatric surgery has at least a protec-
tive effect on maternal complications.
New lessons in hypertension and
diabetes: an update on clinical trials
and clinical guidelines
Peter Nilsson critically appraised the current
guidelines regarding the treatment of hyper-
tension in patients with diabetes. It is proven
that lowering blood pressure reduces the risk
for stroke. In the UKPDS, lowering blood pres-
sure also led to a reduction in retinopathy.
Most guidelines advocate treating blood
pressure at 140/80 mmHg or higher, or
at a lower blood pressure in the presence
of target-organ damage. While the ADA
guideline advocates treating blood pressure
to below 130/80 mmHg in diabetes, it is of
concern that randomised, controlled studies
and observational studies show either no
benefit or harm (increased coronary heart
disease risk) if the systolic blood pressure
goal is below 130 mmHg.
Refer to the new 2012 SEMDSA guidelines
for the management of type 2 diabetes.
Alternative markers of glycaemia in
the ARIC study
Quartiles of glycated albumin, fructosamine
and 1.5 anhydroglucitol (AG) levels were
assessed for utility as risk factor markers
for the development of diabetes in a subset
of patients from the ARIC study. Upper
quartiles of glycated albumin and fructos-
amine levels and the lowest quartile of AG
levels were associated with diabetes risk.
The value of these markers for predicting
long-term outcome should be assessed in
further studies, this Baltimore study recom-
mended.
Source: Jurascheck SP,
et al
.
Alternative markers of gly-
caemia and risk of diabetes in the Atherosclerosis Risk
In Communities (ARIC) study. (22 OR, abstract for oral
presentation).
Dr D Jivan
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