SA Journal of Diabetes & Vascular Disease: Vol 10, Issue 2, June 2013

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SAJDVD: VOLUME 10, ISSUE 2, JUNE 2013

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Non-communicable diseases: an ongoing challenge : editorial
Authors: Lombard, Landi; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 47
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Abstract: The global burden of cardiovascular disease and diabetes presents a major challenge to health systems and human development. A series of five papers on non-communicable diseases (NCDs), recently published in Lancet, presents the latest results and ideas from some of the world's most eminent scientists. In the first Series paper, Sir George Alleyne and fellow researchers highlight the fundamental link between health and development and the disproportionate effect that NCDs have on poor people. According to Alleyne, "Health is essential to the ability of people to contribute to sustainable development, productivity, economic growth; and to adapt to environmental change. Since NCDs are a major contributor to ill health... any realistic attempt to make human development sustainable must take NCDs into account."
Dyslipidaemia in Type 2 diabetes : review
Authors: Blom, Dirk J.; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 48-50 Full text: Click here to order »
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Abstract: Cardiovascular disease is the commonest cause of death in patients with type 2 diabetes (T2DM) and dyslipidaemia is an important atherosclerotic risk factor. Dyslipidaemia is very common in T2DM and is characterized by mild to moderate hypertriglyceridaemia, low high density lipoprotein cholesterol (HDL-C) and the presence of small dense low density lipoprotein (LDL) particles. Almost all patients with T2DM will require lipid lowering therapy with statins aiming for a target LDL-cholesterol of 1.8 mmol/l in the majority of patients. Younger patients with a shorter duration of diabetes and no other risk factors can be treated to a target of 2.5 mmol/l. The role of statin and fibrate combination therapy in reducing residual risk by ameliorating hypertriglyceridaemia and low HDL-cholesterol that may persist despite statin monotherapy is not well defined and is not included in guideline recommendations. Diabetes is the commonest secondary cause of severe hypertriglyceridaemia that may trigger acute pancreatitis. Patients with severe hypertriglyceridaemia require good glycaemic control, a very low fat diet and a fibrate.
Diabetes mellitus and the skin : review
Authors: Kannenberg, S.M.; Visser, W.I.; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 51-53
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Abstract: The skin may provide vital clues for the diagnosis of diabetes mellitus (DM). Certain skin signs may even portend advanced disease. Skin complications associated with DM may lead to severe impairment in the quality of life. Recognising various skin signs is critical in the diagnosis and management of patients with DM. This review will aim to overview the diagnosis and management of some of the important skin conditions associated with DM.
Hypertension and associated factors in older adults in South Africa : review
Authors: Peltzer, Karl; Phaswana-Mafuya, Nancy; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 54-58
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Abstract: Background: Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Little attention has been focused on hypertension and associated factors among older adults in Africa. Therefore, this study aimed to investigate the prevalence and associated factors of hypertension in a national sample of older South Africans who participated in the Study of Global Ageing and Adults' Health (SAGE) in 2008.
Methods: In 2008 we conducted a national, population-based, cross-sectional study of a sample of 3 840 subjects aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements.
Results: The prevalence of hypertension in the sample population was 77.3% (male 74.4%, female 79.6%). The rates of awareness, treatment and control among the hypertensive participants were 38.1, 32.7 and 17.1%, respectively. The results of multivariate logistic regression analysis revealed that the prevalence of hypertension was associated with being in the Coloured population group, having had a stroke, being overweight or obese and having had five or more outpatients care visits in the past 12 months. Hypertension was inversely associated with current alcohol use.
Conclusion: This study revealed high rates of hypertension among older adults (50 years and more) in South Africa, which puts them at risk for cardiovascular disease. The percentages of hypertensive subjects who were aware, treated and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure-monitoring systems to better manage hypertension among older adults in South Africa.
The ADVANCE cardiovascular risk model and current strategies for cardiovascular disease risk evaluation in people with diabetes : review
Authors: Kengne, Andre Pascal; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 59, 61-64
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Abstract: Purpose: To critically examine existing approaches to cardiovascular disease (CVD) risk evaluation in people with diabetes, and discuss the use of accurate and validated absolute CVD risk tool as an appropriate basis for CVD prevention in people with diabetes.
Methods: Narrative review, using evidence from the ADVANCE study and all relevant publications identified via PubMed MEDLINE.
Results: There is sufficient evidence that diabetes does not confer a CVD risk equivalent to that in non-diabetic people with existing CVD in all circumstances. In people with diabetes, CVD risk follows a gradient. Reliably capturing this gradient depends upon an adequate combination of several risk factors. Many global CVD risk tools applicable to people with diabetes have been developed. Those derived from older cohorts are less accurate in contemporary populations and many newer tools have not been tested. The ADVANCE risk engine, recently developed from the large multinational ADVANCE study, showed acceptable performance on the ADVANCE population and largely outperformed the popular Framingham risk equation when tested on the multinational DIAB-HYCAR cohort of people with type 2 diabetes.
Conclusions: The high-risk status conferred by diabetes does not preclude estimation of absolute CVD risk using tools such as the ADVANCE risk engine and its use as the basis for initiating and intensifying CVD preventative measures. Adopting such an accurate and validated tool will likely improve prescriptions and outcomes of diabetes care.
Vitamin D and diabetes - a D-lemna : review
Authors: Conradie, Marli; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 65-66
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Abstract: The worldwide prevalence of diabetes, most notably Type 2 diabetes (T2DM), is increasing rapidly. Estimated projections for Sub-Saharan Africa are a prevalence of 18.6 million by 2030. Most strategies to halt this increase have been aimed at preventing or treating obesity as a major risk factor for the development of diabetes. Unfortunately, most efforts have failed and the prevalence of obesity remains alarmingly high. Novel risk factors for the development of diabetes have been described. Included are adipose-derived factors (e.g. adiponectin and leptin), liver-derived factors (e.g. CRP and ALT/GGT ratio), endothelial-derived factors, inflammatory markers and nutritional factors. To be considered amongst the nutritional factors is the link between hypovitaminosis D and diabetes.
Aim for tighter control in hypothyroid disorders : drug trends
Authors: Wagenaar, P.; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 67
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Abstract: When it comes to the management of hypothyroid disorders, it's important to aim for tighter control and to get thyroid-stimulating hormone (TSH) levels to target. This is the message conveyed by Dr Sindeep Bhana, a Johannesburg endocrinologist who works in the public sector. He was speaking at the Johannesburg launch of Abbott Laboratories' Synthroid, a new levothyroxine sodium formulation that gives healthcare professionals an additional option for the treatment of hypothyroidism.
Improving cholesterol management : lifestyle changes and taking medicine : patient information leaflet
Authors: Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 68-69
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Abstract: Many factors can cause unhealthy cholesterol levels. Most of these factors can be modified, but some cannot be changed. High blood cholesterol can be inherited, but even so, action can be taken to lower levels of bad (LDL) cholesterol. Cholesterol levels also rise as we age and in the case of women, menopause may elevate cholesterol levels too. Factors under our control include diet, weight and levels of physical activity. Of equal importance, if taking cholesterol-lowering medicines, we need to learn to take them properly.
Minimising travel-associated risks in cardiac and diabetic patients : diabetes educators' focus
Authors: Klotnick, Jonathan; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 70-71
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Abstract: Travel, especially when it involves long-haul flights, can be hazardous to some patients with cardiac conditions and diabetes. It is important therefore for their doctors and nurses/educators to be aware of this and advise them accordingly.
Diabetes camps provide fun and education for young people living with the condition : diabetes news
Authors: Wagenaar, Peter; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 72-73
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Abstract: The history of Youth With Diabetes' camps for young people with the condition goes back to the middle of the last decade, when diabetes nurse educator, Sr Hester Davel, from the Centre for Diabetes and Endocrinology, and paediatric endocrinologist, Dr David Segal, recognised a need for them. "I had always wanted to create a space for children with diabetes where they could play, laugh, sing, paint and just feel at one with each other," says Hester. "A place where they could experience unconditional love and where everything they needed would be available to them. In addition, I wanted to raise awareness of diabetes among children."
Cardiology & Diabetes At The Limits 2013 : conference report
Authors: Dalby, A.J.; Aalbers, J.L.; Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 74-75
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Abstract: The 15th At The Limits conference was held in Cape Town under the auspices of the Hatter Institute and organised and chaired by Prof Derek Yellon of University College London and Prof Lionel Opie of the University of Cape Town. The meeting was sponsored by AstraZeneca, Bayer HealthCare, Boehringer Ingelheim, Bristol-Myers Squibb, Discovery Health, Medtronic, Novo Nordisk, Roche, Servier, Takeda and The Coca-Cola Company.
4th All African Conference on Heart Disease, Diabetes and Stroke
11th Pan African Society of Cardiology (PASCAR) Conference : conference report
Authors: Published: 2013
From: SA Journal of Diabetes and Vascular Disease, Vol 10, Issue 2, Jun, Pages: 76-80
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Abstract: The 4th All African Conference on Heart Disease, Diabetes and Stroke was hosted in Dakar, Senegal, 16th-20th May, 2013. A record turnout of both registered delegates and number of African nations represented reflected kudos on the co-hosts PASCAR and the Senegalese Society of Cardiology (SOSECAR). Selected abstracts are reported by theme; view the full book of abstracts at http://www.cvja.co.za/onlinejournal/vol24/pascar_2013/

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