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SAJDVD: VOLUME 17, ISSUE 2, December 2020

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From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, November 2020
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Prognostic value of admission hyperglycaemia in black Africans with acute coronary syndromes: a cross-sectional study
Authors: Hermann Yao, Arnaud Ekou, Thierry Niamkey, Camille Touré, Charles Guenancia, Isabelle Kouamé, Christelle Gbassi, Christophe Konin, Roland N’Guetta
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, December 2020
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Aim: The aim of the study was to determine the relationship between acute hyperglycaemia and in-hospital mortality in black Africans with acute coronary syndromes (ACS).
Methods: From January 2002 to December 2017, 1 168 patients aged ≥ 18 years old, including 332 patients with diabetes (28.4%), consecutively presented to the intensive care unit of the Abidjan Heart Institute for ACS. Baseline data and outcomes were compared in patients with and without hyperglycaemia at admission (> 140 mg/dl; 7.8 mmol/l). Predictors for death were determined by multivariate logistic regression.
Results: The prevalence of admission hyperglycaemia was 40.6%. It was higher in patients with diabetes (55.3%).In multivariate logistic regression, acute hyperglycaemia (hazard ratio = 2.33; 1.44–3.77; p < 0.001), heart failure (HR = 2.22; 1.38–3.56; p = 0.001), reduced left ventricular ejection fraction (HR = 6.41; 3.72–11.03; p < 0.001, sustained ventricular tachycardia or ventricular fibrillation (HR = 3.43; 1.37–8.62; p = 0.008) and cardiogenic shock (HR = 8.82; 4.38–17.76; p < 0.001) were predictive factors associated with in-hospital death. In sub-group analysis according to the history of diabetes, hyperglycaemia at admission was a predictor for death only in patients without diabetes (HR = 3.12; 1.72–5.68; p < 0.001).
Conclusion: In ACS patients and particularly those without a history of diabetes, admission acute hyperglycaemia was a potentially threatening condition. Appropriate management, follow up and screening for glucose metabolism disorders should be implemented in these patients.
Improvement of cardiac ventricular function by magnesium treatment in chronic streptozotocin-induced diabetic rat heart
Authors: Hamida Aboalgasm, Morea Petersen, Asfree Gwanyanya
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, December 2020
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Objective: Chronic diabetes mellitus is associated with detrimental cardiovascular complications and electrolyte imbalances such as hypomagnesaemia. We investigated the effect of magnesium (Mg2+) on cardiac function and the possible role of histological and electrical alterations in chronic, streptozotocin-induced diabetic rats.
Methods: Wistar rats were treated once intraperitoneally with streptozotocin or citrate, and then daily with MgSO4 or saline for four weeks. Cardiac contractile and electrocardiographic parameters were measured on Langendorff-perfused hearts.Other hearts were histologically stained or immunoblotted for the mitochondrial ATP synthase (ATP5A).
Results: In diabetic hearts, Mg2+ prevented a diabetes-induced decrease in left ventricular developed pressure and improved contractility indices, as well as attenuated the reduction in heart rate and prolongation of QT interval, but not the QT interval corrected for heart rate (QTc). Histologically, there were neither differences in cardiomyocyte width nor interstitial collagen. The expression of ATP5A was not different among the treatment groups.
Conclusion: Mg2+ supplementation improved cardiac contractile activity in chronic diabetic hearts via mechanisms unrelated to electrocardiographic or histologically detectable myocardial alterations.
‘Diabesity’: interlinking treatments to improve outcomes in diabetes and obesity
Authors: Takalani Clearance Muluvhu, Makama Andries Monyeki, Gert Lukas Strydom, Abel Lamina Toriola
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, December 2020
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Introduction: Over recent decades obesity has emerged as the largest chronic health concern globally, with major driving factors being the consumption of high-calorie, high-carbohydrate and high-fat foods and a shift towards a sedentary lifestyle. Moreover, the incidence of severe obesity [i.e. a body mass index (BMI) > 40 kg/m2] is increasing rapidly and carries an especially elevated mortality risk. Obesity is associated with more than 45 co-morbidities and is known to be the primary risk factor for cardiovascular disease, type 2 diabetes mellitus (T2DM), hypertension, coronary heart disease and certain types of cancer. Obesity is also a cause of diverse psychological problems and various physical disabilities, including a significantly
increased risk of developing an arthritic condition. In the context of the COVID-19 pandemic, obesity and diabetes are associated with more severe outcomes of the disease and markedly increased mortality. The infection itself may precipitate acute metabolic complications through direct negative effects on pancreatic β-cell function.
A few kilograms’ weight loss nearly halves the risk of diabetes: large UK clinical trial
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, December 2020
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Introduction: Losing a few kilograms in weight almost halves people’s risk of developing type 2 diabetes, according to a large-scale research study led by the Norfolk and Norwich University Hospital and the University of East Anglia, published in J Am Med Assoc Internal Medicine. The study shows how providing support to help people with pre-diabetes make small changes to their lifestyle, diet and physical activity can almost halve the risk of developing type 2 diabetes.
Statins linked to doubled risk of type 2 diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 17, Issue 2, December 2020
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Introduction: A study of thousands of patients’ health records found that those who were prescribed cholesterol-lowering statins had at least double the risk of developing type 2 diabetes. The detailed analysis of health records and other data from patients in a private insurance plan in the Midwest provides a real-world picture of how efforts to reduce heart disease may be contributing to another major medical concern, said Victoria Zigmont, who led the study as a graduate student in public health at The Ohio State University.

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