SAJDVD: VOLUME 18, ISSUE
1, JULY
2021
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- From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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- Prevalence of gestational diabetes mellitus in urban womenin Blantyre, Malawi: a cross sectional study evaluatingdiagnostic criteria and traditional risk factors
Authors: Tamara J Phiri, Marianne Kasiya, Theresa J Allain
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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Background: Gestational diabetes mellitus (GDM) is associated with maternal and neonatal complications. The application of appropriate diagnostic criteria is essential. There is a paucity of GDM prevalence data for African countries, including Malawi. Objectives: This study aimed to establish the prevalence of GDM in Blantyre, Malawi and assess the implications of applying different cut-off points for diagnosis as defined by WHO criteria and the recently established International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. It evaluated the relevance of internationally defined risk factors for GDM and compared the risk factors and prevalence between women accessing antenatal care in private hospitals to those accessing antenatal care at government hospitals. Patients at private hospitals are generally of a higher socio-economic status, have better access to care and are more likely to have a sedentary lifestyle and Westernised diet.
Methods: In this cross-sectional study, 2 274 consecutive women presenting at five antenatal clinic sites in Blantyre were screened for GDM, employing a random blood glucose (RBG) test. Of these, 250 women were randomly selected for an oral glucose tolerance test (OGTT). Logistic regression was used to quantify the association between various exposure variables and prevalence of GDM. Characteristics of patients attending government and private antenatal clinics were compared.
Results: The study population was predominantly urban, with a mean age of 25 years (range 14–43) with 66% being in the third trimester. The mean RBG level was 5.1 mmol/l (range 2.4–10.6) and overall prevalence of GDM based on the OGTT was 1.6 and 24% using the WHO and IADPSG criteria, respectively. GDM, diagnosed using WHO criteria, was associated with older maternal age, high parity, and attendance at government antenatal clinics but not with mid upper-arm circumference, a positive family history of diabetes mellitus (DM) or previous poor neonatal outcome. There was no correlation between RBG level and GDM diagnosed on the OGGT.
Conclusions: The prevalence of GDM in Blantyre using WHO criteria was low in the predominantly young population that was screened. A much higher proportion had GDM based on the IADPSG criteria and these may warrant long-term follow up. GDM was not associated with some previously described risk factors for GDM, suggesting a different riskfactor profile compared to the high-income countries.
- Severe bradycardia caused by diabetic ketoacidosis
Authors: João Ferreira, João Martins, Lino Gonçalves
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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Abstract: Atrial standstill is an uncommon but serious clinical entity that is often unrecognised in the clinical setting. Its diagnosis and treatment should be swift as malignant arrhythmias and thromboembolic complications can arise. We present a 79-year-old man brought to our emergency department with acute confusion, heart failure and severe bradycardia in the context of diabetic ketoacidosis, and discuss the diagnosis and management of this arrhythmic condition.
- Dairy-rich diet linked to lower risk of diabetes andcardiovascular disease
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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Introduction: Eating at least two daily servings of dairy is linked to lower risks of diabetes and high blood pressure, as well as the cluster of factors that heighten cardiovascular disease risk (the metabolic syndrome), finds a large international study, led by Dr Andrew Mente at the Population H ealth Research Institute, H amilton H ealth Sciences and McMaster University. The observed associations were strongest for full-fat dairy products, the findings indicated. Previously published research has suggested that higher dairy intake is associated with a lower risk of diabetes, high blood pressure and the metabolic syndrome. But these studies have tended to focus on North America and Europe to the exclusion of other regions of the world.
- Diabetes powerfully associated with CHD in women:Women’s Health study
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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Introduction: Diabetes and insulin resistance, in addition to hypertension, obesity and smoking, appeared to be the strongest risk factors for premature onset of coronary heart disease (CHD), found an analysis from the large, decades-long Women’s H ealth study.
- CVD the leading cause of death in patients with type 2 diabetes
From: South African Journal of Diabetes and Vascular Disease, Vol 18, Issue 1, July 2021
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Introduction: Cardiovascular disease was the leading cause of death among the over 16 000 patients with type 2 diabetes (T2DM) who were enrolled in the SAVOR-TIMI 53 trial. Two-thirds (66.3%) of all 798 deaths after a median 2.1 years of follow up were caused by one of five cardiovascular (CV) conditions, with sudden cardiac death accounting for the largest share (30.1%) of the total, Dr Ilaria Cavallari, and associates at the University Campus Bio-Medico of Rome, Italy said.
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RELIABLE EXPERT INFORMATION
The SAJDVD’s main focus is
providing new and relevant information for doctors,
nurses and allied professionals involved in caring
for the diabetes patient.
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
