SA Journal of Diabetes & Vascular Disease: Vol 8, Issue 1, March 2011

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SAJDVD: VOLUME 8, ISSUE 1, March 2011

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Insulin therapy in South Africa : barriers, dilemmas and paradoxes : editorial
Authors: Mollentze, W.F.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 4
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Abstract: It is common knowledge that the quality of diabetes care is poor in the public healthcare sector in South Africa - evidence is not hard to find. Gill and co-workers demonstrated that it is possible to improve diabetes care at a rural primary healthcare clinic in KwaZulu-Natal by introducing a simple protocol and education-based diabetes care intervention system. Although some slippage of control did occur, this improvement was sustained for up to four years. Similarly, a chronic diseases outreach programme in Soweto successfully supported primary-health nurses in detecting patients with advanced disease, and ensuring early referral to a specialist centre. Resistance to switching patients to insulin is at least partly to blame for the poor quality of diabetes care.
Vitiligo : review
Authors: Adamjee, B.B.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 5-9
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Abstract: Vitiligo is an acquired, idiopathic condition characterised by well-circumscribed flat, non-palpable areas (macules) of total loss of melanin pigment (depigmentation). This depigmented skin is functionally different from normally pigmented skin. It does not react normally to contact sensitisation or to contact allergens and while normal white skin is prone to skin cancers, skin with vitiligo is generally resistant to carcinogenesis of keratinocytic origin. It is not susceptible to melanomas, due to the absence of melanocytes. By contrast, skin in albinism is susceptible to squamous cell carcinomas and rarely melanomas. Vitiligo affects approximately 0.5 to 2% of the general population and may appear from after birth to senescence. Peak age of onset is between 10 and 30 years. Both genders are probably equally affected, but the female predominance in some studies is likely attributable to concern about a cosmetic problem.
Genetic counselling in type 1 diabetes mellitus : review
Authors: Henderson, Bertram D.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 10-13
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Abstract: In 1976, James Neel, the renowned human geneticist, titled a book chapter 'Diabetes mellitus: a geneticist's nightmare'. Eleven years later, in 1987, Harry Keen wrote 'The genetics of diabetes: from nightmare to headache', closing with the title of Rotter's 1981 article 'no longer a nightmare but still a headache'. Since then a wealth of information has been accumulated about diabetes mellitus. Diabetes is now considered a group of metabolic disorders characterised by chronic hyperglycaemia resulting from defects in insulin secretion, action or both. In type 1 diabetes mellitus (T1D) there is destruction of the pancreatic islet β-cells. T1D is divided into type 1A where there is T-cell mediated destruction of the pancreatic islet β-cells, and type 1B where the destruction of these cells is not immune mediated. The full classification of diabetes is set out in Table 1. Diabetes mellitus, including T1D, is being diagnosed more frequently than previously, thus putting a greater demand on health resources. The identification of at-risk individuals in order to embark on preventative strategies has therefore become a valuable approach to the reduction of the diabetic burden of disease.
Living with diabetes in the family : review
Authors: Germishuizen, Shauna; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 13
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Abstract: Diabetes affects all members of the family, not just the individual suffering with the disease. Even when the patient is stable on medication, one tends to watch him like a hawk for any uncharacteristic behaviour that could indicate that something is amiss. Untreated sores could potentially become infected, lethargy could indicate hypoglycaemia, and lack of appetite any number of problems. And there is the constant niggle at the back of one's mind about possible long-term organ damage.
Diabetes and thyroid disorders : review
Authors: Brenta, Gabriela; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 14-18
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Abstract: It has long been recognised that thyroid hormones have marked effects on glucose homeostasis. Glucose intolerance is associated with hyperthyroidism and most recently it was shown that hypothyroidism is characterised by insulin resistance. Although autoimmune thyroid disease is more prevalent in type 1 diabetes as a result of their common origin, in patients with type 2 diabetes the prevalence of hypothyroidism and hyperthyroidism is similar to that of the general population. However, in type 2 diabetic patients, the presence of the highly frequent sub-clinical forms of hyperthyroidism and hypothyroidism should be ruled out since they may be associated with higher cardiovascular risk. While there are no doubts about the therapeutic impact of normalising hypothyroidism and hyperthyroidism, the information available about the benefit of treating sub-clinical thyroid disease in diabetes remains insufficient.
The new world of biosimilars : what diabetologists need to know about biosimilar insulins : review
Authors: Kramer, Irene; Sauer, Thomas; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 19-25
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Abstract: Biosimilar pharmaceuticals are emerging as patent protection on the original biopharmaceutical products expires. However, biopharmaceuticals are particularly complex molecules, and biosimilar insulins present special challenges. In part this reflects their structure and chemical modification after synthesis to attain a biologically active form. Their therapeutic window is narrow and the accuracy of their dosing is highly dependent on the formulation and quality of the administration device. For these reasons, the European Medicines Agency has issued stringent guidelines that must be fulfilled in order to receive approval as a biosimilar soluble insulin. Prescribers should therefore consider issues of manufacture, protein quality, formulation, reliability of supply, and other factors that might affect efficacy, safety and tolerability when making choices regarding the selection of biosimilar products.
You and your thyroid supplement : patient information leaflet
Authors: Van Zyl, P.M.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 26
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Abstract: Levothyroxine (T4) is the preferred drug for the treatment of hypothyroidism. Liothyronine (T3) is used in extreme cases requiring rapid response.
A passion for people : diabetes personality
Authors: Wagenaar, Peter; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 27-28
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Abstract: Port Elizabeth-based diabetes nurse educator, Sr Hannie Williams, believes that you cannot be a good nurse if you do not have a passion for people. She therefore makes her patients - and their individuality - central to her work.
In memoriam - Dr Mojapela Mhlakaza
Authors: Mollentze, W.F.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 28
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Abstract: Dr Mojapela Mhlakaza (52 years old) lost his life at the hands of unknown assailants who shot and killed him when he arrived home on 29 November 2010. A colleague described Dr Mhalakza as a softly spoken introvert and a gentleman. After qualifying as a medical practitioner in the USSR, Dr Mhlakaza eventually settled in Bloemfontein where he set up practice as a general practitioner with an interest in diabetes.
Extracts from the 11th annual South African Heart Association Congress, Aug 2010 : cardiovascular focus
Authors: Visagie, Gideon; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 29-30
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Abstract:
Antiplatelet agents
Acute coronary syndrome and atrial fibrillation
Primary pulmonary hypertension
Coronary heart disease and the millennium woman
Cardiotoxicity of anti-cancer agents, particularly in breast cancer
Direct thrombin inhibitors in atrial fibrillation
Chronic pulmonary thrombo-embolic disease
Cardiovascular care of older adults : challenging dynamics
Improving hypertension control in patients with diabetes : the case for telmisartan-based therapy : opinions in hypertension management
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 31-32
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Abstract: Strategies to improve hypertension control are clearly warranted in light of the frequently expressed view that only 50% of treated hypertensive patients are able to meet their target blood pressure levels.
Report from the Advanced Technologies and Treatments for Diabetes meeting, London, 16-19 February 2011 : cutting edge of diabetes technology
Authors: Segal, David; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 32-33
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Abstract: After completion of yet another successful ATTD conference, the mind is suitably topped up with the latest advances in diabetes care. This is the fourth annual conference, which has grown from a mere 250 delegates in 2008 to over 1 200 delegates in 2011, testimony to the thirst for knowledge in the diabetes field and the calibre of the content of this meeting. The ATTD meeting provides a forum for exchange of ideas with chief opinion leaders and researchers in diabetes and what follows is a summary of some of the major themes and sessions.
Diary for 2011 diabetes congresses
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 33
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Abstract: Diary for 2011 diabetes congresses.
Boehringer Ingelheim and Eli Lilly and Company announce strategic alliance to bring new diabetes treatments to patients worldwide : industry news
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 34 Full text: Click here to order »
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Abstract: Boehringer Ingelheim (Germany and Indianapolis, USA) and Eli Lilly and Company (NYSE: LLY) recently announced a global agreement to jointly develop and commercialise a portfolio of diabetes compounds currently in mid- and late-stage development. Included are Boehringer Ingelheim's two oral diabetes agents, linagliptin and BI10773, and Lilly's two basal insulin analogues, LY2605541 and LY2963016, as well as the option to co-develop and co-commercialise Lilly's anti-TGF-beta monoclonal antibody.
Diabetes alliance between Novo Nordisk and Accu-Chek® : industry news
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 34
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Abstract: Novo Nordisk (Pty) Ltd and Roche Diabetes Care - Accu-Chek® are proud to announce that they have formed a partnership to improve the overall management of patients with diabetes through a comprehensive product and support package. These two leading companies aim to change diabetes care in South Africa and strengthen the way forward for those people living with diabetes.
Clinical perspectives on managing diabetes : an expert South African view : drug trends
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 37-41
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Abstract: At a recent meeting of specialist diabetologists held in Sun City, out-spoken South African clinicians challenged firstly, the simplistic approach of treating all type 2 diabetes patients as a single homogenous group, and secondly, compartmentalising type 1 and type 2 diabetes into two separate groups. Human nature seeks to simplify and reduce complexity in order to manage the issues at hand; yet in doing this, clinicians may undervalue breakthroughs in knowledge and practice.
Managing heart failure patients : choosing the best angiotension receptor blockers : drug trends
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 42
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Abstract: Mortality in heart failure patients with impaired left ventricular ejection fraction (LVEF) was significantly reduced with candesartan in comparison to losartan in a large population of patients in everyday care. Fifteen per cent of the patients in this registry study of Swedish patients had diabetes; as could be expected from broad estimations that one in five diabetic patients will develop heart failure in the course of their disease.
Substantial evidence for colorectal cancer reduction with daily low-dose aspirin : drug trends
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 45
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Abstract: Mortality in heart failure patients with impaired left ventricular ejection fraction (LVEF) was significantly reduced with candesartan in comparison to losartan in a large population of patients in everyday care. Fifteen per cent of the patients in this registry study of Swedish patients had diabetes; as could be expected from broad estimations that one in five diabetic patients will develop heart failure in the course of their disease.
Autoimmunity in a South African and African context : journal update
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 46-47
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Abstract: This review of the latest international journals focuses on the theme of autoimmunity with the particular inclusion of recent articles by South African researchers in the broader field of diabetes care.
Diabetes news
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 1, Mar, Pages: 48
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Abstract: Changing Diabetes Day village - 'Let's take control of diabetes - now'.
Diabetes youth camps.

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