SA Journal of Diabetes & Vascular Disease: Vol 8, Issue 2, June 2011

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SAJDVD: VOLUME 8, ISSUE 2, JUNE 2011

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Women and diabetes : editorial
Authors: Mahomed, F.A.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 51
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Abstract: The theme for this issue of the journal is 'women's healthcare and diabetes'. Women face a number of factors that have a profound effect on their health and this issue looks at some of these.
Taking women into the new millennium : updated guidelines for prevention of cardiovascular disease : editorial
Authors: Rapeport, Naomi; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 52-53
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Abstract: A pandemic of cardiovascular disease (CVD) is afflicting women. Heart disease is the leading cause of death in women in every major developed country and most emerging economies. Although it is often thought of as a disease of affluence, CVD mortality rates in women over the age of 60 years are more than double in low- and middle-income countries than in high-income countries.
Diabetes care in pregnancy : review
Authors: Green-Thompson, R.R.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 54-57
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Abstract: The incidence of diabetes mellitus has increased dramatically over the last four decades, particularly type 2 and gestational diabetes. This is a consequence of obesity. Great strides have been made in the areas of diagnosis and management of hyperglycaemia in pregnancy/gestational diabetes mellitus (GDM), for example the ACHOIS, MiG and HAPO trials, as well as the IADPSG panel consensus statement and the NICE, SIGN and ADA guidelines for the management of diabetes in pregnancy. The IADPSG statement is a bold step in achieving an international norm, thereby enabling standard diagnostic criteria for hyperglycaemia in pregnancy, as well as research comparisons. Certain oral hypoglycaemic agents have been shown to be as safe and effective as the mainstay insulin therapy (in the short term). However, long-term safety data are lacking. The latter advances have enabled better pregnancy outcomes as well as improving long-term health for both mother and baby.
An approach to urinary incontinence in the diabetic female : review
Authors: Naidoo, T.D.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 58-61
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Abstract: Diabetes mellitus has reached epidemic proportions worldwide. It is also evident that urinary incontinence among adult women is increasing in prevalence, especially with advanced age. Bladder dysfunction, occurring as a complication of diabetes mellitus, usually presents with a variety of symptoms ranging from overactive bladder, urge incontinence to overflow incontinence, reduced bladder sensation, and even stress urinary incontinence. This article focuses on the association between urinary incontinence in women and diabetes mellitus. We highlight the possible pathophysiological processes involved and examine the evidence regarding management of these patients.
Prevalence of cardiovascular disease and risk biomarkers in patients with unknown type 2 diabetes visiting cardiology specialists : results from the DIASPORA study : review
Authors: Schondorf, Thomas; Lubben, Georg; Karagiannis, Efstrathios; Erdmann, Erland; Forst, Thomas; Pfutzner, Andreas; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 62-66
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Abstract: Background: Patients with diabetes mellitus and IGT have a high risk for cardiovascular events. It is tempting to speculate that these patients are often first seen by cardiologists.
Design: This cross-sectional study investigates the diabetes prevalence in cardiology care units and the correlated metabolic conditions as assessed by several circulating biomarkers.
Methods: Patients aged 55 or older with suspected or overt coronary heart disease were eligible for trial participation. Fasting blood samples were drawn from patients to determine HOMA score, glycaemic and lipid profile, and several risk biomarkers. An OGTT was performed in patients without known diabetes.
Results: We enrolled 530 patients (181 male, 349 female, mean age, 68 ± 7 years) in this study from 22 German cardiology centres; 156 patients (29. 4%) had known diabetes and OGTT revealed that 184 patients (34.7%) had no diabetes, 106 patients (20. 0%) had IGT or IFG and 84 patients (15. 9%) were newly diagnosed with diabetes. Increased cardiovascular risk as reflected by increased hsCRP, ICAM and MMP-9 values was observed in diabetes patients. A higher cardiovascular biomarker risk profile was seen in the IGT/IFG cohort.
Conclusions: This study confirms the observation that one-third of patients in a cardiology care unit suffer from impaired glucose regulation. Furthermore,the cardiology patients with previously unknown glucose homeostasis abnormalities had a higher prevalence of macrovacular disease and an impaired biomarker risk profile. This study underlines the importance of joint treatment efforts by cardiologists in concert with diabetologists for treatment of this patient group at high risk for cardiovascular events.
The Sinatra Solution. Metabolic Cardiology, Stephen T. Sinatra : book review
Authors: Straughan, John; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 66
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Abstract: With less self-aggrandisement, this book might have carried an alternative title You and your Mitochondria, with a subtitle such as Take Care of your Mitochondria, and your Body Will Take Care of the Rest! The term 'mitochondrion' comes from the Greek [mitos = thread, and chondrion = granule]. Every nucleated cell in our bodies contains mitochondria, sometimes - as in cardiomyocytes - thousands per cell, and these organelles produce the energy in the form of ATP for all our vital functions.
Weight management in overweight and obese patients with type 2 diabetes mellitus : review
Authors: Kyrou, Ioannis; Kumar, Sudesh; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 67-73
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Abstract: Obesity is recognised as an important risk factor for type 2 diabetes, inducing insulin resistance and pancreatic beta-cell dysfunction. These obesity-related defects tend to progress following weight gain and can eventually lead to worsening hyperglycaemia over time. Thus, effective weight management is crucial for glycaemic control in overweight and obese patients with type 2 diabetes. Current standard strategies for weight management in these patients include lifestyle interventions and pharmacotherapy. Bariatric surgery has become a promising new option for the treatment of obese patients with type 2 diabetes and in recent years incretin-based therapies have become available, which exhibit favourable effects on body weight. Herein, the efficacy of available weight-loss interventions is assessed and the role of newer antidiabetic agents examined, focusing on incretin-based therapies.
Diabetes in pregnancy : ethical considerations : ethics focus
Authors: Titus, M.J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 74-75
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Abstract: Gestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy and results in significant adverse effects for mother and child, both in the short and long term. It is associated with an increased rate of foetal malformations as well as risks for foetal macrosomia, birth trauma and neonatal hypoglycaemia. Women with a previous history of unexplained stillbirth have a high incidence of GDM.
Surgical interventions to correct metabolic disorders : current topics
Authors: Lahsen, Rodolfo; Berry, Marcos; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 76-79
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Abstract: Obesity and related metabolic disorders are increasing, especially in developing countries. It is widely accepted that in extremely obese patients bariatric surgery reduces body weight and improves type 2 diabetes and the metabolic syndrome. Weight loss partially explains this effect as do weight loss-independent mechanisms linked to gut hormones, peptide YY, ghrelin, glucagon-like peptide-1, and glucose-dependent insulinotropic peptide/gastric inhibitory polypeptide. Several groups performing established and novel surgical techniques have shown encouraging metabolic results. Herein we consider whether it is theoretically plausible to use surgery as an alternative or complementary approach to medical treatment of diabetes in overweight and mildly obese patients.
Diabetes education - well worth doing and worth doing well : diabetes personality
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 80
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Abstract: 'The reward of a thing well done is to have actually done it.' That's the motto of Durban-based diabetes specialist nurse, Fiona Prins. She's one busy woman. Not only does she still have a private practice, which is run in her own time, but she is also currently working full time for a pharmaceutical company. Her portfolio there is exclusively diabetes education. 'To this end, I assist patients one on one with the issues of daily living associated with diabetes and the motivation-induced behavioural changes the condition requires for optimal management.' In addition, Fiona does a fair amount of training of medical personnel at hospitals and allied healthcare professional training centres, for example the Pharmacology Department at the University of KwaZulu-Natal and various nursing schools. 'I also undertake insulin pump training and pump initiation for patients in KwaZulu-Natal when required', she says.
Diabetes in pregnancy - keep and copy series : patient information leaflet
Authors: Green-Thompson, Randolph; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 81-82
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Abstract: Diabetes is a disease of poor blood sugar (glucose) control, usually due to a lack of or resistance to the hormone insulin. The effects of diabetes mellitus are many and can affect various organs of the body. In pregnancy, diabetes can pose potential risks for both the mother and baby, such as big babies (macrosomia). Many of these problems can be avoided or minimised by careful management of the pregnancy - from its planning to after delivery. Outlined below are certain important principles and facts regarding diabetes and pregnancy. The information provided should be used in conjunction with the care given to you by your doctor. Do not use this information to change your treatment without consulting your doctor first.
The role of the glycaemic index in diabetes : dietician review
Authors: Jogiat, Ruwaida; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 83-84
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Abstract: There is much controversy about the use of the glycaemic index (GI) for people with diabetes. What is well established however is that good glycaemic control is essential in this patient population. The GI is considered to be one of the tools used to achieve optimal glycaemic control in patients with diabetes.
Beating the post-MI blues : improving detection and treatment of depression after a heart attack : prevention in practice
Authors: Haws, Joanne; Gray, Richard; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 85-87
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Abstract: Depression after myocardial infarction (MI) is extremely common, affecting almost half of all patients. The combination of MI and depression reduces the chance of recovery and makes it much more likely that patients will have another cardiac event. Depressed patients are also less likely to get back to work and they use health services more than those who are not depressed.
New incretin agents offer opportunity to improve care for type 2 diabetes : drug trends
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 88
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Abstract: The best partner to metformin and lifestyle changes in the early treatment of type 2 diabetes is an incretin analogue or a DPP-4 inhibitor. Prof Stephan Jacob, director of the Institute for Cardiometabolic Medicine, Villingen, West Germany, presented this view at a recent symposium sponsored by Astrazeneca.
Fenofibrate benefits in cardiovascular risk reduction : Heartwire discussion endorses use in type 2 diabetes : drug trends
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 91
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Abstract: A recent discussion on Heartwire following data released on fenofibrate usage in the United States and Canada highlights 25 years of clinical experience and the proven benefit of fenofibrate when used with a statin to reduce cardiovascular risk, particularly in patients with a high triglyceride concentration (> 2 mmol/l).
Clinical audit of autoimmune disorders in type 1 diabetes : South African CDE study : journal update
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 92
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Abstract: In the previous issue of the South African Journal of Diabetes and Vascular Disease (volume 8, number 1, March 2011) we reviewed advances in the field of autoimmune diseases in diabetes, with a particular focus on published South African research contributions. The following important study from the Centre for Diabetes and Endocrinology (CDE) in Johannesburg was not included.
Diary for 2011 diabetes congresses
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 92
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Abstract: Diary for 2011 diabetes congresses.
Serving diabetes and cardiology : round three of the South African diabetologist/cardiologist debate : reports
Authors: Aalbers, J.; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 95-97
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Abstract: The diabetes/cardiology debate was made possible by an annual unrestricted educational grant by Servier, in line with their long-term commitment to continuing medical education in South Africa.
Bongi Ngema-Zuma Foundation and Novo Nordisk (Pty) Ltd bring diabetes screening to the 12th annual conference of the Apostolic Church
Authors: Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 97
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Abstract: The Bongi Ngema-Zuma Foundation and Novo Nordisk participated in the gathering of over 12 000 women from the Apostolic Church on 25-26 May 2011 at the Ntabazwe Township in Harrismith. The goal was to raise awareness, provide education on diabetes, and screen for diabetes. Novo Nordisk took their Changing Diabetes bus to Harrismith in order to facilitate the screening of the many volunteers attending the conference.
Neglected topics in diabetes care : a Novo Nordisk-sponsored symposium at the 2011 SEMDSA congress : reports
Authors: Aalbers, J.; Mohamed, Fazleh; Published: 2011
From: South African Journal of Diabetes and Vascular Disease, Vol 8, Issue 2, Jun, Pages: 98-100
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Abstract: This Novo Nordisk-sponsored symposium, the seventh in the series, focused on 'neglected topics in diabetes care'. Although well attended, the sponsors are very aware that many diabetes healthcare professionals would have liked to share in this annual update event, but for a variety of reasons, were not able to do so.

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