DRUG TRENDS
SA JOURNAL OF DIABETES & VASCULAR DISEASE
176
VOLUME 7 NUMBER 4 • NOVEMBER 2010
Drug Trends
Once-daily duloxetine reduces pain symptoms
D
uloxetine (Cymbalta), an effective antide-
pressant, has been shown to reduce pain
in diabetic patients with peripheral neuropathy
who did not have clinical depression.
In a double-blind study, patients with both
type 1 and type 2 diabetes, with peripheral
neuropathy treated with duloxetine benefited
with greater overall pain reduction, compared
to those patients not receiving the drug.
1
Patients who were given a once-daily dosage
regimen of 60 mg were also less likely to
discontinue medication due to nausea, som-
nolence and constipation than those on the
twice-daily dose of 60 mg (2 vs 12% discon-
tinuation rate). There were no adverse effects
on diabetic control and both doses were safely
administered and generally well tolerated.
While duloxetine is recommended in inter-
national treatment guidelines for the manage-
ment of peripheral neuropathy, because of
concerns over costs, particularly in the State
sector, it has limited first-line use in South
Africa. A recent cost-effectiveness analysis
makes interesting reading.
Cost evaluation in a US healthcare system
of patients treated with duloxetine versus
other standard-of-care treatments, such as tri-
cyclic antidepressants, gabapentin or pregaba-
lin, has shown lower overall healthcare costs in
these duloxetine-treated patients over a one-
year period. These patients also had a longer
opioid-free period, and when opioids were
used, they were taken in significantly lower
doses. Outpatient costs and total healthcare
costs were reduced by 40 to 50% in patients
on duloxetine.
These costs were retrospectively evaluated
in the claims database, and although the study
is not without limitations, there were clear
financial benefits for patients and the health-
care providers.
J Aalbers, special assignment editor
1.
Raskin J, Pritchett YL, Wang F, D’Souza DN,
et al
.
Am Academy of Pain Med
2005;
6
(5): 345–356.
1526/2375/05/$15.00/346.
2.
Chen S,
et al
.
Curr Med Res Opin
2010;
26
(10):
2507–2516.
Advertorial
Lilly supports development of diabetes youth leaders
‘
Life can be sweet’ for teens and young adults
living with diabetes
As an industry leader in diabetes care, Lilly
Pharmaceuticals has once again furthered
their commitment to patients with diabetes by
sponsoring a diabetes youth leadership camp,
in order to educate, train and motivate diabe-
tes ambassadors, who are then able to educate
communities and mentor newly diagnosed
children.
This camp, the fourth consecutive diabetes
youth leader training camp to take place in
Gauteng since the concept was first initiated in
2006, took place between 29 September and 3
October 2010 at Magalies Retreat in Magalies-
burg, with 44 children attending, all between
the ages of 14 and 19. These camps are run by
the NGO, Youth With Diabetes (YWD).
Originally the brainchild of endocrinologist
Dr David Segal and diabetes nurse educator Sr
Hester Davel of the Centre for Diabetes and
Endocrinoligy (CDE) in Houghton, Johannes-
burg, these camps see teens and young adults
who have well-controlled diabetes, are accept-
ing of their diabetes, and have good leadership
skills, being invited from around the country
and beyond its borders to participate in this
rigorous five-day educational course.
‘This year the focus of the leadership train-
ing was not only to empower these young lead-
ers to walk their talk when it comes to living
with diabetes, but also for them to implement
projects in their communities through which
others will be empowered’, says Sr Hester
Davel, the facilitator of these camps.
The programme of the leadership camp this
year focused on three main objectives, namely
to create opportunities for the leaders to learn
more about themselves and discover their nat-
ural leadership talents, to allow them to prac-
tice their team leadership skills in a relaxed and
fun environment, and to facilitate the process
whereby they can learn how to plan a project
and lead a team in the execution of the plan
within their communities over the coming year.
‘Because we are an NGO, we mostly depend
on our sponsors for funding these initiatives.
We thank them all for their support through-
out the years and their role in the success
we have experienced in all our projects’, says
Hester Davel. ‘We especially thank Lilly and
John Smith, endocrine manager: Partnerships
& Key Accounts, for continuously supporting
our diabetes youth camps and diabetes lead-
ership camps every year. We would like more
pharmaceutical companies to come on board
and see the merits and benefits of providing
for the diabetes community in the long term.’
On the final day of camp, all of the youth
leaders presented their project plans to Charl
Oosthuizen, YWD chairman, and camp
founder, endocrinologist Dr Dave Segal. They
have one year in which to implement their
projects and are required to report on their
progress throughout the year. All leaders will
return to camp in 2011 and a winner will be
chosen, based on whose project was the most
successful.
‘Diabetes doesn’t limit you, you are not
alone with your diabetes, and you can manage
your diabetes while having fun – these are
some of the main messages that come out of
these camps’, says Kerry Kalweit, the youth
chairperson for YWD, who was one of the del-
egates on this camp. Kerry is currently studying
medical sciences at the University of Pretoria.
She has been a type 1 diabetic for six years.
Her time within YWD is spent coordinating
various awareness and fundraising projects, as
well as contacting newly diagnosed diabetics
about this support group. Another important
role of YWD is to help educate teachers within
schools about diabetes and the symptoms, as
well as tackling stigma issues that may exist
towards children with diabetes.
‘Lilly is proud to once again be associated
with Youth With Diabetes and their youth
leader camps. We have a long-standing com-
mitment to diabetes care and continuously aim
to help people with diabetes to live full and
active lives. These youth leaders are an inspi-
ration and we have no doubt that they will
continue to help and motivate others with dia-
betes within their communities. We look for-
ward to being involved in these initiatives for
many years to come’, said John Smith.
For more information on Youth with Diabetes,
go to
To learn more about Lilly, visit
