VOLUME 8 NUMBER 3 • SEPTEMBER 2011
127
SA JOURNAL OF DIABETES & VASCULAR DISEASE
ADA WATCH
ADA WATCH
SUMMARIES
2011 UPDATE FROM SAN DIEGO, USA
American Diabetes Association
24–29 June 2011
Contributor:
J Aalbers
EPIDEMIOLOGY
African data still sparse on FPG
trends and prevalence of diabetes:
Lancet
symposium at ADA
An immense global investigation has been
done on the changes in mean fasting
plasma glucose (FPG) levels since 1980 and
the prevalence of diabetes in adults, includ-
ing data on 199 countries and territories.
Data were obtained from surveys on
health examinations and published epide-
miological studies covering 370 country-
years and 2.7 million participants. Mean
FPG and its uncertainty were calculated
by age, country and year, according to the
quality of data available.
Sub-Saharan Africa was divided into
four regions: Central, East, West and south-
ern Africa (Botswana, Lesotho, Namibia,
South Africa, Swaziland and Zimbabwe).
The paucity of published data on Africa is
shown in the map. Only four articles are
cited for South Africa covering a sample
size of 3 000 peoples (Levitt 1993, Mol-
lentze 1995, Motala 2008, Omar 1993).
No published data were found for Central
Africa, although East and West Africa had
more studies than southern Africa.
The study developed a model, which
was tested against countries with sufficient
data (and withholding the data), compar-
ing the predictive model with actual data.
This modelling, according to the authors,
did well and holds validity for countries/
regions with insufficient data.
The bottom line is that incidences of
glycaemia and diabetes are rising globally,
driven by population growth and ageing,
and by increasing age-specific prevalence.
The mean FPG level in 2008 was lowest
in sub-Saharan Africa (mainly estimated),
east and south-east Asia, and high-income
Asia-Pacific countries.
The global age-standarised mean FPG
levels in 2008 were 5.50 mmol/l for men
and 5.42 mmol/l for women. The age-
standarised adult diabetes prevalence was
9.8% in men and 9.2% in women in 2008,
up from 8.3 and 7.5%, respectively, in
1980.
Source: Danaei G,
et al
. National regional and global
trends in fasting plasma glucose and diabetes prevalence
since 1980.
Lancet
. Published online 25/6/2011:DOI:
10.1016/50140-6736(11)60679-X.
A
1
chieve: type 2 diabetes study in
rapidly growing, developing coun-
tries
Baseline data on 66 726 people with type
2 diabetes across Asia, Africa, Europe and
Latin America have shown that up to 80%
of patients have complications, and HbA
1c
levels are poorly controlled. The average
blood sugar level was 9.5% before initia-
TABLE OF CONTENTS
EPIDEMIOLOGY
African data still sparse on FPG trends and
prevalence of diabetes: Lancet symposium
at ADA ��������������������������������������������������������������127
A
1
chieve: type 2 diabetes study in rapidly
growing, developing countries �����������������127
SOUTH AFRICAN CONTRIBUTIONS
NAVIGATOR trial provides clinical setting predictors for
type 2 diabetes, including
black patients �����������������������������������������������������128
CDE study sheds additional light on diabetic
retinopathy risk in African patients����������������������128
Identifying patients at high risk of sight-threatening
diabetic retinopathy: the
CDE database (2001–2009) ��������������������������������128
TG/HDL-C ratio fails to identify insulin
resistance in overweight black women
worldwide ����������������������������������������������������������128
Glucose uptake by myocytes more sensitive
to fatty acids than adipocytes������������������������������128
PATHOPHYSIOLOGY OF TYPE 1 DIABETES
Glycaemic control and incidence of heart
failure in young type 1 diabetes patients �������������129
PHARMACOLOGICAL TREATMENT OF DIABETES
New ultra long-acting insulin: insulin degludec
matches insulin glargine in both type 1 and type 2
diabetes patients, with less hypoglycaemia����������129
Insulin addition to GLP-1 receptor agonist
(GLP-1RA) therapy in type 2 diabetes ������������������129
Metformin still at core of first-line treatment
for type 2 diabetes in focus on older
patients ��������������������������������������������������������������129
Once-weekly exenatide shows continued
benefits at 18 months in Duration-3 study ����������130
Insulin glargine less effective in women?����������������130
Early intensive dietary intervention improves
glycaemic control in type 2 diabetes��������������������130
Look Ahead Lifestyle trial: four-year data����������������130
Brief highlights from the oral poster sessions����������130
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