Journal of Endocrinology, Metabolism and Diabetes in South Africa - latest Issue
Volume 21, Issue 2, 2016
Author F.J. PirieSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 21 (2016)More Less
Educate is a word that was first used in the 16th century and derives from the Latin word educatus (to rear) and educere (to lead forth). In modern language, education refers to training of the mind, with acquisition of new knowledge and skills. In South Africa, education is a hot topic with important unresolved issues in basic and postgraduate education. People with diabetes require ongoing education as an integral part of their management. Knowledge acquired on the nature of the condition, factors that influence glycaemic control and the medication used is crucial to ensuring successful overall management. However, in busy clinics and resource-starved centres of health delivery, this aspect of care may easily be overlooked. Many diabetes clinics operate without the services of an educator and this is clearly not an optimal situation, if efforts to limit the morbidity and mortality associated with poor glycaemic control are serious.The dire situation with regard to diabetes education has been highlighted in a recent study on the status of programmes for diabetes education in both the private and the public sectors in South Africa. This survey reported that of 27 respondents, only 5 (18.5%) offered a structured programme for patients with diabetes and that most diabetes education was provided on an opportunistic ad hoc basis. The situation is made even more challenging by varying rates of literacy and cultural values and beliefs. Against this backdrop, it is encouraging to see studies on diabetes education in South Africa.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 21, pp 16 –19 (2016) http://dx.doi.org/10.1080/16089677.2016.1191243More Less
This study reports on three patients who were seen at Tygerberg Hospital within a short period of six months, with a new diagnosis of biochemically severe primary hypothyroidism. Pericardial effusion was suspected on clinical and X-ray findings and confirmed with echocardiography in all cases. All had evidence of pericardial tamponade based on echocardiographic criteria. Pericardiocentesis was performed on all patients and other causes of pericardial effusions were excluded. Although infrequently described, hypothyroidism needs to be considered in patients presenting with unexplained large pericardial effusions and cardiac tamponade.
Effects of self-monitoring of blood glucose on diabetes control in a resource-limited diabetic clinic : researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 21, pp 20 –25 (2016) http://dx.doi.org/10.1080/16089677.2016.1198112More Less
Background: Diabetes mellitus places an enormous burden upon both patients and countriesâ?? health systems. Integral to achieving control is patients assuming responsibility for their condition. Self-monitoring of blood glucose (SMBG) can serve as a powerful tool modifying lifestyle behaviour and can aid in achieving optimal control.
Methods: This study assessed the effect on diabetes control in patients who received glucometers and education over 12 months. This data was analysed at baseline, 6 and 12 months.
Results: Glycaemic control improved significantly between baseline, 6 and 12 months (HbA1c% 12.29 ± 3.17 vs. 11.16 ± 3.09 vs. ±10.68 ± 3.10, respectively). The number of patients achieving target glycaemic control increased substantially while the number of patients achieving target total cholesterol and triglyceride levels improved at six months. Mean HDL cholesterol increased significantly between baseline and 12 months (1.20 ± 0.42 vs. 1.31 ± 0.40, respectively; p-value 0.0095). The mean BMI of male patients in the study increased between 6 and 121 months (27.59 ± 6.42 vs. 31.90 ± 8.85, respectively, p = 0.0012) and between baseline and 12 months (27.64 ± 6.13 vs. 31.90 ± 8.85, respectively, p = 0.0012).
Conclusion: This study demonstrated that the introduction of SMBG and patient education, within this resource-limited clinic setting, had beneficial effects on diabetes control; however, obesity remains an obstacle to optimal control.
Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa : a randomised controlled trial : researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 21, pp 26 –34 (2016) http://dx.doi.org/10.1080/16089677.2016.1200324More Less
Objective: To evaluate the effect of a nutrition education (NE) programme on diabetes knowledge and attitudes of adults with type 2 diabetes mellitus (T2DM).
Methods: Eighty-two adults (40-70 years) with poorly controlled T2DM (HbA1c ≥ 8%) and attending two community health centres in Moretele, North West Province (South Africa) participated in a one-year randomised controlled trial. Participants were randomised to the intervention group (n = 41; 8 weekly group education (2-2.5 hours); follow-up meetings and education materials) or control group (education materials only). Diabetes Knowledge Form B assessed knowledge about diabetes. Diabetes Attitudes Scale-III assessed the attitudes towards diabetes and treatment. Assessments were done at 6 and 12 months. Analysis of co-variance compared the groups (baseline, age, gender and clinic adjustments). An intention-to-treat analysis was employed.
Results: The intervention group had higher mean diabetes knowledge scores + 0.95 (p = 0.033) and + 2.05 (p < 0.001) at 6 and 12 months respectively. However, the scores were below 50%. Patient autonomy for diabetes attitudes was the only score significantly higher in the intervention group + 0.27 (p = 0.028) at 12 months.
Conclusion: NE significantly improved diabetes knowledge in the intervention group, though not satisfactorily, but had limited effects on the attitudes towards diabetes.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 21, pp 35 –39 (2016) http://dx.doi.org/10.1080/16089677.2016.1205822More Less
Background: In South Africa, the prevalence rate of diabetes is 9.27%, with an estimated 2.6 million people living with the disease. Diabetes-related distress has been described as encompassing the patient's concerns about the self-management of diabetes, perception of support, emotional burden and access to quality health care. There has been little or no research done in South Africa regarding diabetes-related distress.
Objectives: The aim of this paper was: (1) to identify the level of diabetes-related distress in a cohort of diabetes type 2 patients in KwaZulu-Natal and (2) to identify the factors that contribute to diabetes-related distress.
Methods: This cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Diabetes Distress Scale was administered, together with a demographic questionnaire, to 401 participants.
Results: In total, 44% of the sample reported having moderate to high levels of distress. The mean scores of the Emotional Burden dimension (M = 2.6; SD = 1.42) and the Regimen Distress dimension (M = 2.33; SD = 1.29) suggested moderate levels of distress. Factors that significantly contributed to high levels of distress were younger age, high HbA1C levels, female gender, attending the public health sector, unemployment and being a person of colour.
Conclusion: Healthcare providers need to pay particular attention to the psychological needs of the patient, which impact on the medical outcomes of the disease.