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- Volume 16, Issue 1, 2011
Journal of Endocrinology, Metabolism and Diabetes in South Africa - Volume 16, Issue 1, 2011
Volume 16, Issue 1, 2011
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 5 –6 (2011)More Less
Author Dirk J. BlomSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16 (2011)More Less
The 2011 LASSA (Lipid and Atherosclerosis Society of Southern Africa) Congress takes place in Bloemfontein in April in conjunction with SEMDSA (Society for Endocrinology, Diabetes and Metabolism of South Africa) meeting. Although South Africa only has a small number of dedicated lipid specialists, I am confident that delegates will enjoy and benefit from both the scientific and educational aspects of the congress.
Author Jeannie BergSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16 (2011)More Less
For all those who were lucky enough to attend this year's NOD conference, the above quotation should bring back good memories. Doing something one step at a time is a guaranteed way to sustain personal motivation and drive. As educators we are prone to burnout and demotivation. Working with a disease such as diabetes is highly demanding, and sometimes emotionally draining. We need to have regular "spa" days, in order to recharge and move forward again. NOD greatly inspired the attendees, who as part of the experience, were asked to participate in an online assessment called DISC. This assessment is used to measure levels of dominance, influence, conscientiousness and steadiness.
Author D. JivanSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 10 –14 (2011)More Less
Although the mortality of diabetic ketoacidosis (DKA) has decreased substantially in the developed world, high mortality rates still prevail in South Africa, thus making this an important condition to recognise early and manage well. This review discusses the treatment of DKA, with emphasis on the controversial aspect of initial fluid replacement therapy. Current guidelines recommend the use of normal saline. The concern is that normal saline, when used in large volumes, leads to the development of a hyperchloraemic metabolic acidosis which is of uncertain clinical significance. This hyperchloraemic acidosis is better quantified using Stewart's model, as opposed to the "traditional" Henderson-Hasselbalch equation. Ringer's lactate is an alternative choice for initial fluid resuscitation, but may exacerbate the high lactate to pyruvate ratio in patients in DKA, and may cause hyperkaleamia. Insulin therapy, prevention of electrolyte abnormalities, and the replacement of bicarbonate and phosphate, are other important considerations in the management of the patient with DKA.
Author D.J. BlomSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 17 –24 (2011)More Less
Familial hypercholesterolaemia (FH) is a monogenic disorder of low-density lipoprotein (LDL) metabolism. It is characterised by markedly elevated LDL cholesterol, autosomal dominant inheritance, premature cardiovascular disease and tendon xanthomata. FH is a genetically heterogeneous disorder, but the most common underlying molecular cause is mutation of the LDL receptor gene. The worldwide prevalence of FH is 1:500. South Africa has three founder populations in which the prevalence of FH may be as high as 1:70. FH is diagnosed clinically, but the diagnosis can be confirmed by DNA analysis. DNA testing cannot always identify the causative mutation because there are several genes to examine and more than 1500 different mutations have been identified in the LDL receptor alone. Statins are the treatment of choice for patients with FH. Ezetimibe or cholestyramine can be added if additional LDL lowering is required, or if patients are unable to tolerate high statin doses.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 29 –41 (2011)More Less
Diagnosis and treatment of diabetic ketoacidosis
The prevalence and relationship with waist circumference of metabolic syndrome and related disorders in an urban population of African females
Normal saline vs. Ringer's lactate as initial fluid therapy of diabetic ketoacidosis
Measured glomerular filtration rate (mGFR) and estimated glomerular filtration rate (eGfR) in patients with diabetes mellitus at the Inkosi Albert Luthuli Hospital diabetes clinic, Durban
Thyroid disease and pregnancy
Low prevalence of thyroid microsomal and thyroglobulin antibodies in thyroid disease patients presenting at Nelson Mandela Academic Hospital, Eastern Cape
The effect of glucocorticoid receptor polymorphisms on the sensitivity to cortisol in Addison's disease
Inappropriate TSH secretion a case-based approach
Diabetic Pregnancy: Will HAPO make us happy?
A benign paraganglioma in the organs of Zuckerkandl presenting as a hypertensive emergency in pregnancy
The prevalence and clinical significance of acanthosis nigricans in women of mixed ancestry
An unusual case of primary hyperparathyroidism
The anthropometric determinants of insulin resistance change with increasing body mass index
Adrenocortical carcinoma in a child
Leukocyte O-GlcNAcylation: a novel tool for the early detection of type 2 diabetes mellitus?
A functioning malignant insulinoma in a patient with human immunodeficiency virus infection
Characteristics of children presenting with newly diagnosed type 1 diabetes
The contribution of carbon atoms derived from dietary fructose to lipid synthesis in humans
Comparative measurement of beta hydroxybutyrate (B-OHB) in diabetics with suspected ketoacidosis: electrochemical point of care test vs. manual enzymatic method
Insulin resistance in the donor animal does not affect the insulin-induced proliferative response or differentiation in subcutaneous and visceral adipose-derived stromal cells
Vanadate stimulates osteoblast proliferation both in vitro and in vivo, yet fails to increase bone formation or bone mineral density in the rat
Hypoglycaemia in type 1 diabetes: inevitable or avoidable?
The influence of diabetic patients' knowledge, attitude, and practices regarding diet, lifestyle and their diabetes on glycaemic control and complications: a cross-sectional study
Exploring novel ways to blunt hyperglycaemia-induced contractile dysfunction
Why can't we stop eating? Emerging evidence from neuroimaging studies for appetite dysregulation in metabolic syndrome
Parathyroid hormone replacement treatment in hypoparathyroidism
New guidelines for the management of inpatient hyperglycaemia in a non-intensive care unit setting
Haemoglobin A1c in the diagnosis of diabetes: a balanced view
Genetic defects of the GH-IGF-1 axis in intrauterine growth retardation
Perioperative management of patients with diabetes.
Treatment of asymptomatic primary hyperparathyoroidism
Management of tobacco smoking
Low-density lipoprotein receptor mutations in familial hypercholesterolaemia at the Groote Schuur Hospital Lipid Clinic, Cape Town
Evaluation of eficacy and safety of lapaquistat when coadministered with high-dose statin therapy in subjects with primary hypercholesterolaemia: the Cape Town experience
Reduction in all total and cardiovascular mortality in subjects with homozygous familial hypercholesterolaemia associated with advances in lipid therapy
Comparison of lipid profiles in human immunodeficiency virus-infected treatment-naïve patients, and patients on combination antiretroviral therapy
South African blacks being treated for hyperlipidaemia have a high prevalence of type 2 diabetes and the metabolic syndrome and are not reaching the low-density lipoprotein cholesterol target: results from the CEPHEUS SA study.
Marine foods as a source of protein for middle and later Stone Age hunter-gatherers on the Western Cape coast
Using large-scale epidemiological evidence to help evaluate biomarkers in cardiovascular disease
Processed red and white wines do not lose their antioxidant function after alcohol reduction
Utility of 3-alpha-hydroxy-sterol dehydrogenase assay in plasma for metabolic defects in sterol and bile acid metabolism
Emerging anabolic treatments for osteoporosis
Genetic testing in patients with hypopituitarism
New insights into thyroid hormone action
High prevalence of abnormal liver enymes in patients with type 2 diabetes mellitus : original researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 43 –47 (2011)More Less
Objective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic.
Method: The study was a retrospective chart review of patients with type 2 diabetes attending a diabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver function tests.
Results: The charts of 313 patients were reviewed. Liver function test abnormalities were found in 146 patients (46.6%). Of these, 15 patients had a history of alcohol abuse, or a past medical history that might explain the abnormality, and these patients were excluded from further analysis. Elevations in serum gamma-glutamyl transferase, alkaline phosphatase and alanine transaminase were found in 25.2% (n = 79), 23.3% (n = 73) and 15.3% (n = 48), respectively. Serum total cholesterol, triglycerides and low-density lipoprotein cholesterol were higher in the group with liver function test abnormalities when compared with subjects with normal results. Mean body mass index was similar in the two groups (32.5 vs. 33.2 kg/m2). Although morbidly obese patients (n = 42) demonstrated the highest frequency of liver enzyme derangements (54.8%), this was not statistically significant.
Conclusion: There is a high prevalence of liver function test abnormalities in this group of patients with type 2 diabetes, and this is particularly so in the morbidly obese subjects. This is comparable with the reported prevalence in the Western world. Lipid abnormalities were more frequent in the group with liver enzyme derangements.
Differences in MetS marker prevalence between black African and Caucasian teachers from the North West Province : Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) Study : original researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 49 –56 (2011)More Less
Background: The aim of this study was to compare metabolic syndrome (MetS) prevalence between black and Caucasian Africans using different definitions, and secondly, to determine the association between MetS, anthropometric markers and the albumin:creatinine ratio using the new joint statement criteria. This was a target population study. It included 409 urban African and Caucasian men and women (aged 25-65 years) from the North West Province, who were stratified into gender and ethnic groups.
Method: We obtained anthropometric measurements, levels of microalbuminuria, and other markers of MetS (systolic and diastolic blood pressure, glucose, triglycerides and high-density lipoprotein).
Results: The joint statement criteria included more persons with MetS than the other definitions, and Africans presented with more cases of MetS than the Caucasians. The most prevalent risk factors were blood pressure among men, and waist circumference (WC) and glucose among women. African men, as a group, presented with more risk factors than the other groups. African women, although obese, seem to have few cardiovascular risk factors, while all groups presented with an unhealthy WC according to European cut-points. Multiple linear regression analysis, independent of covariates, showed that the albumin:creatinine ratio is explained only by glucose in Africans.
Conclusion: African women, as a group, present with few MetS risk factors, and glucose is associated with renal function risk in Africans.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 58 –63 (2011)More Less
We present two cases of metastatic carcinoid tumours, complicated by carcinoid syndrome and by cardiac valve involvement, a well-known, but infrequent, complication. Carcinoid tumours are generally more indolent than other cancers and may have a long asymptomatic phase. The symptoms of carcinoid syndrome generally manifest only once metastases to the liver have occurred. Cardiac involvement occurs in up to 50% of patients, and heralds a poor prognosis. However, a multidisciplinary team approach has improved the prognosis and quality of life for patients with carcinoid heart disease. Therapy includes somatostatin analogues and treatment for heart failure, removal of primary or metastatic tumour deposits, valve replacement in the presence of valvular involvement, and radioisotopes therapy.
Prediabetes : a focus on the role of diabetes education in prevention of type 2 diabetes : diabetes educationAuthor L. Van Der MerweSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 64 –65 (2011)More Less
Awareness of the seriousness and magnitude of the diabetes epidemic has heightened, resulting in increasing emphasis being placed on prevention. In the last decade, several major institutions have developed guidelines for prevention measures. The World Health Organization (WHO) developed the Action Plan on Prevention and Control of Non-Communicable Diseases in 2008, and a global strategy on Diet, Physical Activity and Health (DPAS) in 2004. These provide a framework within which governments can develop policies that promote healthy eating and increased physical activity.