Pub Date : 2018-09-02DOI: 10.1080/16089677.2018.1515144
Muhammad Abid Siddiqui, S. Bhana, R. Daya
Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly. This is possibly due to increasing obesity, reduced level of activity, sedentary lifestyle, ageing population and industrialisation. Aim: The primary objective of this study was to ascertain the level of activity using a pedometer. The secondary objectives were: (1) to correlate the baseline level of activity with body mass index (BMI), HbA1c and blood pressure (BP), (2) to assess whether 7 000 steps a day influence HbA1c and BP over a three-month period. Method: A total of 110 patients were screened; 95 patients (n = 95) completed the study. At the first visit HbA1c, BMI and BP were measured. At the end of the first month baseline physical activity was recorded using pedometers. Patients were divided into two groups: active (n = 50) and control (n = 45). Patients in the active group were asked to walk a minimum of 7 000 steps/day. The control group were asked to continue their usual activity. These patients were followed up monthly over a period of three months. At each visit BMI, BP and step counts were recorded. HbA1c was measured only at the first and last visit. Result: Activity levels increased significantly in the active group throughout the study. Mean step count for the control group at baseline was 2 923.1 ± 1 136.9, which increased to 3 431.2 ± 1 251.7 by the end of the study. Mean step count for the active group at baseline was 4 609.9 ± 1 702.1, which increased to 7 244.8 ± 1 419.4 by the end of the study. The difference between control and active group was statistically significant (p < 0.001). Systolic and diastolic BP decreased significantly in both groups (p = 0.017) for systolic BP and (p = 0.002) for diastolic BP but no interaction was found between the groups as systolic and diastolic BP decreased at the same rate over time in both groups. HbA1c decreased by 1.04% in the active group; this difference was statistically highly significant (p < 0.001). Conclusion: Increase in activity levels decreases HbA1c by 1.04 percentage point over three months in T2DM (p < 0.001), which is statistically significant.
{"title":"The relationship between objectively measured physical activity and parameters of disease control in an African population of type 2 diabetes mellitus","authors":"Muhammad Abid Siddiqui, S. Bhana, R. Daya","doi":"10.1080/16089677.2018.1515144","DOIUrl":"https://doi.org/10.1080/16089677.2018.1515144","url":null,"abstract":"Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly. This is possibly due to increasing obesity, reduced level of activity, sedentary lifestyle, ageing population and industrialisation. Aim: The primary objective of this study was to ascertain the level of activity using a pedometer. The secondary objectives were: (1) to correlate the baseline level of activity with body mass index (BMI), HbA1c and blood pressure (BP), (2) to assess whether 7 000 steps a day influence HbA1c and BP over a three-month period. Method: A total of 110 patients were screened; 95 patients (n = 95) completed the study. At the first visit HbA1c, BMI and BP were measured. At the end of the first month baseline physical activity was recorded using pedometers. Patients were divided into two groups: active (n = 50) and control (n = 45). Patients in the active group were asked to walk a minimum of 7 000 steps/day. The control group were asked to continue their usual activity. These patients were followed up monthly over a period of three months. At each visit BMI, BP and step counts were recorded. HbA1c was measured only at the first and last visit. Result: Activity levels increased significantly in the active group throughout the study. Mean step count for the control group at baseline was 2 923.1 ± 1 136.9, which increased to 3 431.2 ± 1 251.7 by the end of the study. Mean step count for the active group at baseline was 4 609.9 ± 1 702.1, which increased to 7 244.8 ± 1 419.4 by the end of the study. The difference between control and active group was statistically significant (p < 0.001). Systolic and diastolic BP decreased significantly in both groups (p = 0.017) for systolic BP and (p = 0.002) for diastolic BP but no interaction was found between the groups as systolic and diastolic BP decreased at the same rate over time in both groups. HbA1c decreased by 1.04% in the active group; this difference was statistically highly significant (p < 0.001). Conclusion: Increase in activity levels decreases HbA1c by 1.04 percentage point over three months in T2DM (p < 0.001), which is statistically significant.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"1 1","pages":"80 - 85"},"PeriodicalIF":0.5,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90502702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-02DOI: 10.1080/16089677.2018.1518825
P. Ukegbu, H. Kruger, Jd Meyer, C. Nienaber-Rousseau, C. Botha-Ravyse, SJ Moss, M. Kruger
Background: Sarcopenia, the loss of muscle mass and strength, is associated with adverse health outcomes. Calf circumference (CC) has been proposed as a surrogate measure of muscle mass in the elderly; however, ethnic/sex specific cut-off values remain to be established. Objective: A study was undertaken to investigate the relationship between CC and appendicular skeletal muscle mass (ASM), and the ASM index (ASMI), as well as to determine whether CC could be used to diagnose sarcopenia. Methods: This was a cross-sectional study of 247 older black women living from Tlokwe, South Africa. ASM was measured using dual-energy X-ray absorptiometry, and the ASMI was calculated. Receiver operator characteristics curves and maximum Youden index were applied to identify a CC cut-off point for sarcopenia according to low gait speed (< 0.8 m/s), low hand-grip strength (< 16 kg) and low ASMI using a South African cut-off point for sarcopenia (ASMI < 4.94 kg/m2). Results: A strong positive correlation between CC and ASMI (r = 0.84, p < 0.001) was observed. The CC to predict low hand-grip strength was 34.3 cm and 37.8 cm for low gait speed. A CC of 29.9 cm was indicative of sarcopenia. The area under the curve for all outcomes was > 0.60. Conclusion: A CC of 30 cm is proposed as a simple and inexpensive way to predict, screen or diagnose sarcopenia in black women in low-resource health settings. An accessible, inexpensive screening or diagnostic tool could facilitate timely interventions and prevention.
{"title":"The association between calf circumference and appendicular skeletal muscle mass index of black urban women in Tlokwe City","authors":"P. Ukegbu, H. Kruger, Jd Meyer, C. Nienaber-Rousseau, C. Botha-Ravyse, SJ Moss, M. Kruger","doi":"10.1080/16089677.2018.1518825","DOIUrl":"https://doi.org/10.1080/16089677.2018.1518825","url":null,"abstract":"Background: Sarcopenia, the loss of muscle mass and strength, is associated with adverse health outcomes. Calf circumference (CC) has been proposed as a surrogate measure of muscle mass in the elderly; however, ethnic/sex specific cut-off values remain to be established. Objective: A study was undertaken to investigate the relationship between CC and appendicular skeletal muscle mass (ASM), and the ASM index (ASMI), as well as to determine whether CC could be used to diagnose sarcopenia. Methods: This was a cross-sectional study of 247 older black women living from Tlokwe, South Africa. ASM was measured using dual-energy X-ray absorptiometry, and the ASMI was calculated. Receiver operator characteristics curves and maximum Youden index were applied to identify a CC cut-off point for sarcopenia according to low gait speed (< 0.8 m/s), low hand-grip strength (< 16 kg) and low ASMI using a South African cut-off point for sarcopenia (ASMI < 4.94 kg/m2). Results: A strong positive correlation between CC and ASMI (r = 0.84, p < 0.001) was observed. The CC to predict low hand-grip strength was 34.3 cm and 37.8 cm for low gait speed. A CC of 29.9 cm was indicative of sarcopenia. The area under the curve for all outcomes was > 0.60. Conclusion: A CC of 30 cm is proposed as a simple and inexpensive way to predict, screen or diagnose sarcopenia in black women in low-resource health settings. An accessible, inexpensive screening or diagnostic tool could facilitate timely interventions and prevention.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"329 1","pages":"86 - 90"},"PeriodicalIF":0.5,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83070702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-13DOI: 10.1080/16089677.2018.1465252
Wadei Elhakimi, A. Al Othman, Mazen El Yahia, Amal Al Dawood, Sarah Al Sadiq, M. Mosli, Turki Al Ameel
Context: The number of women in academic medicine has increased significantly in recent years. However, female authors are underrepresented in major medical journals. Objective: The aim was to determine the distribution of female first and senior authors of original articles in four American endocrinology journals over a period of 25 years. Design: A retrospective analysis of the literature was undertaken. Setting: Four journals were selected: Journal of Clinical Endocrinology & Metabolism; Thyroid; Journal of Bone and Mineral Research and Diabetes Care. Participants: The first and senior authors of all original articles published in 1991, 1996, 2001, 2006 and 2015 were included. Intervention: none. Results: The main outcome measure was the distribution of female first and senior authors of original articles. A total of 4 148 articles were included. Of these, 28.9% (1 199) articles were authored by females of whom 751 (62%) were first authors. Over the study period, there was a shift towards female authorship. A statistically significant trend was observed (p < 0.001).
背景:近年来，从事学术医学工作的妇女人数显著增加。然而，女性作者在主要医学期刊上的代表性不足。目的:目的是确定25年来在美国四种内分泌学期刊上发表原创文章的女性第一作者和高级作者的分布。设计:对文献进行回顾性分析。环境:选取4种期刊:Journal of Clinical Endocrinology & Metabolism;甲状腺;骨与矿物质研究与糖尿病护理杂志。参与者:包括1991年、1996年、2001年、2006年和2015年发表的所有原创文章的第一作者和高级作者。干预:没有。结果:主要结局指标为女性原创文章第一作者和高级作者的分布。共纳入4148篇文章。其中女性作者占28.9%(1199篇)，其中第一作者占751篇(62%)。在研究期间，有一种转向女性作者的趋势。有统计学意义的趋势(p < 0.001)。
{"title":"Female authorship in major endocrinology journals: a 25-year progression","authors":"Wadei Elhakimi, A. Al Othman, Mazen El Yahia, Amal Al Dawood, Sarah Al Sadiq, M. Mosli, Turki Al Ameel","doi":"10.1080/16089677.2018.1465252","DOIUrl":"https://doi.org/10.1080/16089677.2018.1465252","url":null,"abstract":"Context: The number of women in academic medicine has increased significantly in recent years. However, female authors are underrepresented in major medical journals. Objective: The aim was to determine the distribution of female first and senior authors of original articles in four American endocrinology journals over a period of 25 years. Design: A retrospective analysis of the literature was undertaken. Setting: Four journals were selected: Journal of Clinical Endocrinology & Metabolism; Thyroid; Journal of Bone and Mineral Research and Diabetes Care. Participants: The first and senior authors of all original articles published in 1991, 1996, 2001, 2006 and 2015 were included. Intervention: none. Results: The main outcome measure was the distribution of female first and senior authors of original articles. A total of 4 148 articles were included. Of these, 28.9% (1 199) articles were authored by females of whom 751 (62%) were first authors. Over the study period, there was a shift towards female authorship. A statistically significant trend was observed (p < 0.001).","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"14 1","pages":"76 - 79"},"PeriodicalIF":0.5,"publicationDate":"2018-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80844922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-07DOI: 10.1080/16089677.2018.1465247
D. Mukona, S. Munjanja, M. Zvinavashe, B. Stray-Pederson
Objectives: To analyse the association between adherence to anti-diabetic therapy (diet, physical activity and medications) and perinatal outcomes. Methods: A cohort design was used. Participants were 157 pregnant women with diabetes, and the setting was Mbuya Nehanda and Chitungwiza Maternity Hospitals, Harare, Zimbabwe. Results: Main outcome measures were maternal and perinatal outcomes. Mean adherence to anti-diabetic therapy was 66.7%. Perinatal outcomes observed were hypertensive disorders (34.5%), Caesarean delivery (45.9%), maternal diabetic ketoacidosis (5.1%), maternal hypoglycaemia (15.9%), and candidiasis (19.7%). Neonatal outcomes were perinatal mortality (15.9%), low Apgar score at 1 minute (26.8%), low Apgar score at 5 minutes (24.8%), macrosomia (33.8%), neonatal hypoglycaemia (15.3%), and neonatal hyperbilirubinemia (7.6%). There were significant associations between adherence and Caesarean delivery (RR 1.9, 95% CI 1.28 to 2.81, p = 0.0014), candidiasis (RR 3.95, 95% CI 1.65 to 9.47, p = 0.002), low Apgar score at 1 minute (RR 2.15, 95% CI 1.16 to 3.98, p = 0.015) and at 5 minutes (RR 1.95, 95% CI 1.03 to 3.69, p = 0.039), and perinatal mortality (RR 3.08, 95% CI 1.11 to 8.52, p = 0.018). Conclusions: Adherence to anti-diabetic therapy was sub-optimal and was associated with some adverse perinatal outcomes. Promotion of adherence, through routine individualised counselling, monitoring and assessment, is vital to minimise adverse outcomes.
目的:分析抗糖尿病治疗(饮食、体力活动和药物)依从性与围产期结局之间的关系。方法:采用队列设计。参与者是157名患有糖尿病的孕妇，地点是津巴布韦哈拉雷的Mbuya Nehanda和Chitungwiza妇产医院。结果:主要结局指标为产妇结局和围产儿结局。抗糖尿病治疗的平均依从性为66.7%。围产期结果为高血压(34.5%)、剖宫产(45.9%)、产妇糖尿病酮症酸中毒(5.1%)、产妇低血糖(15.9%)和念珠菌病(19.7%)。新生儿结局为围产期死亡率(15.9%)、1分钟低Apgar评分(26.8%)、5分钟低Apgar评分(24.8%)、巨大儿(33.8%)、新生儿低血糖(15.3%)和新生儿高胆红素血症(7.6%)。依从性与剖宫产(RR 1.9, 95% CI 1.28 ~ 2.81, p = 0.0014)、念菌感染(RR 3.95, 95% CI 1.65 ~ 9.47, p = 0.002)、1分钟Apgar评分低(RR 2.15, 95% CI 1.16 ~ 3.98, p = 0.015)和5分钟Apgar评分低(RR 1.95, 95% CI 1.03 ~ 3.69, p = 0.039)以及围产期死亡率(RR 3.08, 95% CI 1.11 ~ 8.52, p = 0.018)存在显著相关。结论:坚持抗糖尿病治疗是次优的，并与一些不良的围产期结局相关。通过常规的个体化咨询、监测和评估来促进依从性，对于尽量减少不良后果至关重要。
{"title":"Association between adherence to anti-diabetic therapy and adverse maternal and perinatal outcomes in diabetes in pregnancy","authors":"D. Mukona, S. Munjanja, M. Zvinavashe, B. Stray-Pederson","doi":"10.1080/16089677.2018.1465247","DOIUrl":"https://doi.org/10.1080/16089677.2018.1465247","url":null,"abstract":"Objectives: To analyse the association between adherence to anti-diabetic therapy (diet, physical activity and medications) and perinatal outcomes. Methods: A cohort design was used. Participants were 157 pregnant women with diabetes, and the setting was Mbuya Nehanda and Chitungwiza Maternity Hospitals, Harare, Zimbabwe. Results: Main outcome measures were maternal and perinatal outcomes. Mean adherence to anti-diabetic therapy was 66.7%. Perinatal outcomes observed were hypertensive disorders (34.5%), Caesarean delivery (45.9%), maternal diabetic ketoacidosis (5.1%), maternal hypoglycaemia (15.9%), and candidiasis (19.7%). Neonatal outcomes were perinatal mortality (15.9%), low Apgar score at 1 minute (26.8%), low Apgar score at 5 minutes (24.8%), macrosomia (33.8%), neonatal hypoglycaemia (15.3%), and neonatal hyperbilirubinemia (7.6%). There were significant associations between adherence and Caesarean delivery (RR 1.9, 95% CI 1.28 to 2.81, p = 0.0014), candidiasis (RR 3.95, 95% CI 1.65 to 9.47, p = 0.002), low Apgar score at 1 minute (RR 2.15, 95% CI 1.16 to 3.98, p = 0.015) and at 5 minutes (RR 1.95, 95% CI 1.03 to 3.69, p = 0.039), and perinatal mortality (RR 3.08, 95% CI 1.11 to 8.52, p = 0.018). Conclusions: Adherence to anti-diabetic therapy was sub-optimal and was associated with some adverse perinatal outcomes. Promotion of adherence, through routine individualised counselling, monitoring and assessment, is vital to minimise adverse outcomes.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"52 54 1","pages":"70 - 75"},"PeriodicalIF":0.5,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80415446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-23DOI: 10.1080/16089677.2018.1450109
Abdurraouf Masaud Elbueishi, F. Pirie, A. Motala
Background: The mode of presentation, clinical, radiologic and laboratory characteristics of patients with acromegaly and the outcome following various modalities of treatment are not well documented in South Africa. Aim: To evaluate treatment outcome and follow-up of patients with acromegaly over a period of 10 years. Methods: The study is a retrospective record review of patients with acromegaly attending Inkosi Albert Luthuli Central Hospital, Durban, 2003–2013. Results: The study included 27 patients (16 female and 11 male) with a mean age at diagnosis of 44.2 ± 14.0 years. The mean growth hormone (GH) at diagnosis was 51.8 ± 32.6 μg/l and mean IGF-1 956.8 ± 432.9 μg/l. In 25 patients (92.5%) pituitary macroadenoma was identified; microadenoma was present in 2 (7.4%) patients. Trans-sphenoidal surgery was employed in 26 (96.3%) as the initial therapy; only 1 patient was treated medically. Adjunctive medical therapy was used in 23 (88.5%) and radiotherapy in 6 (22.2%). After a mean follow-up of 4.4 ± 3.4 years, 9 (33.3%) subjects were cured (normal age-matched and gender-matched IGF-1 and random GH < 1.0 μg/l). No deaths were recorded and post-procedural hypopituitarism developed in 22 (84.6%) patients. Conclusions: Patients with acromegaly in KwaZulu-Natal present with advanced clinical features and large pituitary adenomata. The overall cure rate is lower than reported from developed countries.
背景:在南非，肢端肥大症患者的表现模式、临床、放射学和实验室特征以及各种治疗方式后的结果并没有很好的记录。目的:评价肢端肥大症患者10年的治疗效果及随访情况。方法:回顾性分析2003-2013年在德班Inkosi Albert Luthuli中心医院就诊的肢端肥大症患者。结果:共纳入27例患者，其中女性16例，男性11例，平均诊断年龄44.2±14.0岁。诊断时平均生长激素(GH)为51.8±32.6 μg/l，平均IGF-1为956.8±432.9 μg/l。确诊垂体大腺瘤25例(92.5%);2例(7.4%)患者存在微腺瘤。26例(96.3%)采用经蝶窦手术作为初始治疗;只有1名患者接受了医疗治疗。辅助药物治疗23例(88.5%)，放疗6例(22.2%)。平均随访4.4±3.4年，9例(33.3%)患者痊愈(年龄和性别匹配正常的IGF-1和随机GH < 1.0 μg/l)。无死亡记录，22例(84.6%)患者出现术后垂体功能减退。结论:夸祖鲁-纳塔尔省肢端肥大症患者具有晚期临床特征和大垂体腺瘤。总体治愈率低于发达国家报告的治愈率。
{"title":"Characteristics and outcome of surgically treated acromegaly patients attending an endocrinology clinic at a tertiary referral centre in Durban, South Africa over a period of 10 years","authors":"Abdurraouf Masaud Elbueishi, F. Pirie, A. Motala","doi":"10.1080/16089677.2018.1450109","DOIUrl":"https://doi.org/10.1080/16089677.2018.1450109","url":null,"abstract":"Background: The mode of presentation, clinical, radiologic and laboratory characteristics of patients with acromegaly and the outcome following various modalities of treatment are not well documented in South Africa. Aim: To evaluate treatment outcome and follow-up of patients with acromegaly over a period of 10 years. Methods: The study is a retrospective record review of patients with acromegaly attending Inkosi Albert Luthuli Central Hospital, Durban, 2003–2013. Results: The study included 27 patients (16 female and 11 male) with a mean age at diagnosis of 44.2 ± 14.0 years. The mean growth hormone (GH) at diagnosis was 51.8 ± 32.6 μg/l and mean IGF-1 956.8 ± 432.9 μg/l. In 25 patients (92.5%) pituitary macroadenoma was identified; microadenoma was present in 2 (7.4%) patients. Trans-sphenoidal surgery was employed in 26 (96.3%) as the initial therapy; only 1 patient was treated medically. Adjunctive medical therapy was used in 23 (88.5%) and radiotherapy in 6 (22.2%). After a mean follow-up of 4.4 ± 3.4 years, 9 (33.3%) subjects were cured (normal age-matched and gender-matched IGF-1 and random GH < 1.0 μg/l). No deaths were recorded and post-procedural hypopituitarism developed in 22 (84.6%) patients. Conclusions: Patients with acromegaly in KwaZulu-Natal present with advanced clinical features and large pituitary adenomata. The overall cure rate is lower than reported from developed countries.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"1 1","pages":"64 - 69"},"PeriodicalIF":0.5,"publicationDate":"2018-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76210995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-12DOI: 10.1080/16089677.2018.1446592
Abdurraouf Esseid Zorgani, F. Pirie, A. Motala
Objectives: To evaluate the characteristics and outcomes of treatment of patients with pheochromocytoma at Inkosi Albert Luthuli Central Hospital (ILACH) in Durban, South Africa over 14 years. Design: Retrospective chart review. Setting and subjects: Patients with pheochromocytoma attending the endocrinology clinic at IALCH between 2012 and 2016 were studied. Outcome measures: Clinical, biochemical and radiological data were collected at presentation, on discharge, one year and five years after surgical intervention; tumour characteristics, histopathological features and surgical outcome were also assessed. Results: The analysis included 35 patients (mean age 33.2 ± 15.7 years; 60% female). Headache (68.6%), palpitation (60%) and sweating (57.6%) were the three most common presenting symptoms; hypertension was the predominant clinical finding (85.7%). Most pheochromocytomas were sporadic (82.9%), adrenal gland tumours (68.6%) and benign (77.1%); of eight patients with malignant tumours, two were familial. Adrenalectomy was undertaken in the majority (n = 34; 97.1%); 55.2% were large tumours. The use of adjunctive radiotherapy (n = 4; 11.4%) and chemotherapy (n = 1; 2.9%) was low. There was low overall mortality (5.7%), but 57.6% developed intraoperative hypotension. At one year postoperatively, 80% (n = 28) of patients were defined as cure, biochemically in 23 (82.1%) and with radiology in five (17.9%). Conclusions: Most patients presenting to IALCH had large intra-abdominal tumours with high cure rate, low mortality but a high rate of perioperative complications. Late presentation and large tumour size was a feature.
{"title":"Characteristics and outcome of patients with pheochromocytoma at a tertiary endocrinology clinic in Durban, South Africa over 14 years","authors":"Abdurraouf Esseid Zorgani, F. Pirie, A. Motala","doi":"10.1080/16089677.2018.1446592","DOIUrl":"https://doi.org/10.1080/16089677.2018.1446592","url":null,"abstract":"Objectives: To evaluate the characteristics and outcomes of treatment of patients with pheochromocytoma at Inkosi Albert Luthuli Central Hospital (ILACH) in Durban, South Africa over 14 years. Design: Retrospective chart review. Setting and subjects: Patients with pheochromocytoma attending the endocrinology clinic at IALCH between 2012 and 2016 were studied. Outcome measures: Clinical, biochemical and radiological data were collected at presentation, on discharge, one year and five years after surgical intervention; tumour characteristics, histopathological features and surgical outcome were also assessed. Results: The analysis included 35 patients (mean age 33.2 ± 15.7 years; 60% female). Headache (68.6%), palpitation (60%) and sweating (57.6%) were the three most common presenting symptoms; hypertension was the predominant clinical finding (85.7%). Most pheochromocytomas were sporadic (82.9%), adrenal gland tumours (68.6%) and benign (77.1%); of eight patients with malignant tumours, two were familial. Adrenalectomy was undertaken in the majority (n = 34; 97.1%); 55.2% were large tumours. The use of adjunctive radiotherapy (n = 4; 11.4%) and chemotherapy (n = 1; 2.9%) was low. There was low overall mortality (5.7%), but 57.6% developed intraoperative hypotension. At one year postoperatively, 80% (n = 28) of patients were defined as cure, biochemically in 23 (82.1%) and with radiology in five (17.9%). Conclusions: Most patients presenting to IALCH had large intra-abdominal tumours with high cure rate, low mortality but a high rate of perioperative complications. Late presentation and large tumour size was a feature.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"5 1","pages":"52 - 58"},"PeriodicalIF":0.5,"publicationDate":"2018-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87694553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-05DOI: 10.1080/16089677.2018.1433109
P. Guness, T. Diams
Background: T1 Diams, a non-profit organisation on the island of Mauritius, has been working on the implementation of therapeutic and educational activities for its members. It regularly organises a recreational diabetic day (‘Enjoy life’ or ‘T1 Diams en Balade’). Aim: To give an overview of a typical diabetic recreational day. Methods: The author participated in several of these activities organised by the organisation in 2014 and 2015. Results: A total of 22 patients came to the event; 11 (≥ 12 years old) attended for the day. The morning session was dedicated to diabetic therapeutic education and was carried out by two diabetes nurses. During the afternoon session there were physical activities for those > 12 years old and low-intensity activities for the other group. The menu for lunch was devised by a nutritionist. Blood glucose levels were regularly monitored. The patients did their own insulin injections. Conclusion: This recreational diabetic day gives an opportunity for parents to be reassured that their diabetic children can be autonomous. The day was carried out in a professional way so as to empower the patients. These activities should be organised regularly during the year.
背景:T1 Diams是毛里求斯岛上的一个非营利组织，一直致力于为其成员实施治疗和教育活动。它定期组织娱乐性糖尿病患者日(“享受生活”或“T1 Diams en Balade”)。目的:概述典型的糖尿病患者娱乐日。方法:作者于2014年和2015年参加了该组织组织的多次此类活动。结果:共有22例患者参加了活动;11名(≥12岁)参加了当天的活动。上午的课程是糖尿病治疗教育，由两名糖尿病护士进行。在下午的会议上，12岁以上的学生进行体育活动，另一组进行低强度活动。午餐的菜单是由一位营养学家设计的。定期监测血糖水平。病人自己注射胰岛素。结论:这个娱乐糖尿病日为父母提供了一个机会，让他们放心，他们的糖尿病孩子可以自主。这一天以专业的方式进行，以赋予患者权力。年内应定期举办这些活动。
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Pub Date : 2018-03-02DOI: 10.1080/16089677.2018.1434033
Nour Soliman, Mohamed M. El-Shabrawi, S. Omar
Background: Increased production of free radicals and oxidative stress in type II diabetic patients could be one of the probable causes for development of complications. The authors hypothesise that such a mechanism also contributes to the development of diabetic nephropathy in those patients. Aim: The aim of this study was to evaluate the association of DNA fragmentation damage with diabetic nephropathy in type II diabetes mellitus, so as to use it as a future novel predictive marker. Patients and methods: The study population included 100 patients with diabetic nephropathy, 100 diabetic patients without nephropathy and 100 healthy volunteers as controls. Lipid profile, fasting and post-prandial blood glucose, micro-albuminuria (micro-alb) and glycosylated haemoglobin (HbA1c) were assessed in patients and controls. The technique of capillary electrophoresis was used to detect DNA damage. Results: The frequency of DNA damage in peripheral blood mononuclear cells was 71% in diabetic nephropathy compared with 45% in non-nephropathy patients (p < 0.001). None of healthy controls showed such a finding. Oxidative DNA fragmentation in the diabetic nephropathy group was 3.06 times that in the non-nephropathy group. Neither poor glycaemic control nor dyslipidaemia contributed to DNA damage in diabetic patients. Multivariate analysis showed that positive oxidative DNA damage test (OR1.58, p = 0.02) and the duration of ongoing DM (OR 1.48, p = 0.004) were the only independent factors contributing to the occurrence of diabetic nephropathy. Conclusion: Type II diabetic patients have more liability to oxidative DNA damage in general with a significantly higher frequency in diabetic nephropathy. DNA fragmentation analysis can be used as a predictive diagnostic biomarker for diabetic nephropathy.
背景:II型糖尿病患者自由基和氧化应激的增加可能是并发症发生的可能原因之一。作者假设，这种机制也有助于这些患者糖尿病肾病的发展。目的:本研究的目的是评估DNA片段损伤与II型糖尿病肾病的关系，从而将其作为未来新的预测指标。患者和方法:研究人群包括100例糖尿病肾病患者、100例非肾病糖尿病患者和100名健康志愿者作为对照。对患者和对照组的血脂、空腹和餐后血糖、微量蛋白尿(micro-alb)和糖化血红蛋白(HbA1c)进行评估。采用毛细管电泳技术检测DNA损伤。结果:糖尿病肾病患者外周血单个核细胞DNA损伤频率为71%，非肾病患者为45% (p < 0.001)。没有健康的对照组显示出这样的结果。糖尿病肾病组氧化性DNA断裂是非肾病组的3.06倍。糖尿病患者血糖控制不良和血脂异常均不会导致DNA损伤。多因素分析显示，氧化DNA损伤试验阳性(OR1.58, p = 0.02)和糖尿病持续时间(or1.48, p = 0.004)是影响糖尿病肾病发生的唯一独立因素。结论:2型糖尿病患者总体上更易发生DNA氧化损伤，且糖尿病肾病发生率明显增高。DNA片段化分析可作为糖尿病肾病的预测性诊断生物标志物。
{"title":"DNA fragmentation damage as a predictive marker for diabetic nephropathy in Type II diabetes mellitus","authors":"Nour Soliman, Mohamed M. El-Shabrawi, S. Omar","doi":"10.1080/16089677.2018.1434033","DOIUrl":"https://doi.org/10.1080/16089677.2018.1434033","url":null,"abstract":"Background: Increased production of free radicals and oxidative stress in type II diabetic patients could be one of the probable causes for development of complications. The authors hypothesise that such a mechanism also contributes to the development of diabetic nephropathy in those patients. Aim: The aim of this study was to evaluate the association of DNA fragmentation damage with diabetic nephropathy in type II diabetes mellitus, so as to use it as a future novel predictive marker. Patients and methods: The study population included 100 patients with diabetic nephropathy, 100 diabetic patients without nephropathy and 100 healthy volunteers as controls. Lipid profile, fasting and post-prandial blood glucose, micro-albuminuria (micro-alb) and glycosylated haemoglobin (HbA1c) were assessed in patients and controls. The technique of capillary electrophoresis was used to detect DNA damage. Results: The frequency of DNA damage in peripheral blood mononuclear cells was 71% in diabetic nephropathy compared with 45% in non-nephropathy patients (p < 0.001). None of healthy controls showed such a finding. Oxidative DNA fragmentation in the diabetic nephropathy group was 3.06 times that in the non-nephropathy group. Neither poor glycaemic control nor dyslipidaemia contributed to DNA damage in diabetic patients. Multivariate analysis showed that positive oxidative DNA damage test (OR1.58, p = 0.02) and the duration of ongoing DM (OR 1.48, p = 0.004) were the only independent factors contributing to the occurrence of diabetic nephropathy. Conclusion: Type II diabetic patients have more liability to oxidative DNA damage in general with a significantly higher frequency in diabetic nephropathy. DNA fragmentation analysis can be used as a predictive diagnostic biomarker for diabetic nephropathy.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"89 1","pages":"32 - 35"},"PeriodicalIF":0.5,"publicationDate":"2018-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80976299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-01DOI: 10.1080/16089677.2018.1433110
A. Birkinshaw, R. Nel, C. Walsh
Background: Type 2 diabetes mellitus (T2DM) is considered to be the fastest growing chronic disease in the world and thus multi-sectoral, population-based strategies and approaches are needed to address the modifiable risk factors involved in the development and treatment of T2DM. Evidence-based nutrition principles and recommendations are summarised by the Society for Endocrinology, Metabolism and Diabetes in South Africa (SEMDSA) into guidelines for the management of T2DM. This study aimed to determine the adherence of patients with T2DM with the SEMDSA lifestyle guidelines. Methods: A cross-sectional study was conducted in a private practice (n = 50), during which an interviewer-assisted questionnaire related to socio-demographics, diet and lifestyle was completed with each participant. Participants were also weighed and measured. Results: 88% of participants were overweight (22%) or obese (66%). Diets consumed were generally high in total energy (TE) (median: 13 272 kJ), low in carbohydrates (CHO) (56% of participants consumed < 45% of CHO from TE), high in saturated fat (92% consumed ≥ 7% from TE) and high in sodium (74% of participants consumed ≥ 2 300 mg sodium daily). Exercise was not commonplace; 84% of participants did not meet the guideline for aerobic exercise and 92% did not meet the guideline for resistance training. Conclusion: The adherence of participants to the SEMDSA guidelines was poor, thus increasing the risk of long-term complications and poor glycaemic control.
{"title":"Adherence of patients with type 2 diabetes mellitus with the SEMDSA lifestyle guidelines","authors":"A. Birkinshaw, R. Nel, C. Walsh","doi":"10.1080/16089677.2018.1433110","DOIUrl":"https://doi.org/10.1080/16089677.2018.1433110","url":null,"abstract":"Background: Type 2 diabetes mellitus (T2DM) is considered to be the fastest growing chronic disease in the world and thus multi-sectoral, population-based strategies and approaches are needed to address the modifiable risk factors involved in the development and treatment of T2DM. Evidence-based nutrition principles and recommendations are summarised by the Society for Endocrinology, Metabolism and Diabetes in South Africa (SEMDSA) into guidelines for the management of T2DM. This study aimed to determine the adherence of patients with T2DM with the SEMDSA lifestyle guidelines. Methods: A cross-sectional study was conducted in a private practice (n = 50), during which an interviewer-assisted questionnaire related to socio-demographics, diet and lifestyle was completed with each participant. Participants were also weighed and measured. Results: 88% of participants were overweight (22%) or obese (66%). Diets consumed were generally high in total energy (TE) (median: 13 272 kJ), low in carbohydrates (CHO) (56% of participants consumed < 45% of CHO from TE), high in saturated fat (92% consumed ≥ 7% from TE) and high in sodium (74% of participants consumed ≥ 2 300 mg sodium daily). Exercise was not commonplace; 84% of participants did not meet the guideline for aerobic exercise and 92% did not meet the guideline for resistance training. Conclusion: The adherence of participants to the SEMDSA guidelines was poor, thus increasing the risk of long-term complications and poor glycaemic control.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"1 1","pages":"39 - 45"},"PeriodicalIF":0.5,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83350962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-12DOI: 10.1080/16089677.2017.1407097
O. Greeff, J. J. van Tonder, Kershlin Naidu, A. McMaster, A. van Tonder, R. Mothilal
Glucose clamp studies form an integral part of the early development of insulin therapies. Data generated in these studies are used to establish pharmacokinetic (PK) and pharmacodynamic (PD) profiles of the agents, but methodological differences confound comparison of results from different glucose clamp studies. The first part of this series on glucose clamp studies discussed practical tips for the interpretation of glucose clamp studies. The second part of the series compares the PK/PD profiles of longer-acting basal analogue insulins, insulin degludec (IDeg) and insulin glargine U300 (Gla-300). The patient populations for glucose clamp studies with these analogue insulins differ, and therefore direct comparison of the data is not always possible. The maximum duration of action of IDeg is reported as 42 h and that of Gla-300 as 36 h, translating to 24 h coverage. The plasma insulin concentration of IDeg is 56 times that of Gla-300. Results from phase III clinical trials for these analogue insulins confirm the predictability and low within-subject variability observed in glucose clamp studies. Insight into the PK/PD profiles of longer-acting basal analogue insulins allows the treating physician to utilise these characteristics to optimise the treatment of their patients with diabetes.
{"title":"A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part two: Insulin degludec vs. insulin glargine U300","authors":"O. Greeff, J. J. van Tonder, Kershlin Naidu, A. McMaster, A. van Tonder, R. Mothilal","doi":"10.1080/16089677.2017.1407097","DOIUrl":"https://doi.org/10.1080/16089677.2017.1407097","url":null,"abstract":"Glucose clamp studies form an integral part of the early development of insulin therapies. Data generated in these studies are used to establish pharmacokinetic (PK) and pharmacodynamic (PD) profiles of the agents, but methodological differences confound comparison of results from different glucose clamp studies. The first part of this series on glucose clamp studies discussed practical tips for the interpretation of glucose clamp studies. The second part of the series compares the PK/PD profiles of longer-acting basal analogue insulins, insulin degludec (IDeg) and insulin glargine U300 (Gla-300). The patient populations for glucose clamp studies with these analogue insulins differ, and therefore direct comparison of the data is not always possible. The maximum duration of action of IDeg is reported as 42 h and that of Gla-300 as 36 h, translating to 24 h coverage. The plasma insulin concentration of IDeg is 56 times that of Gla-300. Results from phase III clinical trials for these analogue insulins confirm the predictability and low within-subject variability observed in glucose clamp studies. Insight into the PK/PD profiles of longer-acting basal analogue insulins allows the treating physician to utilise these characteristics to optimise the treatment of their patients with diabetes.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"34 1","pages":"46 - 51"},"PeriodicalIF":0.5,"publicationDate":"2018-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87140800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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