Pub Date : 2023-03-03DOI: 10.1080/16089677.2023.2178155
L. Greenstein, R. Daya, D. Jacob, Z. Bayat
Hyponatraemia and Vitamin D deficiency are common conditions in older adults. Both conditions cause bone fragility and gait abnormalities, which are risk factors for falls and poor health outcomes in older adults. Vitamin D deficiency is a risk factor for osteoporosis and increases the risk for fragility fractures. Hyponatraemia, the commonest electrolyte abnormality, causes bone resorption and contributes to falls by impairing cognition and by causing gait abnormalities. Sodium homeostasis is complex and the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a diagnosis of exclusion, is one of the most common causes of hyponatraemia. Instability is a feared geriatric syndrome, as falls can have devastating consequences for the older adult, leading to significant morbidity and mortality. Previous studies have shown that patients with hyponatraemia had a higher rate of vitamin D deficiency and, conversely, those with vitamin D deficiency had a higher rate of hyponatraemia. The exact pathophysiological mechanism behind this correlation is unclear but may involve bone derived hormone fibroblast growth factor 23 and the renin–angiotensin–aldosterone system. A case of an 83-year-old Asian female, who presented with an osteoporotic intertrochanteric femoral fracture following a fall, is presented. She was found to have chronic hyponatraemia and was subsequently diagnosed with SIADH due to vitamin D deficiency.
{"title":"A case of hyponatraemia secondary to vitamin D deficiency","authors":"L. Greenstein, R. Daya, D. Jacob, Z. Bayat","doi":"10.1080/16089677.2023.2178155","DOIUrl":"https://doi.org/10.1080/16089677.2023.2178155","url":null,"abstract":"Hyponatraemia and Vitamin D deficiency are common conditions in older adults. Both conditions cause bone fragility and gait abnormalities, which are risk factors for falls and poor health outcomes in older adults. Vitamin D deficiency is a risk factor for osteoporosis and increases the risk for fragility fractures. Hyponatraemia, the commonest electrolyte abnormality, causes bone resorption and contributes to falls by impairing cognition and by causing gait abnormalities. Sodium homeostasis is complex and the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a diagnosis of exclusion, is one of the most common causes of hyponatraemia. Instability is a feared geriatric syndrome, as falls can have devastating consequences for the older adult, leading to significant morbidity and mortality. Previous studies have shown that patients with hyponatraemia had a higher rate of vitamin D deficiency and, conversely, those with vitamin D deficiency had a higher rate of hyponatraemia. The exact pathophysiological mechanism behind this correlation is unclear but may involve bone derived hormone fibroblast growth factor 23 and the renin–angiotensin–aldosterone system. A case of an 83-year-old Asian female, who presented with an osteoporotic intertrochanteric femoral fracture following a fall, is presented. She was found to have chronic hyponatraemia and was subsequently diagnosed with SIADH due to vitamin D deficiency.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"73 1","pages":"83 - 86"},"PeriodicalIF":0.5,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80543640","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 : 2023-03-03DOI: 10.1080/16089677.2023.2178157
C. Sydney, L. Nandlal, F. Haffejee, Jamila Kathoon, T. Naicker
Background: Despite highly active antiretroviral therapy (HAART) leading to a decline in human immunodeficiency virus (HIV)-induced morbidity and mortality, in recent years HAART has been implicated in abnormal lipid profiles, diabetes mellitus (DM) and predisposition of patients to cardiovascular disease (CVD). Objectives: In this comparative study, the side effects of HAART as well as other lifestyle factors such as diet, exercise, alcohol and/or smoking were assessed, as well as family history of diabetes between HIV-infected and HIV-uninfected patients of African ancestry with DM. Methods: The study population consisted of 80 Black African diabetic patients (18–65 years old) stratified by HIV status (HIV-infected n = 40; HIV-uninfected n = 40). Anthropometric measurements (weight, height and BMI) and blood pressure (BP), as well as biochemical tests for glucose, cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides were performed. Results: The median BMI indicated overweight in the HIV-infected compared with the HIV-uninfected, which was congruent with obesity. Systolic BP was higher in the HIV-infected compared with the HIV-uninfected groups, at 138.15 and 134.75 mmHg (p = 0.1651), respectively. Glucose was high in both groups, confirming diabetes (p = 0.3900). Cholesterol was high (4.85 mmol/l) in the HIV-infected group while HDL was lower (0.95 mmol/l) in the HIV-uninfected group. Triglycerides were elevated in the HIV-uninfected (1.90 mmol/l) compared with the HIV-infected (1.61 mmol/l) (p = 0.7500) group. Conclusion: Despite HAART being documented as a contributor to DM and abnormal lipid profiles in the HIV-infected group, lifestyle factors such as diet also affect obesity phenotype in the uninfected group. Thus, irrespective of DM and/or HIV status, a lack of exercise, behavioural and lifestyle risk factors exacerbate abnormal lipid profiles. Notably, a family history of DM showed a strong susceptibility to its development.
{"title":"Lipid profiles of HIV-infected diabetic patients","authors":"C. Sydney, L. Nandlal, F. Haffejee, Jamila Kathoon, T. Naicker","doi":"10.1080/16089677.2023.2178157","DOIUrl":"https://doi.org/10.1080/16089677.2023.2178157","url":null,"abstract":"Background: Despite highly active antiretroviral therapy (HAART) leading to a decline in human immunodeficiency virus (HIV)-induced morbidity and mortality, in recent years HAART has been implicated in abnormal lipid profiles, diabetes mellitus (DM) and predisposition of patients to cardiovascular disease (CVD). Objectives: In this comparative study, the side effects of HAART as well as other lifestyle factors such as diet, exercise, alcohol and/or smoking were assessed, as well as family history of diabetes between HIV-infected and HIV-uninfected patients of African ancestry with DM. Methods: The study population consisted of 80 Black African diabetic patients (18–65 years old) stratified by HIV status (HIV-infected n = 40; HIV-uninfected n = 40). Anthropometric measurements (weight, height and BMI) and blood pressure (BP), as well as biochemical tests for glucose, cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides were performed. Results: The median BMI indicated overweight in the HIV-infected compared with the HIV-uninfected, which was congruent with obesity. Systolic BP was higher in the HIV-infected compared with the HIV-uninfected groups, at 138.15 and 134.75 mmHg (p = 0.1651), respectively. Glucose was high in both groups, confirming diabetes (p = 0.3900). Cholesterol was high (4.85 mmol/l) in the HIV-infected group while HDL was lower (0.95 mmol/l) in the HIV-uninfected group. Triglycerides were elevated in the HIV-uninfected (1.90 mmol/l) compared with the HIV-infected (1.61 mmol/l) (p = 0.7500) group. Conclusion: Despite HAART being documented as a contributor to DM and abnormal lipid profiles in the HIV-infected group, lifestyle factors such as diet also affect obesity phenotype in the uninfected group. Thus, irrespective of DM and/or HIV status, a lack of exercise, behavioural and lifestyle risk factors exacerbate abnormal lipid profiles. Notably, a family history of DM showed a strong susceptibility to its development.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"24 1","pages":"56 - 61"},"PeriodicalIF":0.5,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87338330","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 : 2023-02-06DOI: 10.1080/16089677.2022.2151175
BN Mkhwanazi, L. Govender, S. Pillay
Background: A prolonged corrected QT (QTc) interval on the electrocardiograph is an important marker of cardiac autonomic neuropathy and increased risk of developing arrhythmias. Various formulae exist for the calculation of QTc, the most common being Bazett’s, which is also the default formula utilised by the Edan SE® ECG machine to automatically calculate QTc. Little or no literature exists on the comparisons of the various formulae in patients living with diabetes, more especially in those diabetes patients with HIV infection. Methods: Retrospective (n = 631) electrocardiographs were collected and analysed. QT and RR were measured for QTc calculation. QTc was calculated using three formulae, namely Bazett (QTcB), Fridericia (QTcFri) and Framingham (QTcFram). Additionally, the automated QTc (QTcM), which used Bazett’s formula, was recorded for comparison purposes. To determine the optimal formula for QTc calculation, slopes and r 2 using a QTc/RR regression analysis were calculated. The formula with the r 2 closest to zero was deemed superior when compared with its counterparts. Results: The QTc Bazett was the worst-performing formula for QTc calculation, with the QTcFri performing best across both type 2 and type 1 diabetes patients with or without HIV infection. To validate which formula was employed in the automated QTc result, a mean difference comparison was performed, which indicated a non-significant difference between the machine-calculated QTcM and QTcB (p = 0.572, 0.384, 0.980) in all groups except for the type 1 diabetic group without HIV (p = 0.009). These findings indicated that the automated QTc employed Bazett’s formula. Conclusion: Evidence from this study has shown that the best formula to calculate QTc in patients with DM, with and without HIV infection, is the Fridericia formula. The authors advise that careful consideration should be taken when selecting a formula for QTc calculation. This will improve precision diagnosis and patient care.
{"title":"Comparison of formulae for calculating the corrected QT (QTc) interval in an adult population attending a diabetes clinic at a rural hospital in South Africa.","authors":"BN Mkhwanazi, L. Govender, S. Pillay","doi":"10.1080/16089677.2022.2151175","DOIUrl":"https://doi.org/10.1080/16089677.2022.2151175","url":null,"abstract":"Background: A prolonged corrected QT (QTc) interval on the electrocardiograph is an important marker of cardiac autonomic neuropathy and increased risk of developing arrhythmias. Various formulae exist for the calculation of QTc, the most common being Bazett’s, which is also the default formula utilised by the Edan SE® ECG machine to automatically calculate QTc. Little or no literature exists on the comparisons of the various formulae in patients living with diabetes, more especially in those diabetes patients with HIV infection. Methods: Retrospective (n = 631) electrocardiographs were collected and analysed. QT and RR were measured for QTc calculation. QTc was calculated using three formulae, namely Bazett (QTcB), Fridericia (QTcFri) and Framingham (QTcFram). Additionally, the automated QTc (QTcM), which used Bazett’s formula, was recorded for comparison purposes. To determine the optimal formula for QTc calculation, slopes and r 2 using a QTc/RR regression analysis were calculated. The formula with the r 2 closest to zero was deemed superior when compared with its counterparts. Results: The QTc Bazett was the worst-performing formula for QTc calculation, with the QTcFri performing best across both type 2 and type 1 diabetes patients with or without HIV infection. To validate which formula was employed in the automated QTc result, a mean difference comparison was performed, which indicated a non-significant difference between the machine-calculated QTcM and QTcB (p = 0.572, 0.384, 0.980) in all groups except for the type 1 diabetic group without HIV (p = 0.009). These findings indicated that the automated QTc employed Bazett’s formula. Conclusion: Evidence from this study has shown that the best formula to calculate QTc in patients with DM, with and without HIV infection, is the Fridericia formula. The authors advise that careful consideration should be taken when selecting a formula for QTc calculation. This will improve precision diagnosis and patient care.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"32 1","pages":"49 - 55"},"PeriodicalIF":0.5,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82916076","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 : 2022-12-21DOI: 10.1080/16089677.2022.2144428
K. Naidu, V. Saksenberg, MF Suliman, B. Bhana
Thyroid paragangliomas (TPG) are rare neuroendocrine tumours
甲状腺副神经节瘤是一种罕见的神经内分泌肿瘤
{"title":"Thyroid paraganglioma – a rare entity","authors":"K. Naidu, V. Saksenberg, MF Suliman, B. Bhana","doi":"10.1080/16089677.2022.2144428","DOIUrl":"https://doi.org/10.1080/16089677.2022.2144428","url":null,"abstract":"Thyroid paragangliomas (TPG) are rare neuroendocrine tumours","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"153 1","pages":"69 - 71"},"PeriodicalIF":0.5,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79647450","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}
Background: Evidence reported a high occurrence of diabetes mellitus (DM) during the time of COVID-19. This study aimed to assess the incidence of DM and its predictors among severe COVID-19 patients admitted to the treatment centre of Wollega University Referral Hospital (WURH), western Ethiopia. Methods: A facility-based retrospective cohort study was conducted among severe COVID-19 patients diagnosed using the rRT-PCR from September 30, 2020, to June 10, 2021. EpiData version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with DM. A multivariable Cox regression model with 95% CI and adjusted hazard ratio (AHR) was used to identify a significant predictor of the incidence of DM at p-value < 0.05. Results: A total of 304 patient cards with complete data were included in the final analysis. The mean age of the participants was 43.3 (SD ± 16.9) years. Of the total 304 patients admitted with severe COVID-19, 14.5% were newly diagnosed with DM with an overall incidence rate of 13.7 per 1 000 person days’ observation (PDO). The median time to occurrence of DM was 11 days (95% CI 7, 13) days. Age > 41 years (AHR = 2.54, 95% CI 1.15, 5.57), living in urban (AHR = 2.49, 95% CI 1.12, 5.52) and loss of appetite (AHR = 2.24, 95% CI 1.16, 4.34) increased the hazard of DM incidence, while presenting to the health facility after two days of clinical manifestation (AHR = 0.49, 95% CI 0.23, 0.96) decreased the risk of developing DM. Conclusions: The incidence rate of DM among patients admitted with severe COVID-19 in the study area was found to be 13.7 per 1 000 person days’ observation. Higher age, urban residence, early presentation to a health facility and loss of appetite were independent predictors of DM incidence. Therefore, we recommend early detection of DM and frequent monitoring of blood glucose for patients diagnosed with COVID-19.
背景:有证据表明，在COVID-19期间，糖尿病(DM)的发生率很高。本研究旨在评估埃塞俄比亚西部沃勒加大学转诊医院(WURH)治疗中心收治的重症COVID-19患者中糖尿病的发病率及其预测因素。方法:对2020年9月30日至2021年6月10日使用rRT-PCR诊断的COVID-19重症患者进行基于医院的回顾性队列研究。数据录入使用EpiData 3.2版本，分析使用STATA 14版本。采用Cox比例风险回归分析确定与糖尿病相关的因素。采用95% CI和校正风险比(AHR)的多变量Cox回归模型确定41岁时糖尿病发病率的显著预测因子(AHR = 2.54, 95% CI 1.15, 5.57)，居住在城市(AHR = 2.49, 95% CI 1.12, 5.52)和食欲减退(AHR = 2.24, 95% CI 1.16, 4.34)增加了糖尿病发病率的风险。临床表现2天后到卫生机构就诊(AHR = 0.49, 95% CI 0.23, 0.96)可降低发生糖尿病的风险。结论:研究区重症COVID-19住院患者的糖尿病发病率为13.7 / 1000人日。较高的年龄、城市居住、早期就诊和食欲减退是糖尿病发病率的独立预测因素。因此，我们建议对诊断为COVID-19的患者早期发现糖尿病并频繁监测血糖。
{"title":"Incidence and predictors of diabetes mellitus among severe COVID-19 patients in western Ethiopia: a retrospective cohort study","authors":"Tadesse Tolossa, Matiyos Lema, B. Wakuma, Ebisa Turi, Ginenus Fekadu, Diriba Mulisa, Getahun Fetensa","doi":"10.1080/16089677.2022.2144016","DOIUrl":"https://doi.org/10.1080/16089677.2022.2144016","url":null,"abstract":"Background: Evidence reported a high occurrence of diabetes mellitus (DM) during the time of COVID-19. This study aimed to assess the incidence of DM and its predictors among severe COVID-19 patients admitted to the treatment centre of Wollega University Referral Hospital (WURH), western Ethiopia. Methods: A facility-based retrospective cohort study was conducted among severe COVID-19 patients diagnosed using the rRT-PCR from September 30, 2020, to June 10, 2021. EpiData version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with DM. A multivariable Cox regression model with 95% CI and adjusted hazard ratio (AHR) was used to identify a significant predictor of the incidence of DM at p-value < 0.05. Results: A total of 304 patient cards with complete data were included in the final analysis. The mean age of the participants was 43.3 (SD ± 16.9) years. Of the total 304 patients admitted with severe COVID-19, 14.5% were newly diagnosed with DM with an overall incidence rate of 13.7 per 1 000 person days’ observation (PDO). The median time to occurrence of DM was 11 days (95% CI 7, 13) days. Age > 41 years (AHR = 2.54, 95% CI 1.15, 5.57), living in urban (AHR = 2.49, 95% CI 1.12, 5.52) and loss of appetite (AHR = 2.24, 95% CI 1.16, 4.34) increased the hazard of DM incidence, while presenting to the health facility after two days of clinical manifestation (AHR = 0.49, 95% CI 0.23, 0.96) decreased the risk of developing DM. Conclusions: The incidence rate of DM among patients admitted with severe COVID-19 in the study area was found to be 13.7 per 1 000 person days’ observation. Higher age, urban residence, early presentation to a health facility and loss of appetite were independent predictors of DM incidence. Therefore, we recommend early detection of DM and frequent monitoring of blood glucose for patients diagnosed with COVID-19.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"42 1","pages":"42 - 48"},"PeriodicalIF":0.5,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80561776","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 : 2022-11-14DOI: 10.1080/16089677.2022.2140517
M. Mphasha, L. Skaal, T. Mothiba, C. Ngoatle, LS Hlahla
Background: Diabetes mellitus is a lifelong disease requiring daily self-care activities for better outcomes. Although most of these self-care activities for outpatients are taught in primary health care, their actual practice occurs at home where patients stay. Family dynamics or established cultures impact the management of the disease, hence a need for primary health care–family partnership to empower both families and patients with ways to manage the disease. This systematic review aims to describe the primary health care–family partnership. Methods: The literature was sourced using Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The Scopus/Elsevier, ScienceDirect and PubMed databases were used to source literature written in English and published between January 1, 2010 and July 31, 2022. Studies were included if focused on self-care activities, management and family-centred care (FCC); participants were diabetes patients and non-diabetic family members; and primary health care diabetes intervention. Results: A total of 62 publications that met inclusion criteria were used in this review. The included studies include quantitative, qualitative and mixed-method studies, including reports. The process of including these publications involved identification, screening and re-screening in line with set eligibility. The key search strategies resulted in the following sub-headings: diabetes self-care, diabetes self-management education and support (DSMES), family-centred care, and primary health care. Conclusion: Evidence from existing literature shows that primary health care is the source of information, yet actual diabetes management occurs at home. This review recommends the adoption of DSMES and FCC modalities to set the foundation for workable primary health care–family partnerships. The adoption of these joint modalities for partnerships will outline the dos and don’ts in managing diabetes at home. The literature further indicates that family support is critical, therefore primary health care–families partnership may lead to improved adherence to self-care activities and better outcomes.
{"title":"Primary health care–family partnership for better diabetes outcomes of patients: a systematic review","authors":"M. Mphasha, L. Skaal, T. Mothiba, C. Ngoatle, LS Hlahla","doi":"10.1080/16089677.2022.2140517","DOIUrl":"https://doi.org/10.1080/16089677.2022.2140517","url":null,"abstract":"Background: Diabetes mellitus is a lifelong disease requiring daily self-care activities for better outcomes. Although most of these self-care activities for outpatients are taught in primary health care, their actual practice occurs at home where patients stay. Family dynamics or established cultures impact the management of the disease, hence a need for primary health care–family partnership to empower both families and patients with ways to manage the disease. This systematic review aims to describe the primary health care–family partnership. Methods: The literature was sourced using Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The Scopus/Elsevier, ScienceDirect and PubMed databases were used to source literature written in English and published between January 1, 2010 and July 31, 2022. Studies were included if focused on self-care activities, management and family-centred care (FCC); participants were diabetes patients and non-diabetic family members; and primary health care diabetes intervention. Results: A total of 62 publications that met inclusion criteria were used in this review. The included studies include quantitative, qualitative and mixed-method studies, including reports. The process of including these publications involved identification, screening and re-screening in line with set eligibility. The key search strategies resulted in the following sub-headings: diabetes self-care, diabetes self-management education and support (DSMES), family-centred care, and primary health care. Conclusion: Evidence from existing literature shows that primary health care is the source of information, yet actual diabetes management occurs at home. This review recommends the adoption of DSMES and FCC modalities to set the foundation for workable primary health care–family partnerships. The adoption of these joint modalities for partnerships will outline the dos and don’ts in managing diabetes at home. The literature further indicates that family support is critical, therefore primary health care–families partnership may lead to improved adherence to self-care activities and better outcomes.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"12 1","pages":"1 - 6"},"PeriodicalIF":0.5,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74274423","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 : 2022-09-15DOI: 10.1080/16089677.2022.2113206
UG Adamu, D. Mpanya, A. Patel, N. Tsabedze
Cardiovascular disease is a significant cause of morbidity and mortality for individuals living with type 2 diabetes mellitus (T2DM). These patients have double the risk of atherosclerotic cardiovascular disease (ASCVD) compared with the general population. Furthermore, approximately a third of T2DM patients live with established ASCVD. The traditional ‘glucocentric’ approaches to managing T2DM have failed to mitigate the burden of ASCVD. In recent years, some cardiovascular outcome trials of the sodium glucose-2 cotransporter inhibitors (SGLT2i) and the glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated an ability to reduce secondary cardiovascular events significantly. These therapies have ushered in an era of ‘thinking beyond HbA1c’ when treating T2DM patients. There is now a renewed focus on assessing patients for ASCVD risk and adding these novel therapies early to mitigate the adverse cardiovascular events that have become familiar to this population. While the exact physiological mechanisms underlying these clinical benefits are not yet explicitly defined, both the glycaemic benefits and other pleiotropic effects improve the metabolic milieu. This review will discuss the burden of cardiovascular disease (CVD) in T2DM and present a summary of these new antidiabetic drug classes proven to reduce CVD in T2DM.
{"title":"Beyond HbA1c cardiovascular protection in type 2 diabetes mellitus","authors":"UG Adamu, D. Mpanya, A. Patel, N. Tsabedze","doi":"10.1080/16089677.2022.2113206","DOIUrl":"https://doi.org/10.1080/16089677.2022.2113206","url":null,"abstract":"Cardiovascular disease is a significant cause of morbidity and mortality for individuals living with type 2 diabetes mellitus (T2DM). These patients have double the risk of atherosclerotic cardiovascular disease (ASCVD) compared with the general population. Furthermore, approximately a third of T2DM patients live with established ASCVD. The traditional ‘glucocentric’ approaches to managing T2DM have failed to mitigate the burden of ASCVD. In recent years, some cardiovascular outcome trials of the sodium glucose-2 cotransporter inhibitors (SGLT2i) and the glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated an ability to reduce secondary cardiovascular events significantly. These therapies have ushered in an era of ‘thinking beyond HbA1c’ when treating T2DM patients. There is now a renewed focus on assessing patients for ASCVD risk and adding these novel therapies early to mitigate the adverse cardiovascular events that have become familiar to this population. While the exact physiological mechanisms underlying these clinical benefits are not yet explicitly defined, both the glycaemic benefits and other pleiotropic effects improve the metabolic milieu. This review will discuss the burden of cardiovascular disease (CVD) in T2DM and present a summary of these new antidiabetic drug classes proven to reduce CVD in T2DM.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"222 1","pages":"7 - 13"},"PeriodicalIF":0.5,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74941648","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 : 2022-09-13DOI: 10.1080/16089677.2022.2109856
M. Moosazadeh, A. Bahar, Ramin Yeganeh Sarhangi, M. Aarabi, M. Khademloo
Background: Approximately 2–10% of pregnant women experience subclinical hypothyroidism during pregnancy. Although some studies have shown that primary hypothyroidism increases the risk of gestational diabetes mellitus (GDM), there are contradictory results. Hence, this study aimed to determine the relationship between hypothyroidism and GDM. Methods: This is a retrospective cohort study in which the researchers followed up 340 pregnant women (170 with hypothyroidism as exposed group and 170 without hypothyroidism as unexposed group) for GDM. To analyse the data, chi-square, Fisher's exact test and independent t-test were employed. Results: The incidence of GDM in the hypothyroidism group was higher than that of the group without hypothyroidism (11.8% vs. 10.6%, p = 0.731). Moreover, the risk of GDM (95% CI:0.61; 2.02) was 1.11 times higher among women with hypothyroidism. However, the observed association was not statistically significant. The mean two-hour oral glucose tolerance test (OGTT) level in pregnant women with hypothyroidism (108.94 ± 19.89 mg/dl) was significantly higher than in the other group (104.49 ± 18.43 mg/dl) with a p-value of 0.033. Conclusions: This study displayed that the risk of GDM is 11% higher among women with hypothyroidism. Furthermore, the difference in the mean two-hour OGTT level in pregnant women with hypothyroidism was 4.4 mg/dl higher than in the other group.
{"title":"Relationship between hypothyroidism and gestational diabetes mellitus: a retrospective cohort study","authors":"M. Moosazadeh, A. Bahar, Ramin Yeganeh Sarhangi, M. Aarabi, M. Khademloo","doi":"10.1080/16089677.2022.2109856","DOIUrl":"https://doi.org/10.1080/16089677.2022.2109856","url":null,"abstract":"Background: Approximately 2–10% of pregnant women experience subclinical hypothyroidism during pregnancy. Although some studies have shown that primary hypothyroidism increases the risk of gestational diabetes mellitus (GDM), there are contradictory results. Hence, this study aimed to determine the relationship between hypothyroidism and GDM. Methods: This is a retrospective cohort study in which the researchers followed up 340 pregnant women (170 with hypothyroidism as exposed group and 170 without hypothyroidism as unexposed group) for GDM. To analyse the data, chi-square, Fisher's exact test and independent t-test were employed. Results: The incidence of GDM in the hypothyroidism group was higher than that of the group without hypothyroidism (11.8% vs. 10.6%, p = 0.731). Moreover, the risk of GDM (95% CI:0.61; 2.02) was 1.11 times higher among women with hypothyroidism. However, the observed association was not statistically significant. The mean two-hour oral glucose tolerance test (OGTT) level in pregnant women with hypothyroidism (108.94 ± 19.89 mg/dl) was significantly higher than in the other group (104.49 ± 18.43 mg/dl) with a p-value of 0.033. Conclusions: This study displayed that the risk of GDM is 11% higher among women with hypothyroidism. Furthermore, the difference in the mean two-hour OGTT level in pregnant women with hypothyroidism was 4.4 mg/dl higher than in the other group.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"419 1","pages":"29 - 33"},"PeriodicalIF":0.5,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88665671","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 : 2022-09-03DOI: 10.1080/16089677.2022.2107972
C. Lame, B. Loum, P. Mazzaglia, C. Ndiaye, T. B. Diallo, A. Ndiaye, Ag Diouf, Aly Toure
Introduction: Poland syndrome is defined primarily by congenital absence of the pectoralis major. Thyroid hemiagenesis is the congenital absence of a single thyroid lobe. The combination of both pathologies has not been previously described. Case presentation: Poland syndrome is a rare congenital condition characterised by aplasia or hypoplasia of the pectoralis major muscle, associated to varying degrees with malformation of the ipsilateral upper limb. It is often accompanied by other congenital abnormalities, but the presence of a single thyroid lobe is exceptional. We report to our knowledge the first observation of thyroid hemiagenesis and Poland syndrome. Observation: A 19-year-old female was referred for chronic right neck swelling. On physical examination, she had a relatively small stature but an overall normal appearance. Neck examination revealed a mobile 3 cm right firm thyroid nodule. There was complete absence of the left breast and pectoralis muscles, with normal development on the right. The left hand was relatively small and exhibited syndactyly. Biochemical testing revealed normal thyroid function. Neck ultrasound revealed complete absence of the left thyroid lobe and the presence of a well-circumscribed hypoechoic 3 cm right thyroid nodule without calcifications, TIRADS score 3. The patient was diagnosed with Poland syndrome, a 3 cm right thyroid nodule, and agenesis of the left thyroid lobe. Her consent was obtained for a right thyroid lobectomy due to the cosmetic impact of the nodule, as well as the small risk that this represented a thyroid malignancy. An uncomplicated right thyroid lobectomy was performed. Final surgical pathology was consistent with a 3 cm benign follicular adenoma. Conclusion: Poland syndrome and thyroid hemiagenesis are both rare congenital malformations. Their association has not been previously described. Prior to surgery, the patient must be informed of the mandatory need for lifelong thyroid hormone replacement.
{"title":"Unexpected finding of thyroid hemiagenesis in a patient presenting with a right thyroid nodule and a history of Poland syndrome","authors":"C. Lame, B. Loum, P. Mazzaglia, C. Ndiaye, T. B. Diallo, A. Ndiaye, Ag Diouf, Aly Toure","doi":"10.1080/16089677.2022.2107972","DOIUrl":"https://doi.org/10.1080/16089677.2022.2107972","url":null,"abstract":"Introduction: Poland syndrome is defined primarily by congenital absence of the pectoralis major. Thyroid hemiagenesis is the congenital absence of a single thyroid lobe. The combination of both pathologies has not been previously described. Case presentation: Poland syndrome is a rare congenital condition characterised by aplasia or hypoplasia of the pectoralis major muscle, associated to varying degrees with malformation of the ipsilateral upper limb. It is often accompanied by other congenital abnormalities, but the presence of a single thyroid lobe is exceptional. We report to our knowledge the first observation of thyroid hemiagenesis and Poland syndrome. Observation: A 19-year-old female was referred for chronic right neck swelling. On physical examination, she had a relatively small stature but an overall normal appearance. Neck examination revealed a mobile 3 cm right firm thyroid nodule. There was complete absence of the left breast and pectoralis muscles, with normal development on the right. The left hand was relatively small and exhibited syndactyly. Biochemical testing revealed normal thyroid function. Neck ultrasound revealed complete absence of the left thyroid lobe and the presence of a well-circumscribed hypoechoic 3 cm right thyroid nodule without calcifications, TIRADS score 3. The patient was diagnosed with Poland syndrome, a 3 cm right thyroid nodule, and agenesis of the left thyroid lobe. Her consent was obtained for a right thyroid lobectomy due to the cosmetic impact of the nodule, as well as the small risk that this represented a thyroid malignancy. An uncomplicated right thyroid lobectomy was performed. Final surgical pathology was consistent with a 3 cm benign follicular adenoma. Conclusion: Poland syndrome and thyroid hemiagenesis are both rare congenital malformations. Their association has not been previously described. Prior to surgery, the patient must be informed of the mandatory need for lifelong thyroid hormone replacement.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"13 1","pages":"34 - 41"},"PeriodicalIF":0.5,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73693858","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 : 2022-09-02DOI: 10.1080/16089677.2022.2074121
Daniel Katey, Abigail Akua Addo, Kabila Abass, Anthony Kwame Morgan
Introduction: The prevalence and risk factors of type 2 diabetes vary across the urban and rural milieus of Ghana's Ashanti Region, yet no study has been conducted to synthesise the available studies. Methods: A comprehensive literature search was carried out in PubMed, CINAHL, Scopus and Web of Science with hand searches in Google Scholar and grey literature between May 15, 2021 and June 30, 2021. Searches were made for articles published between January 1, 2011 and December 31, 2020 on type 2 diabetes mellitus in the Ashanti region of Ghana. MeSH terms and keywords, separated by some Boolean operators, were used. Results: The searches yielded a total of 268 articles, of which 12 studies were selected for the final review. Physical inactivity and obesity were identified as the major risk factors of type 2 diabetes in the region. Higher prevalence of the disease was also identified in females. More so, in terms of rural and urban divides, type 2 diabetes mellitus was found predominantly among urban dwellers. Conclusion: Findings from the study call for mass sensitisation and awareness creation in respect of diabetes, to ensure that people are well informed on the dynamics of the disease in the region and, by extension, the country at large.
在加纳阿散蒂地区的城市和农村环境中，2型糖尿病的患病率和危险因素各不相同，但尚未进行任何研究来综合现有研究。方法:在2021年5月15日至2021年6月30日期间，在PubMed、CINAHL、Scopus和Web of Science中进行综合文献检索，并在Google Scholar和灰色文献中进行手动检索。检索了2011年1月1日至2020年12月31日期间发表的关于加纳阿散蒂地区2型糖尿病的文章。使用一些布尔运算符分隔的MeSH术语和关键字。结果:共检索到268篇文献，其中12篇入选最终评审。缺乏运动和肥胖被确定为该地区2型糖尿病的主要危险因素。该疾病在女性中的患病率也较高。更重要的是，就农村和城市的差异而言，2型糖尿病主要发生在城市居民中。结论:研究结果呼吁在糖尿病方面进行大规模宣传和提高认识，以确保人们充分了解该地区乃至整个国家的疾病动态。
{"title":"Prevalence study of type 2 diabetes mellitus in the Ashanti region of Ghana: a systematic review of risk factors","authors":"Daniel Katey, Abigail Akua Addo, Kabila Abass, Anthony Kwame Morgan","doi":"10.1080/16089677.2022.2074121","DOIUrl":"https://doi.org/10.1080/16089677.2022.2074121","url":null,"abstract":"Introduction: The prevalence and risk factors of type 2 diabetes vary across the urban and rural milieus of Ghana's Ashanti Region, yet no study has been conducted to synthesise the available studies. Methods: A comprehensive literature search was carried out in PubMed, CINAHL, Scopus and Web of Science with hand searches in Google Scholar and grey literature between May 15, 2021 and June 30, 2021. Searches were made for articles published between January 1, 2011 and December 31, 2020 on type 2 diabetes mellitus in the Ashanti region of Ghana. MeSH terms and keywords, separated by some Boolean operators, were used. Results: The searches yielded a total of 268 articles, of which 12 studies were selected for the final review. Physical inactivity and obesity were identified as the major risk factors of type 2 diabetes in the region. Higher prevalence of the disease was also identified in females. More so, in terms of rural and urban divides, type 2 diabetes mellitus was found predominantly among urban dwellers. Conclusion: Findings from the study call for mass sensitisation and awareness creation in respect of diabetes, to ensure that people are well informed on the dynamics of the disease in the region and, by extension, the country at large.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"15 1","pages":"93 - 99"},"PeriodicalIF":0.5,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78927909","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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