Pub Date : 2021-06-07DOI: 10.1080/16089677.2021.1927584
M. Mphasha, T. Mothiba, L. Skaal
Background: Dietary diabetes knowledge is a significant contributor to the improvement of eating habits. Adequate dietary knowledge leads to adherence to a dietary plan, which is viewed as a cornerstone in diabetes treatment, and linked with better diabetes outcomes. The aim of the study is to assess diabetes dietary knowledge and intake of patients. Method: A convergent mixed-methods parallel study design was conducted with 217 participants (200 quantitative and 17 qualitative). The quantitative phase used a cross-sectional descriptive design; data were collected using a close-ended questionnaire and analysed using SPSS Software v24.0. The qualitative phase used a phenomenological exploratory design; data were collected using interviews and analysed using 8 Steps of Tesch’s inductive, descriptive open coding technique. Results: About 81% and 81.5% of quantitative participants understand the importance of nutrition, and that eating large portion sizes may lead to increased blood sugar, respectively, compared with all qualitative participants. However, qualitative participants further reported intake of large portion sizes due to family eating patterns. Only 28.5% of quantitative participants consume breakfast, compared with all qualitative participants. Conclusion: Diabetes patients know the disadvantages of consuming large food portions, but a family culture of eating patterns prohibits patients eating accordingly, justifying the need for the adoption of family-centred diabetes care.
{"title":"Assessment of diabetes dietary knowledge and its impact on intake of patients in Senwabarwana, Limpopo, South Africa","authors":"M. Mphasha, T. Mothiba, L. Skaal","doi":"10.1080/16089677.2021.1927584","DOIUrl":"https://doi.org/10.1080/16089677.2021.1927584","url":null,"abstract":"Background: Dietary diabetes knowledge is a significant contributor to the improvement of eating habits. Adequate dietary knowledge leads to adherence to a dietary plan, which is viewed as a cornerstone in diabetes treatment, and linked with better diabetes outcomes. The aim of the study is to assess diabetes dietary knowledge and intake of patients. Method: A convergent mixed-methods parallel study design was conducted with 217 participants (200 quantitative and 17 qualitative). The quantitative phase used a cross-sectional descriptive design; data were collected using a close-ended questionnaire and analysed using SPSS Software v24.0. The qualitative phase used a phenomenological exploratory design; data were collected using interviews and analysed using 8 Steps of Tesch’s inductive, descriptive open coding technique. Results: About 81% and 81.5% of quantitative participants understand the importance of nutrition, and that eating large portion sizes may lead to increased blood sugar, respectively, compared with all qualitative participants. However, qualitative participants further reported intake of large portion sizes due to family eating patterns. Only 28.5% of quantitative participants consume breakfast, compared with all qualitative participants. Conclusion: Diabetes patients know the disadvantages of consuming large food portions, but a family culture of eating patterns prohibits patients eating accordingly, justifying the need for the adoption of family-centred diabetes care.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"32 1","pages":"89 - 95"},"PeriodicalIF":0.5,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76528120","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 : 2021-05-31DOI: 10.1080/16089677.2021.1927585
R. Chetty, S. Pillay
Background: Obesity is commonly associated with diabetes mellitus (DM). The most frequent anthropometric index utilised to assess obesity is the body mass index (BMI), which uses height and weight as variables, but eliminates height as an independent analytical variable. Currently there are no data available on the relationship between adult height and glycaemic control in patients living with diabetes (PLWD) within the context of HIV infection. Objectives: This study aimed to determine an association between final adult height and glycaemic control in an HIV endemic area. Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done. Results: This study had 957 PLWD. In the height categories of < 1.40 m, 1.40–1.49 m, 1.50–1.59 m, 1.60–1.69 m, 1.70–1.79 m, 1.80–1.89 m and ≥ 1.90 m, there were 11, 60, 321, 343, 121, 26 and 2 patients respectively (with 73 patients having no height recorded). Taller patients had smaller waist circumferences and had poorer glycaemic control. In the lowest vs. highest height (< 1.40 m vs ≥ 1.90 m) categories, the HbA1c values were 8.49% vs. 12.45%, respectively, p = 0.019. Height had a strong positive association with diastolic blood pressure (DBP) (p = 0.001). Those PLWD in the 1.80–1.89 m height cohort had higher triglyceride levels and lower high-density lipoprotein (HDL) levels when compared with the other height categories. Shorter PLWD with uncontrolled glycaemic control had significantly elevated systolic blood pressure. Gender and HIV infection had a non-significant role on height categories in PLWD. Conclusion: Taller height categories had poorer glycaemic control. Increasing height was strongly associated with increasing DBP. A higher DBP and triglyceride level with lower HDL level places these PLWD in a higher cardiovascular risk category. Strong emphasis needs to be placed on the monitoring of lipids and blood pressure in PLWD, this more especially in taller patients.
{"title":"Adult height and diabetes control: is there an association?","authors":"R. Chetty, S. Pillay","doi":"10.1080/16089677.2021.1927585","DOIUrl":"https://doi.org/10.1080/16089677.2021.1927585","url":null,"abstract":"Background: Obesity is commonly associated with diabetes mellitus (DM). The most frequent anthropometric index utilised to assess obesity is the body mass index (BMI), which uses height and weight as variables, but eliminates height as an independent analytical variable. Currently there are no data available on the relationship between adult height and glycaemic control in patients living with diabetes (PLWD) within the context of HIV infection. Objectives: This study aimed to determine an association between final adult height and glycaemic control in an HIV endemic area. Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done. Results: This study had 957 PLWD. In the height categories of < 1.40 m, 1.40–1.49 m, 1.50–1.59 m, 1.60–1.69 m, 1.70–1.79 m, 1.80–1.89 m and ≥ 1.90 m, there were 11, 60, 321, 343, 121, 26 and 2 patients respectively (with 73 patients having no height recorded). Taller patients had smaller waist circumferences and had poorer glycaemic control. In the lowest vs. highest height (< 1.40 m vs ≥ 1.90 m) categories, the HbA1c values were 8.49% vs. 12.45%, respectively, p = 0.019. Height had a strong positive association with diastolic blood pressure (DBP) (p = 0.001). Those PLWD in the 1.80–1.89 m height cohort had higher triglyceride levels and lower high-density lipoprotein (HDL) levels when compared with the other height categories. Shorter PLWD with uncontrolled glycaemic control had significantly elevated systolic blood pressure. Gender and HIV infection had a non-significant role on height categories in PLWD. Conclusion: Taller height categories had poorer glycaemic control. Increasing height was strongly associated with increasing DBP. A higher DBP and triglyceride level with lower HDL level places these PLWD in a higher cardiovascular risk category. Strong emphasis needs to be placed on the monitoring of lipids and blood pressure in PLWD, this more especially in taller patients.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"10 1","pages":"96 - 100"},"PeriodicalIF":0.5,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86823770","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 : 2021-05-25DOI: 10.1080/16089677.2021.1927586
Lawrence Kwape, C. Ocampo, A. Oyekunle, J. Mwita
Objective: To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. Methodology: This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. Clinical, anthropometry and laboratory data were collected. Vitamin B12 deficiency was defined by levels < 150 pmol/l. Results: The mean (SD) age of the participants was 57 (15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. Most (89.5%) participants were on metformin. The prevalence of vitamin B12 deficiency was 6.6%. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p = 0.014) and had a longer duration of metformin use (7 vs. 4 years, p = 0.024). The use of acid blockers was also associated with vitamin B12 deficiency (p = 0.012). There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. Conclusion: Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Regular vitamin B12 assessment may be beneficial, especially among diabetes patients who are old, those taking metformin over a long duration and patients on acid blockers.
{"title":"Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana","authors":"Lawrence Kwape, C. Ocampo, A. Oyekunle, J. Mwita","doi":"10.1080/16089677.2021.1927586","DOIUrl":"https://doi.org/10.1080/16089677.2021.1927586","url":null,"abstract":"Objective: To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. Methodology: This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. Clinical, anthropometry and laboratory data were collected. Vitamin B12 deficiency was defined by levels < 150 pmol/l. Results: The mean (SD) age of the participants was 57 (15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. Most (89.5%) participants were on metformin. The prevalence of vitamin B12 deficiency was 6.6%. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p = 0.014) and had a longer duration of metformin use (7 vs. 4 years, p = 0.024). The use of acid blockers was also associated with vitamin B12 deficiency (p = 0.012). There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. Conclusion: Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Regular vitamin B12 assessment may be beneficial, especially among diabetes patients who are old, those taking metformin over a long duration and patients on acid blockers.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"212 1","pages":"101 - 105"},"PeriodicalIF":0.5,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73976107","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 : 2021-04-27DOI: 10.1080/16089677.2021.1903170
Gauhar Nadri, S. Saxena, A. Kaur, Kaleem Ahmad, P. Garg, A. Mahdi, L. Akduman, K. Gazdíková, M. Čaprnda, P. Vesely, P. Kruzliak, V. Krásnik
Purpose: To study the correlation of serum vitamin D levels with quantitative (central subfield thickness [CST], cube average thickness [CAT]), cross-sectional (disorganisation of retinal inner layer [DRIL] and ellipsoid zone [EZ]) and topographic parameters (retinal pigment epithelium [RPE]) on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR), for the first time. Methods: Eighty-eight consecutive cases of type 2 diabetes mellitus with no retinopathy (No DR; n = 22); non-proliferative DR (NPDR; n = 22); proliferative DR (PDR; n = 22) and healthy controls (n = 22) were included, after sample size calculation. On SD-OCT, physician-friendly grading systems were created for DRIL, EZ disruption and RPE alterations. Serum vitamin D was analysed using a standard protocol. Statistical analysis was done using Pearson correlation, Student’s t-test, ANOVA, Newman–Keuls test, chi-square test and univariate ordinal logistic regression analysis. Results: Mean serum vitamin D levels (ng/ml) were: No DR = 23.36 ± 2.00, NPDR = 17.88 ± 1.86, PDR = 14.07 ± 1.21, and controls = 25.11 ± 1.59. Low vitamin D levels correlated significantly with severity of retinopathy, VA (r = 0.50), CST (r = 0.36), CAT (r = 0.41), DRIL (r = 0.35), EZ disruption (r = 0.40) and RPE alterations (r = 0.37), respectively (p < 0.01). Significantly low vitamin D levels were observed in subjects with DRIL present versus DRIL absent; EZ disruption, focal versus global versus intact; RPE alterations, focal versus global versus none, respectively (p < 0.05). Conclusions: Low serum vitamin D levels correlate with the presence of DRIL, EZ disruption and RPE alterations and increased severity of DR.
{"title":"Correlation between vitamin D serum levels and severity of diabetic retinopathy in patients with type 2 diabetes mellitus","authors":"Gauhar Nadri, S. Saxena, A. Kaur, Kaleem Ahmad, P. Garg, A. Mahdi, L. Akduman, K. Gazdíková, M. Čaprnda, P. Vesely, P. Kruzliak, V. Krásnik","doi":"10.1080/16089677.2021.1903170","DOIUrl":"https://doi.org/10.1080/16089677.2021.1903170","url":null,"abstract":"Purpose: To study the correlation of serum vitamin D levels with quantitative (central subfield thickness [CST], cube average thickness [CAT]), cross-sectional (disorganisation of retinal inner layer [DRIL] and ellipsoid zone [EZ]) and topographic parameters (retinal pigment epithelium [RPE]) on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR), for the first time. Methods: Eighty-eight consecutive cases of type 2 diabetes mellitus with no retinopathy (No DR; n = 22); non-proliferative DR (NPDR; n = 22); proliferative DR (PDR; n = 22) and healthy controls (n = 22) were included, after sample size calculation. On SD-OCT, physician-friendly grading systems were created for DRIL, EZ disruption and RPE alterations. Serum vitamin D was analysed using a standard protocol. Statistical analysis was done using Pearson correlation, Student’s t-test, ANOVA, Newman–Keuls test, chi-square test and univariate ordinal logistic regression analysis. Results: Mean serum vitamin D levels (ng/ml) were: No DR = 23.36 ± 2.00, NPDR = 17.88 ± 1.86, PDR = 14.07 ± 1.21, and controls = 25.11 ± 1.59. Low vitamin D levels correlated significantly with severity of retinopathy, VA (r = 0.50), CST (r = 0.36), CAT (r = 0.41), DRIL (r = 0.35), EZ disruption (r = 0.40) and RPE alterations (r = 0.37), respectively (p < 0.01). Significantly low vitamin D levels were observed in subjects with DRIL present versus DRIL absent; EZ disruption, focal versus global versus intact; RPE alterations, focal versus global versus none, respectively (p < 0.05). Conclusions: Low serum vitamin D levels correlate with the presence of DRIL, EZ disruption and RPE alterations and increased severity of DR.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"127 1","pages":"82 - 88"},"PeriodicalIF":0.5,"publicationDate":"2021-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87280377","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 : 2021-04-19DOI: 10.1080/16089677.2021.1897230
H. Kaplan, A. Amod, A. Chadli, J. Mbanya, A. McMaster, K. Naidoo, MG Musa
Diabetes is a major economic burden and has rapidly increased worldwide. Type 2 diabetes, which accounts for 90–95% of cases, has increased particularly in the developing world. Early treatment intensification may decrease the morbidity and mortality of diabetes by lowering the risk of related chronic complications. The majority of patients, however, do not achieve glycaemic targets, and consequently suffer from complications secondary to suboptimal glycaemic control. A large number of epidemiological studies or national registers have been analysed at both country and regional levels, particularly in developed countries, in order to assess the quality of care in patients with diabetes, or to determine compliance with national treatment guidelines. There is a paucity of data from the developing world, particularly in Africa, with regard to the quality of care of people with type 2 diabetes. A better understanding of the missing gaps within current diabetes management is therefore required in order to improve the quality of care of these patients.
{"title":"IDMPS Wave 7 Africa","authors":"H. Kaplan, A. Amod, A. Chadli, J. Mbanya, A. McMaster, K. Naidoo, MG Musa","doi":"10.1080/16089677.2021.1897230","DOIUrl":"https://doi.org/10.1080/16089677.2021.1897230","url":null,"abstract":"Diabetes is a major economic burden and has rapidly increased worldwide. Type 2 diabetes, which accounts for 90–95% of cases, has increased particularly in the developing world. Early treatment intensification may decrease the morbidity and mortality of diabetes by lowering the risk of related chronic complications. The majority of patients, however, do not achieve glycaemic targets, and consequently suffer from complications secondary to suboptimal glycaemic control. A large number of epidemiological studies or national registers have been analysed at both country and regional levels, particularly in developed countries, in order to assess the quality of care in patients with diabetes, or to determine compliance with national treatment guidelines. There is a paucity of data from the developing world, particularly in Africa, with regard to the quality of care of people with type 2 diabetes. A better understanding of the missing gaps within current diabetes management is therefore required in order to improve the quality of care of these patients.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"483 1","pages":"76 - 81"},"PeriodicalIF":0.5,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73060569","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 : 2021-03-23DOI: 10.1080/16089677.2021.1897227
A. Kok, A. Hariram, D. Webb, A. Amod
Objectives: To describe disease management patterns and associated outcomes in patients with type 2 diabetes initiating a second-line glucose-lowering therapy in routine clinical practice in South Africa. Design: Non-interventional observational study. Setting: General and specialist private practices. Subjects Patients with diabetes initiating second-line glucose-lowering therapy. Outcome measures: Variables collected at baseline and at 6-, 12- and 24-month follow-up visits included sociodemographics, first- and second-line glucose-lowering treatments and other medications, reasons for change in diabetes therapy, HbA1c target set by the attending clinician at the time of change, comorbidities and health-related quality of life (HRQoL). Results: Baseline data were collected for 519 patients (69% female). Mean age was 54.6 years and mean time since initial diagnosis was 7.5 years. Mean HbA1c at baseline was 9.0% and the most common second-line treatment approach was to combine metformin with a sulphonylurea. Median HbA1c and median fasting glucose measurements were marginally lower at 24 months than at baseline (8.0% vs. 8.4%, and 8.5 mmol/l vs. 8.8 mmol/l, respectively). Only approximately 5% of patients had had their diabetes medication changed at any time after the baseline visit. Conclusions: Management of type 2 diabetes mellitus in private practice in South Africa is suboptimal.
{"title":"Patterns of diabetes management in South Africa: baseline and 24-month data from the South African cohort of the DISCOVER study","authors":"A. Kok, A. Hariram, D. Webb, A. Amod","doi":"10.1080/16089677.2021.1897227","DOIUrl":"https://doi.org/10.1080/16089677.2021.1897227","url":null,"abstract":"Objectives: To describe disease management patterns and associated outcomes in patients with type 2 diabetes initiating a second-line glucose-lowering therapy in routine clinical practice in South Africa. Design: Non-interventional observational study. Setting: General and specialist private practices. Subjects Patients with diabetes initiating second-line glucose-lowering therapy. Outcome measures: Variables collected at baseline and at 6-, 12- and 24-month follow-up visits included sociodemographics, first- and second-line glucose-lowering treatments and other medications, reasons for change in diabetes therapy, HbA1c target set by the attending clinician at the time of change, comorbidities and health-related quality of life (HRQoL). Results: Baseline data were collected for 519 patients (69% female). Mean age was 54.6 years and mean time since initial diagnosis was 7.5 years. Mean HbA1c at baseline was 9.0% and the most common second-line treatment approach was to combine metformin with a sulphonylurea. Median HbA1c and median fasting glucose measurements were marginally lower at 24 months than at baseline (8.0% vs. 8.4%, and 8.5 mmol/l vs. 8.8 mmol/l, respectively). Only approximately 5% of patients had had their diabetes medication changed at any time after the baseline visit. Conclusions: Management of type 2 diabetes mellitus in private practice in South Africa is suboptimal.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"5 1","pages":"60 - 65"},"PeriodicalIF":0.5,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85843526","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 : 2021-03-23DOI: 10.1080/16089677.2021.1897228
A. Coetzee, R. Bhikoo, Bianca D. Berndorfler, W. Conradie, J. Taljaard, M. Conradie-Smit
Subacute thyroiditis is a granulomatous inflammatory disorder often triggered by a preceding viral infection. Patients typically present with complaints of anterior neck pain associated with a tender enlarged thyroid gland. The coronaviruses have never before been implicated in the aetiology of subacute thyroiditis. It is postulated that the pathogenesis related to thyroid disease in Coronavirus disease 2019 (COVID-19) is multifactorial. Contributory factors include effects of the virus-related cytokine storm and direct action of the virus on SARS-CoV-2 receptors in the thyroid. This article further reviews the association between thyroiditis and COVID-19. The clinical characteristics, diagnostic workup and management of a patient who presented with subacute thyroiditis following COVID-19 are discussed. Furthermore, complications are entertained and suggestions for the management of thyroiditis following COVID-19 are provided.
{"title":"Thyrotoxicosis secondary to thyroiditis following SARS-CoV-2 infection","authors":"A. Coetzee, R. Bhikoo, Bianca D. Berndorfler, W. Conradie, J. Taljaard, M. Conradie-Smit","doi":"10.1080/16089677.2021.1897228","DOIUrl":"https://doi.org/10.1080/16089677.2021.1897228","url":null,"abstract":"Subacute thyroiditis is a granulomatous inflammatory disorder often triggered by a preceding viral infection. Patients typically present with complaints of anterior neck pain associated with a tender enlarged thyroid gland. The coronaviruses have never before been implicated in the aetiology of subacute thyroiditis. It is postulated that the pathogenesis related to thyroid disease in Coronavirus disease 2019 (COVID-19) is multifactorial. Contributory factors include effects of the virus-related cytokine storm and direct action of the virus on SARS-CoV-2 receptors in the thyroid. This article further reviews the association between thyroiditis and COVID-19. The clinical characteristics, diagnostic workup and management of a patient who presented with subacute thyroiditis following COVID-19 are discussed. Furthermore, complications are entertained and suggestions for the management of thyroiditis following COVID-19 are provided.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"104 1","pages":"72 - 75"},"PeriodicalIF":0.5,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73689592","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 : 2021-03-18DOI: 10.1080/16089677.2021.1897226
A. Thompson, B. Zipfel, C. Aldous
Foot posture and function is important in diabetes, particularly as neuropathy in diabetes may present with motor in addition to sensory neural deficits. Examination of the anatomical architecture of the foot can inform on its load-bearing and balancing function. An examination that does not feature in guidelines on assessment of the diabetic foot is that of assessing whether a metatarsal parabola is present or malformed. The metatarsal ‘parabola’ (in the transverse plane) is so called because the cascade of the differing lengths of the metatarsals form a parabola, defined as the intersection of an arc with a flat (plantar) surface. The parabola serves a function in the rollover motion or forefoot rocker of the foot before heel rise to provide stability and balance in static stance. A further function ensures that the lever-action at the first metatarsophalangeal joint takes place with dorsiflexion of the hallux. This narrative review summarises the literature regarding methods of measuring the metatarsal parabola, dysfunction of the foot due to a dysmorphic metatarsal parabola, clinical relevance, examination and management in diabetes care. It documents the short first metatarsal (SFM) as a risk factor for diabetic foot ulceration. Examination for identification and management of dysmorphic metatarsal parabolae is recommended for foot examinations in diabetes care.
{"title":"The dysmorphic metatarsal parabola in diabetes—clinical examination and management: a narrative review","authors":"A. Thompson, B. Zipfel, C. Aldous","doi":"10.1080/16089677.2021.1897226","DOIUrl":"https://doi.org/10.1080/16089677.2021.1897226","url":null,"abstract":"Foot posture and function is important in diabetes, particularly as neuropathy in diabetes may present with motor in addition to sensory neural deficits. Examination of the anatomical architecture of the foot can inform on its load-bearing and balancing function. An examination that does not feature in guidelines on assessment of the diabetic foot is that of assessing whether a metatarsal parabola is present or malformed. The metatarsal ‘parabola’ (in the transverse plane) is so called because the cascade of the differing lengths of the metatarsals form a parabola, defined as the intersection of an arc with a flat (plantar) surface. The parabola serves a function in the rollover motion or forefoot rocker of the foot before heel rise to provide stability and balance in static stance. A further function ensures that the lever-action at the first metatarsophalangeal joint takes place with dorsiflexion of the hallux. This narrative review summarises the literature regarding methods of measuring the metatarsal parabola, dysfunction of the foot due to a dysmorphic metatarsal parabola, clinical relevance, examination and management in diabetes care. It documents the short first metatarsal (SFM) as a risk factor for diabetic foot ulceration. Examination for identification and management of dysmorphic metatarsal parabolae is recommended for foot examinations in diabetes care.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"63 1","pages":"40 - 45"},"PeriodicalIF":0.5,"publicationDate":"2021-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81083271","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 : 2021-03-16DOI: 10.1080/16089677.2021.1897229
R. Chetty, S. Pillay
Background: Type 2 diabetes mellitus (T2DM) is a familial condition with a strong genetic component. International studies have highlighted associations between a positive family history of diabetes (FHD) and poorer glycaemic control. No current data are available on this association within the context of HIV. Objectives: To determine a relationship between FHD and glycaemic control in patients living with DM (PLWD) in an HIV endemic area. Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done. Results: This study had 957 patients living with diabetes (PLWD); 498 (52.2%) had a positive FHD while 456 (47.8%) had no FHD. There were 146 (15.3%) HIV-infected patients; with 84 (57.5%) on a fixed dose combination (FDC) of anti-retroviral treatment (ART). Patients aged between 18 and 30 with a maternal FHD had significantly higher mean HbA1c levels than those without a maternal FHD (HbA1c: 10.80% vs. 9.72%, p = 0.025). Patients living with type 1 DM (PLWT1DM) in the HIV-uninfected cohort had significantly higher HbA1c levels than patients living with type 2 DM (PLWT2DM) (10.38% vs. 9.46%, p = 0.002). HIV-infected PLWD (PLWDH) on a FDC with a positive FHD had significantly higher HbA1c levels than those without a FHD (9.52% vs. 8.52%, p = 0.04). PLWDH with a positive maternal FHD on an FDC had increased HbA1c levels (9.81% vs. 8.55%, p = 0.009). Conclusion: Genes significantly affect glycaemic control among PLWD. PLWT1DM and PLWDH with a positive FHD (especially a maternal FHD) should be regarded as being in a higher risk category requiring more intensive lifestyle and therapeutic intervention to achieve optimal diabetes control. Our study suggests that a positive FHD affects glycaemia in PLWT1DM as significantly, if not more, than in PLWT2DM and recommends screening for a FHD to be incorporated in the comprehensive management of DM.
背景:2型糖尿病(T2DM)是一种具有强烈遗传成分的家族性疾病。国际研究强调了糖尿病家族史阳性与较差的血糖控制之间的联系。目前尚无关于艾滋病毒背景下这种关联的数据。目的:确定艾滋病流行地区糖尿病(PLWD)患者FHD与血糖控制的关系。方法:使用2019年1月1日至2019年12月31日来自南非彼得马里茨堡Edendale医院DM诊所的标准化临床表格。进行统计分析。结果:本研究纳入957例糖尿病患者(PLWD);FHD阳性498例(52.2%)，无FHD 456例(47.8%)。艾滋病毒感染者146例(15.3%);84例(57.5%)接受抗逆转录病毒治疗(ART)的固定剂量联合治疗。年龄在18 - 30岁之间，母亲患有FHD的患者的平均HbA1c水平明显高于没有母亲患有FHD的患者(HbA1c: 10.80% vs. 9.72%， p = 0.025)。未感染hiv的1型糖尿病(PLWT1DM)患者的HbA1c水平显著高于2型糖尿病(PLWT2DM)患者(10.38% vs. 9.46%， p = 0.002)。FHD阳性的FDC上hiv感染PLWD (PLWDH)的HbA1c水平显著高于无FHD的FDC (9.52% vs. 8.52%， p = 0.04)。母亲FHD在FDC上呈阳性的PLWDH HbA1c水平升高(9.81%比8.55%，p = 0.009)。结论:基因对PLWD患者血糖控制有显著影响。伴有FHD阳性的PLWT1DM和PLWDH(尤其是母体FHD)应被视为高危人群，需要更强化的生活方式和治疗干预，以达到最佳的糖尿病控制。我们的研究表明，FHD阳性对PLWT1DM患者血糖的影响与PLWT2DM患者一样显著，甚至更多，并建议将FHD筛查纳入糖尿病的综合管理中。
{"title":"Glycaemic control and family history of diabetes mellitus: is it all in the genes?","authors":"R. Chetty, S. Pillay","doi":"10.1080/16089677.2021.1897229","DOIUrl":"https://doi.org/10.1080/16089677.2021.1897229","url":null,"abstract":"Background: Type 2 diabetes mellitus (T2DM) is a familial condition with a strong genetic component. International studies have highlighted associations between a positive family history of diabetes (FHD) and poorer glycaemic control. No current data are available on this association within the context of HIV. Objectives: To determine a relationship between FHD and glycaemic control in patients living with DM (PLWD) in an HIV endemic area. Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done. Results: This study had 957 patients living with diabetes (PLWD); 498 (52.2%) had a positive FHD while 456 (47.8%) had no FHD. There were 146 (15.3%) HIV-infected patients; with 84 (57.5%) on a fixed dose combination (FDC) of anti-retroviral treatment (ART). Patients aged between 18 and 30 with a maternal FHD had significantly higher mean HbA1c levels than those without a maternal FHD (HbA1c: 10.80% vs. 9.72%, p = 0.025). Patients living with type 1 DM (PLWT1DM) in the HIV-uninfected cohort had significantly higher HbA1c levels than patients living with type 2 DM (PLWT2DM) (10.38% vs. 9.46%, p = 0.002). HIV-infected PLWD (PLWDH) on a FDC with a positive FHD had significantly higher HbA1c levels than those without a FHD (9.52% vs. 8.52%, p = 0.04). PLWDH with a positive maternal FHD on an FDC had increased HbA1c levels (9.81% vs. 8.55%, p = 0.009). Conclusion: Genes significantly affect glycaemic control among PLWD. PLWT1DM and PLWDH with a positive FHD (especially a maternal FHD) should be regarded as being in a higher risk category requiring more intensive lifestyle and therapeutic intervention to achieve optimal diabetes control. Our study suggests that a positive FHD affects glycaemia in PLWT1DM as significantly, if not more, than in PLWT2DM and recommends screening for a FHD to be incorporated in the comprehensive management of DM.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"2 1 1","pages":"66 - 71"},"PeriodicalIF":0.5,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82541700","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 : 2021-03-08DOI: 10.1080/16089677.2021.1886724
S. Botha, M. Maphayi, N. Cassim, Jaya A George
Introduction: There has been a significant increase in vitamin D [25(OH)D] testing in recent years. Aims: To describe the number of tests, concentrations for 25(OH)D and 1,25(OH)2D in adults (≥ 18 years), characteristics of those tested and to determine the 25(OH)D concentration at which parathyroid hormone increases (PTH threshold). Methods: Data were extracted for 25(OH)D and 1,25(OH)2D tests, from the National Health Laboratory Services data warehouse for Charlotte Maxeke Johannesburg Academic Hospital from 2015 to 2017. Results were categorised by age, sex and race. Vitamin D status was described using National Academy of Medicine guidelines. The PTH threshold was determined by LOWESS plots. Results: 25(OH)D and 1,25(OH)2D tests increased, with no change in median concentrations over time. Black Africans (6.7%) had the highest prevalence of Vitamin D deficiency (VDD). Males had significantly lower 25(OH)D values (p < 0.001) and a higher proportion of VDD (p = 0.009). Younger patients (< 30 years; 7.9%) and elderly (> 74 years; 10.5%) black Africans had highest prevalence of VDD. The PTH threshold differed by race group. Conclusions: Clear testing guidelines are needed to curb test overutilisation. Further work is required to understand the appropriate cut-off levels to define VDD in our populations.
{"title":"Vitamin D [25(OH)D] and 1,25(OH)2D serum concentrations in patients tested at the Charlotte Maxeke Johannesburg Academic Hospital","authors":"S. Botha, M. Maphayi, N. Cassim, Jaya A George","doi":"10.1080/16089677.2021.1886724","DOIUrl":"https://doi.org/10.1080/16089677.2021.1886724","url":null,"abstract":"Introduction: There has been a significant increase in vitamin D [25(OH)D] testing in recent years. Aims: To describe the number of tests, concentrations for 25(OH)D and 1,25(OH)2D in adults (≥ 18 years), characteristics of those tested and to determine the 25(OH)D concentration at which parathyroid hormone increases (PTH threshold). Methods: Data were extracted for 25(OH)D and 1,25(OH)2D tests, from the National Health Laboratory Services data warehouse for Charlotte Maxeke Johannesburg Academic Hospital from 2015 to 2017. Results were categorised by age, sex and race. Vitamin D status was described using National Academy of Medicine guidelines. The PTH threshold was determined by LOWESS plots. Results: 25(OH)D and 1,25(OH)2D tests increased, with no change in median concentrations over time. Black Africans (6.7%) had the highest prevalence of Vitamin D deficiency (VDD). Males had significantly lower 25(OH)D values (p < 0.001) and a higher proportion of VDD (p = 0.009). Younger patients (< 30 years; 7.9%) and elderly (> 74 years; 10.5%) black Africans had highest prevalence of VDD. The PTH threshold differed by race group. Conclusions: Clear testing guidelines are needed to curb test overutilisation. Further work is required to understand the appropriate cut-off levels to define VDD in our populations.","PeriodicalId":43919,"journal":{"name":"Journal of Endocrinology Metabolism and Diabetes of South Africa","volume":"591 1","pages":"52 - 59"},"PeriodicalIF":0.5,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76787105","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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