Prevalence study of type 2 diabetes mellitus in the Ashanti regionof Ghana: a systematic review of risk factors
Diabetes remains one of the most prominent diseases of public health concern in the twenty-first century. According to the International Diabetes Federation (IDF),1 1 in every 11 people worldwide, the equivalent of about 463 million people globally, suffers from the disease. Similarly, the World Health Organization (WHO) also indicates that, globally, diabetes has claimed over 4.2 million lives since the beginning of the twenty-first century. For the year 2019, the IDF1 reports that over US$ 760 billion has been committed to combating diabetes globally. Despite this attempt, the WHO2 noted that over 374 million more people presently are at high risk of developing complications related to diabetes. In the same way, the IDF1 projected that, by end of 2045, over 700 million people across the world are likely to be suffering from the disease due to changing psychosocial and institutional factors. These recent developments have resulted in diabetes being listed as one of the top four noncommunicable diseases of the twenty-first century.
Practical aspects of insulin administration: what the healthcare provider knows
Diabetes mellitus (DM), a metabolic disorder characterised by chronic hyperglycaemia, places a significant burden on health systems. Type 2 DM is reportedly responsible for more deaths than malaria, human immunodeficiency virus and tuberculosis combined. The measurable impact on the South African health system is unfortunately limited by the lack of screening and accurate data on DM prevalence and expenditure. Local prevalence figures for diabetes mellitus, based on available published data, vary widely but range between 3.6% and 14.6%. Experts are, however, of the opinion that some of the reported figures are an underestimation of the true burden of the disease. Hyperglycaemia characteristic of DM occurs due to one or a combination of the following: the inability of the pancreatic beta cells to produce adequate amounts of insulin known as insulin secretion (IS) and/or a decrease in insulin action commonly known as insulin resistance (IR). Type 1 DM is an auto-immune disease that primarily targets pancreatic β-cells and impairs IS. Type 2 DM is characterised by a relative insulin deficiency that progresses over time, coupled with mostly acquired, lifestyle-associated IR.
Correspondence: Role of clinical laboratories in reporting results of transgender individuals on hormonal therapy by Phiri-Ramongane and Khine
A study on haematological reference intervals in transgender individuals concluded that haematology parameters in transgender men and transgender women receiving stable hormone therapy should be compared with cisgender male and cisgender females reference ranges, respectively. Other studies that determined endocrine reference intervals in transgender men and transgender women state that clinicians and laboratories should use appropriate reference intervals to interpret results. In fact, we recently were, to our knowledge, the first in Africa to determine biochemical reference intervals in our local transgender population. We found clinically significant differences for sodium, alkaline phosphatase (ALP), gamma-glutamyl transferase and testosterone in transgender men, while transgender women had clinically significant differences in creatinine, albumin, aspartate transaminase, ALP and oestradiol when compared with their cisgender counterparts.
Journal of Endocrinology, Metabolism and Diabetes of South Africa - December 2022 Vol 27 No 3