https://www.ajol.info/index.php/jemdsa/issue/feed Journal of Endocrinology, Metabolism and Diabetes of South Africa 2025-03-28T15:39:05+00:00 Stephen Hough fsh@sun.ac.za Open Journal Systems <p><em>The Journal of Endocrinology, Metabolism and Diabetes of South Africa (JEMDSA)</em> is published by the South African Medical Association and publishes papers related to endocrinology, metabolism and diabetes.</p> <p>Other websites related to this journal: <a title="http://www.jemdsa.co.za" href="http://www.jemdsa.co.za" target="_blank" rel="noopener">http://www.jemdsa.co.za</a></p> https://www.ajol.info/index.php/jemdsa/article/view/291965 Clinical, biochemical, and densitometric profiles and FRAX risk calculations of South African patients with fragility fractures of the hip: observations from a tertiary care centre 2025-03-28T14:51:46+00:00 E. du Plessis dr@drelanaduplessis.co.za M.M. Conradie dr@drelanaduplessis.co.za K. Jordaan dr@drelanaduplessis.co.za M. Burger dr@drelanaduplessis.co.za T. de Villiers dr@drelanaduplessis.co.za M. Conradie dr@drelanaduplessis.co.za <p><strong>Purpose</strong>: Although fragility hip fractures (HF) in the South African (SA) population are among the lowest worldwide, the incidence of HF is&nbsp; expected to more than double over the next few decades. Little is known about the contributors to increased hip fracture risk,&nbsp; including low bone mineral density (BMD), in our unique population. In addition, the ability of the recently calibrated SA Fracture Risk&nbsp; Assessment Tool (FRAX) to identify high fracture risk in the SA population accurately has not been validated.</p> <p><strong>Methods</strong>: A retrospective, descriptive, cohort study of SA postmenopausal women and men ≥ 50 years who presented with fragility HFs&nbsp; was conducted. The ability of clinical risk factors (CRFs) and BMD measured by dual-energy X-ray absorptiometry (DXA), as well as&nbsp; calculated FRAX probability scores, to identify the known high fracture risk in SA patients were evaluated. The SA FRAX tool was used, and&nbsp; a high fracture risk defined if the United States (US) fixed thresholds for major osteoporotic (MOF) and/or HF risk were exceeded (≥ 20%&nbsp; and ≥ 3% over 10 years respectively).&nbsp;</p> <p><strong>Results</strong>: A total of 163 patients were included. The most useful predictive CRFs were age and&nbsp; gender, recreational toxins in men, and a history of falls. Most were females (71%), who were older than males. DXA-BMD and FRAX-HF&nbsp; calculations best identified the known high fracture risk in the study cohort. FRAX-MOF calculations performed poorly.&nbsp;</p> <p><strong>Conclusion</strong>:&nbsp; Fracture risk assessment tools did not identify the known high fracture risk in all of the elderly study cohort with HF. Clinicians must&nbsp; continue to appreciate the important role of a good clinical assessment to ensure optimal fracture risk prediction.</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025 https://www.ajol.info/index.php/jemdsa/article/view/291966 Clinical characteristics of endocrine disturbances in post-COVID-19 condition, case report with review of literature 2025-03-28T14:57:34+00:00 W. Ji xxm2324@126.com X.M. Xie xxm2324@126.com L. Zhang xxm2324@126.com H.Y. Zhou xxm2324@126.com G.R. Bai xxm2324@126.com L. Li xxm2324@126.com Y.T. He xxm2324@126.com J. He xxm2324@126.com C.Y. Xia xxm2324@126.com H. Li xxm2324@126.com R.D. Li xxm2324@126.com R. Ping xxm2324@126.com D. Qiang xxm2324@126.com <p>Post-COVID-19 condition (PCC) is frequently associated with multiple endocrine hormone disturbances, primarily involving the hypothalamic–pituitary–adrenal axis. However, the exact cause remains unclear, particularly concerning whether these symptoms result&nbsp; from hypothalamus damage. This study reports on the clinical characteristics and examination methods of five patients exhibiting&nbsp; multiple endocrine disorders during PCC following SARS-CoV-2 infections, as well as the corresponding treatment strategies. Insulin&nbsp; tolerance test (ITT), arginine stimulation test, rapid adrenocorticotropic hormone (ACTH) stimulation test, and supine–standing test were&nbsp; used to evaluate endocrine hormone disturbances. Magnetic resonance imaging of the pituitary and computed tomography of the&nbsp; adrenal gland on one patient were performed to reveal the pathology. All five patients had hypothalamic syndrome with secondary&nbsp; adrenal insufficiency, growth hormone (GH) deficiency, and secondary hyperaldosteronism. Treatment included ACTH injection,&nbsp; recombinant human GH injection, and/or oral administration of synthetic glucocorticoids (prednisone acetate or methylprednisolone) and mineralocorticoid receptor antagonist finerenone. Remarkable improvement was observed within one week for all patients. To&nbsp; assess disorders in the hypothalamic–pituitary–§adrenal axis, dynamic endocrine testing is recommended. Upon confirmation of a&nbsp; diagnosis, timely supplementation of ACTH, glucocorticoids, GH, and aldosterone antagonists can yield remarkable therapeutic&nbsp; outcomes.&nbsp;</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025 https://www.ajol.info/index.php/jemdsa/article/view/291967 Clinical insights from continuous glucose monitor use in patients living with type 1 diabetes in rural Malawi 2025-03-28T15:12:04+00:00 G. Ferrari gferrari@bwh.harvard.edu M. Boti gferrari@bwh.harvard.edu D. Nakotwa gferrari@bwh.harvard.edu A. Gomber gferrari@bwh.harvard.edu M.M. Coates gferrari@bwh.harvard.edu K. Kumwenda gferrari@bwh.harvard.edu F Valeta gferrari@bwh.harvard.edu L. Drown gferrari@bwh.harvard.edu A. Thapa gferrari@bwh.harvard.edu V. Mithi gferrari@bwh.harvard.edu A. Msekandiana gferrari@bwh.harvard.edu C. Kachimanga gferrari@bwh.harvard.edu P.H. Park gferrari@bwh.harvard.edu A.J. Adler gferrari@bwh.harvard.edu G. Bukhman gferrari@bwh.harvard.edu T. Ruderman gferrari@bwh.harvard.edu C. Trujillo gferrari@bwh.harvard.edu <p><strong>Background</strong>: People living with type 1 diabetes (PLWT1D) in low-resource settings face numerous barriers to achieving glycaemic&nbsp; targets. Use of continuous glucose monitoring (CGM) is increasing but uptake remains low in sub-Saharan Africa. In 2022, a randomised&nbsp; controlled trial (RCT) evaluating feasibility of CGM was conducted in Neno, Malawi. This is a retrospective sub-study examining three- month blood glucose trends from participants randomised to the CGM arm.&nbsp;</p> <p><strong>Methods</strong>: This is a sub-study of a 2:1 parallel arm open&nbsp; randomised controlled trial to assess the feasibility and impact of CGM. Ambulatory glucose profiles (AGP) from 29 participants in the&nbsp; CGM arm were reviewed by clinicians. Two patient reports with AGP patterns exemplifying observed trends were identified and described&nbsp; in detail, and interventions were highlighted.&nbsp;</p> <p><strong>Results</strong>: Time below optimal blood glucose range was highest from 12 am to 6&nbsp; am: 7.0%, 6.9%, and 5.1% for months one, two, and three respectively. From baseline to endline, the average absolute value (increase or&nbsp; decrease) of the percentage change in total daily dose (TDD) of insulin was 11.2%. Case studies of two patients who demonstrated a&nbsp; positive impact of CGM are reported.&nbsp;</p> <p><strong>Conclusions</strong>: CGM provided compelling insights into blood glucose trends with significant clinical&nbsp; implications, specifically high prevalence of overnight hypoglycaemia. The ability to monitor blood glucose levels is critical because high&nbsp; variability and severe hypoglycaemia increase the risk of morbidity and mortality. CGM is a tool that can enhance patient education and&nbsp; the ability to guide treatment decisions for patients and clinicians in low-resource settings.&nbsp;&nbsp;&nbsp;&nbsp;</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025 https://www.ajol.info/index.php/jemdsa/article/view/291968 Prevalence and treatment-related outcome of hospitalised type 2 diabetes mellitus patients with comorbidities at an academic hospital in Johannesburg 2025-03-28T15:20:51+00:00 T. Makhabane taoanamakhabane@gmail.com G. Gabriels taoanamakhabane@gmail.com S. Chetty taoanamakhabane@gmail.com <p><strong>Background</strong>: Diabetic patients with comorbidities face increased risks of morbidity, mortality, and hospitalisation, leading to higher&nbsp; healthcare costs. Despite compliance with treatment, many do not achieve desired glycaemic control (HbA1c &lt; 7%). Identifying&nbsp; comorbidities in T2DM patients can enable more comprehensive care. This study aimed to investigate T2DM control in hospitalised T2DM&nbsp; patients with and without comorbidities.&nbsp;</p> <p><strong>Method</strong>: A retrospective chart review of 246 T2DM patients aged ≥ 18 admitted in 2019 to Helen&nbsp; Joseph Academic Hospital was conducted. Files were randomly selected and data summarised using descriptive statistics.&nbsp;</p> <p><strong>Results:</strong> The&nbsp; mean age was 52 ± 13.4 years. Comorbidities were present in 73% (179) of patients, with a majority being female (51%, 126). Among those&nbsp; with comorbidities, 30% (74) had complications. Hypertension was the most common concordant disease, and HIV the most&nbsp; common discordant disease. Diabetes-related conditions led to hospitalisation in 63% (155) of T2DM patients.&nbsp;</p> <p><strong>Conclusion</strong>: A high&nbsp; prevalence of comorbidities was observed in hospitalised T2DM patients. Although there was no significant association with some cardiac&nbsp; risk factors (blood glucose, cholesterol, HbA1c), blood pressure was higher in T2DM patients with comorbidities compared with&nbsp; those without.&nbsp;&nbsp;&nbsp;&nbsp;</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025 https://www.ajol.info/index.php/jemdsa/article/view/291969 Knowledge, attitude, and practices related to diabetes among patients with type 2 diabetes mellitus at Tshepong Hospital 2025-03-28T15:29:00+00:00 U. Maduemezia emekazadok@yahoo.co.uk E. Variava emekazadok@yahoo.co.uk T. Moloantoa emekazadok@yahoo.co.uk P. Abraham emekazadok@yahoo.co.uk B. Rambau emekazadok@yahoo.co.uk T.S. Ndaba emekazadok@yahoo.co.uk S. Bhana emekazadok@yahoo.co.uk R. Daya emekazadok@yahoo.co.uk <p><strong>Background</strong>: Despite advancements in pharmacological treatments for diabetes mellitus (DM), the significance of adequate knowledge,&nbsp; a positive attitude, and proper self-care practices among individuals with DM cannot be overstated.</p> <p><strong>Aim:</strong> This study assessed the&nbsp; knowledge, attitude, and practices (KAP) related to diabetes among patients with type 2 diabetes mellitus (T2DM).</p> <p><strong>Materials and&nbsp; methods</strong>: This cross-sectional study surveyed 161 patients with T2DM at Tshepong Hospital over five months. An interviewer- administered questionnaire was used to evaluate their KAP. Glycaemic control was assessed using the most recent glycated haemoglobin&nbsp; (HbA1c). Data were analysed descriptively using means (standard deviation), frequencies, and correlation statistics.&nbsp;&nbsp;</p> <p><strong>Results</strong>: The mean age of the participants was 55.94 ± 14 years, with females comprising 59% of the sample. Scores for knowledge,&nbsp; attitude, and practice were 57 ± 17%, 94 ± 9%, and 40 ± 10%, respectively. No correlation was found between KAP and sociodemographic&nbsp; or clinical characteristics. A significant but weak positive correlation was identified between knowledge and practice (r = 0.19391, p-value&nbsp; 0.013). There was no association between composite KAP scores and glycaemic control. Poor glycaemic control (HbA1c ≥ 7%) was&nbsp; observed in 86.34% of participants.&nbsp;</p> <p><strong>Conclusion</strong>: The study indicates that a positive attitude alone is insufficient for effective self-care&nbsp; practices, due to poor knowledge. The absence of a significant relationship between KAP and participants’ characteristics suggests the&nbsp; presence of other unexplored confounding factors. Further research is needed to identify these determinants of KAP.&nbsp;</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025 https://www.ajol.info/index.php/jemdsa/article/view/291964 Editorial 2025-03-28T14:44:45+00:00 Joel Dave fsh@sun.ac.za <p>No Abstract</p> 2025-03-28T00:00:00+00:00 Copyright (c) 2025