Background: Diabetes mellitus (DM) is a common secondary cause of dyslipidaemia, particularly if glycaemic control is poor, which in turn is an important risk factor for atherosclerosis and coronary artery disease. Objectives: (1) To study the prevalence and pattern of dyslipidaemia in patients with type 2 DM. (2) To determine the relationship (if any) between HbA 1C and the lipid profile in type 2 diabetic patients. Methods: This was a cross-sectional study done in 200 type 2 diabetic patients attending the Diabetic Clinic at the Helen Joseph Hospital. Patients suffering from other known causes of secondary dyslipidaemia were excluded. Each patient's HbA 1C and lipid profile results were recorded from their clinic files. The lipid profile included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C). Patients with one or more of the above parameters outside the targets recommended by the 2012 South African Dyslipidaemia Guidelines were considered to have uncontrolled dyslipidaemia. Results: Of the 200 type 2 DM patients studied, 86 (43%) were male and 114 (57%) female. Despite all patients being treated with lipid-lowering therapy (simvastatin at a mean daily dose of 20 mg), 187 patients (93.5%) did not achieve all their lipid targets. The most prevalent lipid parameter not at target was an LDL-C of ≥ 1.8 mmol/l in nearly 80% of patients. The most common pattern of dyslipidaemia was a combined dyslipidaemia (any two abnormal lipid parameters) affecting a total of 82 out of the 187 patients (43.8%) not reaching recommended targets. No significant relationship was found between HbA 1C and any of the lipid parameters. Conclusion: The vast majority of the type 2 diabetic patients studied had dyslipidaemia not meeting recommended targets, despite the use of lipid-lowering therapy in all patients. There is a need for more intensive lipid-lowering therapy, particularly statin therapy in patients with dyslipidaemia. Measures aimed at combating obesity and other lifestyle-related risk factors are also vital and need to be implemented for effectively controlling dyslipidaemia and reducing the burden of CVD.

No association was found between HRQOL and other clinical parameters, namely number of insulin units used per day, exercise, BMI, lipogram and the use of oral hypoglycaemic agents. Demographic parameters (age, gender, age at diagnosis, employment status and living arrangements) were also shown to have no impact on HRQOL. We found no association between HRQOL in patients who consumed alcohol and smoked cigarettes and in those who did not.

The incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly. This is possibly due to increasing obesity, reduced level of activity, sedentary lifestyle, ageing population and industrialisation. Aim: The primary objective of this study was to ascertain the level of activity using a pedometer. The secondary objectives were: (1) to correlate the baseline level of activity with body mass index (BMI), HbA1 c and blood pressure (BP), (2) to assess whether 7 000 steps a day influence HbA1c and BP over a three-month period. Method: A total of 110 patients were screened; 95 patients (n = 95) completed the study. At the first visit HbA1c, BMI and BP were measured. At the end of the first month baseline physical activity was recorded using pedometers. Patients were divided into two groups: active (n = 50) and control (n = 45). Patients in the active group were asked to walk a minimum of 7 000 steps/day. The control group were asked to continue their usual activity. These patients were followed up monthly over a period of three months. At each visit BMI, BP and step counts were recorded. HbA1c was measured only at the first and last visit. Result: Activity levels increased significantly in the active group throughout the study. Mean step count for the control group at baseline was 2 923.1 ± 1 136.9, which increased to 3 431.2 ± 1 251.7 by the end of the study. Mean step count for the active group at baseline was 4 609.9 ± 1 702.1, which increased to 7 244.8 ± 1 419.4 by the end of the study. The difference between control and active group was statistically significant (p < 0.001). Systolic and diastolic BP decreased significantly in both groups (p = 0.017) for systolic BP and (p = 0.002) for diastolic BP but no interaction was found between the groups as systolic and diastolic BP decreased at the same rate over time in both groups. HbA1c decreased by 1.04% in the active group; this difference was statistically highly significant (p < 0.001). Conclusion: Increase in activity levels decreases HbA1c by 1.04 percentage point over three months in T2DM (p < 0.001), which is statistically significant.

A 24-year-old man presented to the Chris Hani Baragwanath Academic Hospital emergency department with recurrent seizures having previously been diagnosed with epilepsy from age 14. The biochemical investigations and brain imaging were suggestive of seizures secondary to hypocalcemia, and a diagnosis of idiopathic hypoparathyroidism was confirmed. After calcium and vitamin D replacement, the patient recovered well and is seizure free, and off antiepileptic therapy. This case highlights the occurrence of brain calcinosis in idiopathic hypoparathyroidism; the occurrence of acute symptomatic seizures due to provoking factors other than epilepsy; and the importance, in the correct clinical setting, of considering alternative, and sometimes treatable, causes of seizures other than epilepsy.