Thyroid hormone is the mainstay of therapy for patients with hypothyroidism. The correlation between biochemical parameters, clinical parameters, and satisfaction with thyroid hormone therapy has been a subject of spirited discussion for some time.
Modern Medicine – Issue 2 2023
Keep Your Eyes Open for Non-anaemic Iron Deficiency
Iron deficiency is one of the most common global nutritional health problems, affecting an estimated 2 billion people. Iron deficiency anaemia affects approximately 20% of the world’s population. Iron deficiency without anaemia is three to four times more common than iron deficiency anaemia and is an under-recognised and under-treated condition.
Modern Medicine – Issue 2 2023
Metabolic Decline can Point to the Thyroid
Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body. Untreated hypothyroidism can contribute to hypertension, dyslipidaemia, infertility, cognitive impairment and neuromuscular dysfunction. Thyroid hormone replacement therapy with levothyroxine, the exogenous form of T4, has been the gold standard for the treatment of primary hypothyroidism for more than 60 years.
Modern Medicine – Issue 1 2023
Stalling the March of Diabetic Retinopathy
Diabeticretinopathy , a common and sight – threatening microvascular complication of diabetes mellitus, is a leading cause of blindness among workingaged adults. Systemic fenofibrate therapy has been shown to be effective in reducing the progression of diabetic retinopathy independently of serum lipid levels.
Modern Medicine – Issue 1 2023
Type 2 Diabetes in Young Adults: A management guide for GPs
Type 2 diabetes is increasing among young adults, who are at higher risk of early complications and mortality and require a nuanced approach to management. Clinicians can be guided by recommendations from the recently published Australian consensus statement on the management of type 2 diabetes in young adults, which highlights areas where management might differ from that of older adults. GPs play an important role in identifying type 2 diabetes in young adults and are encouraged to facilitate access to endocrinologists and specialised multidisciplinary care teams where available. GPs are pivotal in providing support and education, particularly with respect to pregnancy, contraception and psychological health, and in providing continuity of care, especially during transition periods.
Modern Medicine – Issue 1 2023
Levothyroxine for Hashimoto Thyroiditis: Finding the optimal dose
Clinical presentation includes thyrotoxicosis, euthyroidism, and hypothyroidism. The dose of levothyroxine (LT4) used for treatment is based on the degree of preserved thyroid functionality and lean body mass, and usually ranges from 1.4 to 1.8mcg/kg/day.
Modern Medicine – Issue 1 2023
Identifying Prediabetes to Nip Type 2 Diabetes in the Bud
Diabetes prevalence, as well as that of prediabetes, is rapidly increasing in South Africa. Individuals with pre-diabetes have a high risk of developing type 2 diabetes. Screening asymptomatic adults for prediabetes and type 2 diabetes may allow earlier detection, diagnosis and treatment, with the ultimate goal of improving health outcomes. If left untreated, diabetes can lead to serious health complications.
Modern Medicine – Issue 4 2022
Ignoring Adolescent Obesity is a Risk for Later Adult Health
Adolescent obesity is concerning given its high prevalence and associations with adverse physical, social, and emotional health consequences in adolescence and later in life. It also poses a considerable financial burden on the healthcare system as ~ 70% of adolescents with obesity become adults with obesity. In a randomised, controlled trial of adolescents with obesity, the use of liraglutide (3mg) plus lifestyle therapy led to a significantly greater reduction in the BMI standard-deviation score than placebo plus lifestyle therapy.
Modern Medicine – Issue 3 2022
Meaningful Relief in Painful Diabetic Neuropathy
Neuropathic pain is often associated with diabetic peripheral neuropathy and is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system. Pregabalin is a firstline treatment in all major international guidelines on the management of painful diabetic neuropathy (pDPN). Treatment with pregabalin leads to a clinically meaningful improvement in pain scores, offers consistent relief of pain and has an acceptable tolerance level.
Modern Medicine – Issue 2 2022
Diagnosing and Treating Metabolic Syndrome
The presence of the metabolic syndrome raises potential health concerns, particularly as we search for early disease markers with the aim of prevention and/ or early intervention. The metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidaemia and hypertension. Management of metabolic syndrome and its comorbidities ideally involves a multidisciplinary team approach to risk-factor management.
Modern Medicine – Issue 1 2022
