May 2008 Contents 2 In the news 4 Review Article

Contents
2 In the news
4 Review Article
A practical education
programme for rural Africa
C Price, D Shandu, and G Gill
10 Review Article
Editor
Professor Geoff Gill
The role of the pharmacist
in the management of the
hypertensive diabetic patient
A Adeyemi
Liverpool School of Tropical
Medicine, and
University Hospital, Aintree, UK
11 Review Article
Consulting Editor
Professor Sir George Alberti
Senior Research Fellow,
Imperial College London
Past President,
International Diabetes Federation
Editorial Board
Dr Ibrahim Sherif – Libya
Prof Ken Huddle – South Africa
Dr Kaushik Ramaiya – Tanzania
Dr Nigel Unwin – UK/Switzerland
Dr J C Mbanya – Cameroon
Publisher
Bryan Pearson
Managing Editor and
Production
Penny Lang
Advertisement Manager
Jo Paul
Business Manager
Grant Docking
ISSN 1468-6570
All contents are © 2008
FSG Communications Ltd
Diabetic heart disease:
risk factors and pathogenisis
O A Busari, O T Olarewaju, and
O G Opadijo
14 More news
15 Original Article
Association between
glycaemic control and erectile
dysfunction amongst Nigerian
diabetic patients
B C Unadike, A Eregie, and
A E Ohwovoriole
19 Original Article
Glycaemic response to
different preparations of yam
in diabetic and non-diabetic
Nigerians
A K Jimoh, S O Adediran,
S A Adebisi, A A Akande,
J K Olarinoye, and A B Okesina
23 Original Article
Does diabetic mastopathy
exist in north-eastern Nigeria?
A U Hamidu, M Alkali, and
M A Abdul
24 Guidance for authors
May 2008
May 2008
New drugs for diabetes
In Europe recently, a new class of
oral hypolycaemic agents (OHAs)
have been released, working in an
entirely different way from other drugs
for type 2 diabetes. These operate by
stimulating the incretin hormone systems. Incretins are hormones which
are released from the small intestine
in response to food intake, stimulating
insulin release, inhibiting glucagon,
and increasing gastric emptying. The
effect is to lower blood glucose, without hypoglycaemia, and usually with
weight loss rather than weight gain.
The commonest incretin hormone is
GLP–1 (glucagon-like peptide 1), and
the drug exanetide is an agonist of this
hormone. Exanetide has to be given
subcutaneously, twice daily (bd), but
the dose regimen is simple – 5 μg bd
(initially, increasing to 10 μg bd after
1 month if there are no side-effects.
There are no other dose titrations
after that. Sitagliptin is an orally active
drug that inhibits the enzyme which
breaks down GLP–1, thus increasing
its overall activity.
Initital experience with these drugs
appears positive. The lack of weight
gain as a side-effect is particularly
useful in the common problem of
the overweight or obese, poorly controlled type 2 patient. Naturally, they
are expensive, and it is likely to be
some time before they are available
to African doctors. Nevertheless, we
at Diabetes International always feel
that diabetes care workers in Africa
should be kept aware of important
advances in the specialty.
Prof. Geoff Gill,
Liverpool School of Tropical
Medicine,
Liverpool, UK
Editor, Diabetes International
Correspondence to:
Diabetes International
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