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Issue

Vol 129 No 1436: 10 June 2016

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Issue Summary

SUMMARY

The management of Graves disease in New Zealand 2014

Stephanie C Cox, Jade AU Tamatea, John V Conaglen, Marianne S Elston

We did an online survey of specialists asking how they usually treat patients with Graves disease (A condition where the thyroid gland produces too much thyroid hormone, caused by an over-active immune system). There are several equally good treatments available, so doctors must help their patients choose the right treatment for them. The results were compared with surveys from specialists in Europe and North America to see if New Zealand doctors use the same tests and treatments. We also compared results with a similar survey done in New Zealand in 1991 to see if how we treat Graves disease has changed over time. We found that how we treat Graves disease has changed over time, and we also manage the disease differently to specialists overseas.

SUMMARY

Access to diabetes drugs in New Zealand is inadequate

Jeremy Krebs, Kirsten Coppell, Pip Cresswell, Michelle Downie, Paul Drury, Ann Gregory, Timothy Kenealy, Catherine McNamara, Steven Miller, Kate Smallman

New Zealand is well behind the rest of the developed world in access to funded drugs for managing type 2 diabetes. Over the last 12 years three new classes of glucose-lowering drugs have come through clinical trials to market. The principal strengths of all three novel classes of medicine are their lack of hypoglycaemia (low blood sugar), their frequent acceptability in patients intolerant of or contraindicated for existing funded drugs, and avoidance of weight gain. International guidelines focus on individualization of treatment and avoidance of hypoglycaemia. This is extremely difficult for New Zealanders with type 2 diabetes when we do not have access to modern drug treatments.

SUMMARY

Trampoline-associated injuries are more common in children in spring

Michael S Yule, Sanjeev Krishna, Jamie-Lee Rahiri, Andrew G Hill

Trampoline-associated injuries are common among children in New Zealand. This study has shown that many of these injuries occur in the spring, when New Zealand clocks change to daylight savings time. Most of these injuries, at least those that present to hospital, are broken bones of the arm or forearm. Public safety messages to decrease injuries associated with playing on trampolines should be targeted around spring when clocks in New Zealand change to daylight savings time.

SUMMARY

Geography matters: the prevalence of diabetes in the Auckland Region by age, gender and ethnicity

Briar Warin, Daniel J Exeter, Jinfeng Zhao, Timothy Kenealy, Susan Wells

We identified and mapped the proportion of people diagnosed with Type 1 or Type 2 diabetes in the Auckland region in 2011 by General Electoral Districts (GEDs). We found marked geographical variation in the prevalence of diabetes across the region, with the highest rates in the electorates based in South Auckland (eg, Mangere, Manakau East and Manurewa) and lowest rates in electoral districts in central and north Auckland (Auckland Central, Epsom, North Shore, and East Coast Bays). The fact that residents living in the Mangere GED, just 25km away from the North Shore GED, are nearly twice as likely to have diabetes is unacceptable. This research highlights the extensive inequities in diabetes among electorates in the Auckland region. Further research into potential geographic factors such as food affordability and availability is required in addition to a more targeted approach to area-based prevention strategies and the provision of health services for people with diabetes.

SUMMARY

The case for a national service for primary immune deficiency disorders in New Zealand

Rohan Ameratunga, Richard Steele, Anthony Jordan, Kahn Preece, Russell Barker, Maia Brewerton, Karen Lindsay, Jan Sinclair, Peter Storey, See-Tarn Woon

Primary immune deficient disorders (PIDS) are rare conditions for which effective treatment is available, particularly if recognised early. Treatment of these conditions requires the expertise of adult and paediatric immunologists. Currently not all patients are under the care of immunologists, leading to variability in care. There also inconsistencies in the use of intravenous immunoglobulin, which may have contributed to a shortage necessitating importation of product. A national PID service would result in an improvement in patient care and a substantial reduction in costs.

SUMMARY

Sleep of Māori and non-Māori of advanced age

Rosemary Gibson, Philippa Gander, Sarah-Jane Paine, Mere Kepa, Lorna Dyall, Simon Moyes, Ngaire Kerse

This is the first study to estimate the prevalence of reporting sleep problems among Mori and non-Mori of advanced age. Among 251 Mori and 398 non-Mori aged 79-90 years, we found that 25.5% of Mori and of 31.7% non-Mori reported a sleep problem. Reporting a current sleep problem was more likely among non-Mori, and among those who reported a past sleep problem, or poorer self-rated physical or mental health. Results highlight the importance of sleep for the health-related quality of life of our rapidly ageing population.

ALL ARTICLES
SUMMARY

The management of Graves disease in New Zealand 2014

Stephanie C Cox, Jade AU Tamatea, John V Conaglen, Marianne S Elston

Access to diabetes drugs in New Zealand is inadequate

Jeremy Krebs, Kirsten Coppell, Pip Cresswell, Michelle Downie, Paul Drury, Ann Gregory, Timothy Kenealy, Catherine McNamara, Steven Miller, Kate Smallman

Unprovoked DVT, the clot thickens

Sophie Harmos, Tom Kai Ming Wang, Stewart Hawkins, Roger Reynolds

Trampoline-associated injuries are more common in children in spring

Michael S Yule, Sanjeev Krishna, Jamie-Lee Rahiri, Andrew G Hill

Leukoencephalopathy in an HIV patient

Joe James, James Jose, NK Thulaseedharan

Use of full strength fluoride toothpaste among preschoolers in New Zealand, and factors determining toothpaste choice

Judy Li, Sarah Dallas, Karen McBride-Henry

Geography matters: the prevalence of diabetes in the Auckland Region by age, gender and ethnicity

Briar Warin, Daniel J Exeter, Jinfeng Zhao, Timothy Kenealy, Susan Wells

The case for a national service for primary immune deficiency disorders in New Zealand

Rohan Ameratunga, Richard Steele, Anthony Jordan, Kahn Preece, Russell Barker, Maia Brewerton, Karen Lindsay, Jan Sinclair, Peter Storey, See-Tarn Woon

Sleep of Māori and non-Māori of advanced age

Rosemary Gibson, Philippa Gander, Sarah-Jane Paine, Mere Kepa, Lorna Dyall, Simon Moyes, Ngaire Kerse

SUMMARY

The management of Graves disease in New Zealand 2014

Stephanie C Cox, Jade AU Tamatea, John V Conaglen, Marianne S Elston

We did an online survey of specialists asking how they usually treat patients with Graves disease (A condition where the thyroid gland produces too much thyroid hormone, caused by an over-active immune system). There are several equally good treatments available, so doctors must help their patients choose the right treatment for them. The results were compared with surveys from specialists in Europe and North America to see if New Zealand doctors use the same tests and treatments. We also compared results with a similar survey done in New Zealand in 1991 to see if how we treat Graves disease has changed over time. We found that how we treat Graves disease has changed over time, and we also manage the disease differently to specialists overseas.

SUMMARY

Access to diabetes drugs in New Zealand is inadequate

Jeremy Krebs, Kirsten Coppell, Pip Cresswell, Michelle Downie, Paul Drury, Ann Gregory, Timothy Kenealy, Catherine McNamara, Steven Miller, Kate Smallman

New Zealand is well behind the rest of the developed world in access to funded drugs for managing type 2 diabetes. Over the last 12 years three new classes of glucose-lowering drugs have come through clinical trials to market. The principal strengths of all three novel classes of medicine are their lack of hypoglycaemia (low blood sugar), their frequent acceptability in patients intolerant of or contraindicated for existing funded drugs, and avoidance of weight gain. International guidelines focus on individualization of treatment and avoidance of hypoglycaemia. This is extremely difficult for New Zealanders with type 2 diabetes when we do not have access to modern drug treatments.

SUMMARY

Trampoline-associated injuries are more common in children in spring

Michael S Yule, Sanjeev Krishna, Jamie-Lee Rahiri, Andrew G Hill

Trampoline-associated injuries are common among children in New Zealand. This study has shown that many of these injuries occur in the spring, when New Zealand clocks change to daylight savings time. Most of these injuries, at least those that present to hospital, are broken bones of the arm or forearm. Public safety messages to decrease injuries associated with playing on trampolines should be targeted around spring when clocks in New Zealand change to daylight savings time.

SUMMARY

Geography matters: the prevalence of diabetes in the Auckland Region by age, gender and ethnicity

Briar Warin, Daniel J Exeter, Jinfeng Zhao, Timothy Kenealy, Susan Wells

We identified and mapped the proportion of people diagnosed with Type 1 or Type 2 diabetes in the Auckland region in 2011 by General Electoral Districts (GEDs). We found marked geographical variation in the prevalence of diabetes across the region, with the highest rates in the electorates based in South Auckland (eg, Mangere, Manakau East and Manurewa) and lowest rates in electoral districts in central and north Auckland (Auckland Central, Epsom, North Shore, and East Coast Bays). The fact that residents living in the Mangere GED, just 25km away from the North Shore GED, are nearly twice as likely to have diabetes is unacceptable. This research highlights the extensive inequities in diabetes among electorates in the Auckland region. Further research into potential geographic factors such as food affordability and availability is required in addition to a more targeted approach to area-based prevention strategies and the provision of health services for people with diabetes.

SUMMARY

The case for a national service for primary immune deficiency disorders in New Zealand

Rohan Ameratunga, Richard Steele, Anthony Jordan, Kahn Preece, Russell Barker, Maia Brewerton, Karen Lindsay, Jan Sinclair, Peter Storey, See-Tarn Woon

Primary immune deficient disorders (PIDS) are rare conditions for which effective treatment is available, particularly if recognised early. Treatment of these conditions requires the expertise of adult and paediatric immunologists. Currently not all patients are under the care of immunologists, leading to variability in care. There also inconsistencies in the use of intravenous immunoglobulin, which may have contributed to a shortage necessitating importation of product. A national PID service would result in an improvement in patient care and a substantial reduction in costs.

SUMMARY

Sleep of Māori and non-Māori of advanced age

Rosemary Gibson, Philippa Gander, Sarah-Jane Paine, Mere Kepa, Lorna Dyall, Simon Moyes, Ngaire Kerse

This is the first study to estimate the prevalence of reporting sleep problems among Mori and non-Mori of advanced age. Among 251 Mori and 398 non-Mori aged 79-90 years, we found that 25.5% of Mori and of 31.7% non-Mori reported a sleep problem. Reporting a current sleep problem was more likely among non-Mori, and among those who reported a past sleep problem, or poorer self-rated physical or mental health. Results highlight the importance of sleep for the health-related quality of life of our rapidly ageing population.

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