The Minutes of the previous Annual General Meeting were taken as read.
Matters Arising There were no matters arising out of the previous minutes.
Chairperson’s Report Dinky Levitt Reported:
This has been my second and final year as Chairperson of SEMDSA. At the outset I would like to thank Shelley Harris for her support and commitment to our society and to the members of the Executive Council. In particular I would like to thank Derrick Raal, Danie Van Zyl and Magda Conradie who will be standing down.
We have dealt with a number of issues during the past year:
Two fellowships and 1 research bursary/grant were advertised last year. Thereafter selection committee’s were convened. For the SEMDSA and NOVONORDISK fellowships the committees were constituted by HODs of academic units and met telephonically. At the conclusion of this round of meetings, it was suggested that in the selection process be reviewed with the possibility of a personal interview-possibly at SEMDSA Congress, if the timing is right alternatively a formalized telephonic interview, and that centres selected at their preferred training site by candidates be recused from voting
Novo Nordisk Fellowship
The abovementioned company provided a one- off 2 year training fellowship, with a request that preference be given to an applicant who wished to train in paediatric endocrinology. The recipient is Dr. Tayob who has just commenced her training in Durban.
This fellowship which is funded by 8 pharmaceutical companies was also advertised towards the end of last year. The successful applicant was Dr Debbie Gordon who will take up her fellowship this year at Chris Hani- Baragwaneth Hospital
SEMDSA DIABETES RESEARCH GRANT:
This was instituted for the first time in 2009 using monies received from the IDF following the WDC in Cape Town in 2006. There were five applicants. Elize Webb who has registered for a PHD at Pretoria was the successful applicant and will receive funding for 3 years. The excom is considering the possibility of creating a second grant and will review the financial viability in the next few months
We were contacted by The Trustees of the Claude Leon Foundation who have offered an annual award of R5000 to the author of the best paper published in the field of endocrinology and diabetes to be administered by SEMDSA. The award will be called the Claude Leon Richard Frankel Award and sufficient money has been allocated to cover awards for ten years. At the end of that time the matter will be reviewed by the trustees. The trustees would like to have an annual report concerning the award.
Dr Richard Frankel died tragically in a motor vehicle accident. He was a diabetologist working in Great Britain and was a grandson of Claude Leon. He was chairman of the Foundation for a number of years.
It will be for the new committee to decide whether this will replace one of the current SEMDSA awards
I served as chair of the subgroup endocrinology with Aslam who co-ordinated input from clinical endocrinologists. The process was extremely successful
We have previously acted as watchdog eg insuproforte/ solal products and more recently have engaged with HPCSA following a specific complaint against Lancet that was brought to our attention by a member of SEMDSA
REGISTRATION WITH HPCSA
A letter has been sent to HPCSA to determine if it still possible to register under grandfather clause Thus far there has been no response and a follow up letter is required.
INSULIN PUMP GUIDELINES
A new group has been formed and is working on new guidelines
CLINICAL ENDOCRINOLOGY SUBGROUP
I regret to say that there has been little movement on the formalisation of this group thus far. I will ask Aslam to comment on this
We are grateful to Roche for assisting in the printing of the z folder form of the guideline. It is essential that we be in a position to disseminate the guideline further, in particular to medical students and doctors working in primary care clinics. We will be requesting sponsorship from industry to ensure sufficient numbers are printed.
We are all impressed by the journal’s achievements thus far, but there appears to be concern about competing journals. This matter needs to be addressed as JEMDSA is the official journal of our society and as such deserves our support and that of the companies operating in endocrinology and diabetes –Steve Hough will comment further
RELATIONSHIP WITH DSA/DESSA/PAEDSSA
One of our aims this year was to improve our relationship with each of DSA, DESSA and PAEDSSA. To this end we invited the chairperson of each organisation to attend our exco meeting in Februar. We met with of the 3 other groups separately and ended with a joint session. The outcomes were:
A much better understanding of problems relating to diabetes education accreditation programmes, the role of DSA and the challenges it faces in recruiting new paid up members. There was a discussion of the need to reconsider the possibility of a the creation of a single lobby/association/organisation for diabetes in South Africa. This matter was last discussed about 14 years ago and was shelved. At that time, one of the major problem raised was that SEMDSA has a broad mandate relating to subspecialist training in endocrinology as well as diabetes and as such could not submerge its identity into a diabetes specific organization. This issue needs to be revisited in the next year.
It seems as though our organisation is growing-there are more people in training in the various centres around the country and younger faces are appearing consistently at our congresses. There are a number of challenges facing our organization at present:
How to ensure that our trainees are exposed to the latest advances in pharmacotherapy and technology given the limited access to these in the state sector.
To ensure a rich research environment and once again to promote inter institutional research projects
How to advance the concept of a single diabetes society/association.
There was a prolonged discussion regarding apparent unethical practices by colleagues and the question was raised as to what SEMDSA is doing about it. It was reported that the HPCSA recently reached a decision about an endocrine related case without consulting with SEMDSA or an endocrinologist in academic practice. This needs to be addressed with the HPCSA, but it was emphasized that complaints to HPCSA can only be made by patients. A suggestion was made that an article/editorial be written in JEMDSA in which we distance ourselves from certain practices.
Treasurer’s Report Nigel Crowther presented the financial statement. Currently there is R1064094 in the two accounts. Hilton Kaplan recommended that we look at changing the 32 day call account to a market link account which is risk free. Shelley Harris to investigate with Nedbank.
Sub-Committees and Affiliated Societies
Amanda Went, Chairperson of DESSA reported as follows:
The primary thrust of DESSA in 2009 – 2010 has been education. With the completion of the training manual and accompanying training tools, Dessa has already had 100 people through this 3 day programme in Bloemfontein under Elmine Du Toit and 30 trained in Kwazulu Natal under Laurie Van der Merwe.
This programme is now going to be supplemented with an advanced programme for those desiring to become registered with Dessa as accredited diabetes educators. This will include the completion of a required number of diabetes clinical hours, assignments and mentorships.
A 6 month in house diabetes training programme has also been running at Groote Schuur under the directorship of Buyelwa Dlangamandla. 10 students progressed through this course.
The cloud of Occupation Specific Dispensation continues to dominate diabetes education
OSD has lured capable and qualified diabetes educators out of the diabetes field into appropriately remunerated nursing specialties. Diabetes education is not recognized by the South African Nursing Council (SANC) as a specialty.
Numerous initiatives are underway to establish a diabetes educators course registered with SANC. These include meetings held in Cape Town with Buyelwa Dlangamandla and the Prof of Nursing of UCT. From this meeting it was established that considerable funding would be required to establish a new course. It would be a least 2 years before the course could start. There would be no guarantee that it would be eligible for OSD specialty salary.
Dr David Segal is presently investigating running a diabetes training course for health professionals. He is liaising with government and setas
Laurie Van der Merwe is presently studying the post graduate Cardiff diabetes course with view to training in SA at a future date.
These 3 main role players in Western Cape, KZN and Gauteng, plan to network to facilitate speedy development of a registered course
DESSA has undertaken to update its membership database as many of the members which were on the SEMDSA database are no longer active. 640 forms were sent out and we now have a returned hard copy of information of approximately 200 members.
The membership predominates in the Western Cape, KZN and Gauteng. However Dessa is slowly making inroads into Limpopo province, Orange Freestate, Mpumalanga, And Eastern Cape. Membership in the Northern Cape and the North West Provinces remains a challenge.
During this last year we have seen diabetes educators venture into the previous uncharted waters of publishing articles. Compliments to Gerda Van Rensburg and Jeannie Berg who have submitted articles for publication to JEMDSA. Jeannie Berg has also had a very encouraging article published regarding her work in Secunda in the March 2010 SAJDVD. Buyelwa Dlangamandla continues to make inroads into training at grassroots level and has seen her work with agents of change featured in a number of issues of the DSA magazines. Gerda Van Rensburg has taken on the daunting task of obtaining articles
Buyelwa Dlangamandla has recently been chosen as a delegate to represent Africa on the International diabetes federation education team. This is indeed an honour and we support her in her undertakings.
DESSA was approached by Peter Black from CDE to form an affiliation with the aim of utilising the DESSA accredited diabetes educators in their CDE practice. CDE will draw up an application form for DNE’s who wish to see their patients. This will then be forwarded to all on the DESSA database who fulfill the criteria for being registered or accredited DNE’s. Those DNE’s who wish to complete the application form can do so and then it will become a formalized working relationship between them personally and the CDE.
Summary of Accounts as of 31st March 2010
RMB investment [as of 25th February 2010 at 7.22%] - R117,059.54
FNB investment [as of 29th March 2010 at 4.4%] - R 83,180.39
FNB Business account - R 8,321.61
Durban training - R 800.00
Bloemfontein training - R 3,000.00
Membership fees - R 180.00
NEC and education task team meetings - R 23,490.50
Training kits and photocopying - R 3,442.09
INCOMING NEC COMMITTEE April 2010 – April 2011
Stephen Hough reported that NOFSA was doing well. They held 3 educational meeting during the past year which were very successful.
They were also involved with PMBs and managed to ensure that DEXAs are now reimbursed.
The guidelines were now complete and the first draft was presented for review in January. This will be discussed with the stakeholders next month and once finalized will be distributed.
LASSA Derick Raal reported that LASSA remains committed to their association with SEMDSA and will combine with the SEMDSA Congress in 2011 in Bloemfontein.
PAEDS SA Kuben Pillay advised that PAEDS SA will continue their affiliation with SEMDSA. Much of their time has been taken up with examinations and they are currently working on the syllabus for paediatric endocrinology.
A campaign is in process regarding the reduction of diabetic ketoacidosis and they are involved with DSA to support children with camps.
The Type 1 registry should be fully operational by the end of the year.
PAEDS SA will look at contributing presentations at the next SEMDSA Congress.
Clinical Endocrinology Aslam reported that this sub-group was established last year and had achieved the following during 2009:
Practice no for Endocrinologists – resolved with Board of Healthcare Funders in October 2009. This led to an overhaul of practice numbers in other subspecialities.
Aslam also reported that both he and Dinky attended the PMB meeting and in fact were successful in everything that was put forward.
Fee structure – The group did not collect practice cost data for submission to the Department of Health, but this made no difference as the Department of Health then put out a guide to fees which was pure speculation.
The private practice committee of SAMA has been disbanded and the SA Private Practice Forum has been formed.
Aslam reported that the faculty of consulting physicians (head is Adri Kok)is looking for a contribution of R12 000 per annum per doctor. However there is no structure to the group and the cost issue needs resolution.
The Clinical Endocrinology group consists currently of a small committee to address acute issues. This group needs a constitutional framework in which to work with terms of reference.
It was agreed that the group consist of the following members:
Aslam Amod, Willie Mollentze, Dinky Levitt, Hilton Kaplan, Larry Distiller, Joel Dave,
Diabetes South Africa Razanna Allie reported on behalf of DSA and mentioned that many of the volunteers were part time educators referring to medical practitioners. She urged all professionals to become executive members of DSA and contribute R250 annually to the society.
She further mentioned that IDF Africa wish to establish a permanent office and that they would be voting on behalf of their society.
JEMDSA Stephen Hough advised that a meeting was needed to resolve many issues related to JEMDSA. It was agreed that SEMDSA fund a ½ day workshop within the next 2-3 months to discuss everything.
SEMDSA 2010 Aslam reported that although we had managed to raise sufficient funds for most aspects of the congress, the climate is more difficult. We also need to think of ways of growing the congress attendance.
He also reported that the Diabetes Update Pre-congress Symposium was poorly attended by general practitioners and this could also be due to the fact that regional meetings had been held quite close to the symposium.
SEMDSA 2011 Willie Mollentze advised that SEMDSA 2011 will take place form 8 – 12 April 2011 at the University in Bloemfontein. Some members asked if he could not consider another venue.
Scholars Programme Dinky advised the group that this programme run by the American Endocrine Society allowed for training of individuals in the field of research. Unfortunately, we have not been able to identify anyone for the programme despite us lobbying extensively. One reason is that our candidates are already established with families and earning capacity and the remuneration is not enough to uproot them from their current positions.
Type 2 Guidelines Guidelines are now complete and industry will be approached regarding dissemination of the pocket guidelines to all medical schools.
2010/2011 EXCOM The following members were elected to the EXCOM:
Aslam Amod (Chairperson)
Nigel Crowther (Vice Chairperson)
Jacobus van Dyk (Secretary/Treasurer)
Awards SEMDSA Travel Award This award was made to N Mohamed from the University of Witwatersrand, Johannesburg.
SEMDSA Diabetes Award A longitudinal study of the changes in body fat and metabolic parameters in a South African population of HIV-Positive patients receiving an antiretroviral therapeutic regimen containing Stavudine. JA George, WDF Venter, HE van Deventer and NJ Crowther, Department of Chemical Pathology, NHLS and Reproductive Health and HIV Research Unit, University of Witwatersrand, Johannesburg.
SEMDSA Endocrinology Award The tumor necrosis factor-α gene -308 G/A polymorphism modulates the relationship between dietary fat intake, serum lipids and obesity risk in black South African women. YT Joffe, L van der Merwe, M Carstens, M Collins, C Jennings, NS Levitt, EV Lambert, JH Goedecke. UCT/MRC Research unit for Exercise Science and Sports Medicine, Department of Human Biology and the Diabetes Endocrine Unit, Department of Medicine, University of Cape Town, Biostatistics Unit, South African Medical Research Council, Cape Town and Department of Statistics, University of Western Cape.
SEMDSA Best Oral Presentations The clinical award was made to:
Joel Dave for his paper:
Prevalence of the metabolic syndrome in HIV-positive South Africans on antiretroviral therapy.
The basic science award was made to:
Hanel Sadie-Van Gijsen for her paper:
Mitogenic and lipogenic actions of insulin on cultured adipose-derived stromal cells.
SEMDSA Best Poster Presentations The clinical endocrinology award was made to:
Fatima Moosa for her paper
Assessing math literacy skills in type 1 diabetic children and their caregivers.
The basic science award was made to:
Uthra Rajamani for her paper:
Hyperglycaemia-induced activation of the hexosamine biosynthetic pathway triggers
The endocrinology case study award was made to:
D Joseph for his paper:
Increased hexosamine biosynthetic pathway flux leads to PKB/AKT post-translational modification:
Implications for onset of insulin resistance.
Novo Nordisk Travel Grant This award was made to:
Carsten Weinreich from the University of Cape Town Medical School, Cape Town.
Novo Nordisk Diabetes Educators Travel Grant This award was made to:
Jeannie Berg from Secunda.
Sanofi-Aventis Travel Fellowship This award was made to:
Willem de Lange from the Department of Internal Medicine, Universitas Hospital, Bloemfontein.
Sanofi-Aventis Osteoporosis Award This award was made to:
Roy Shires et al for the paper entitled: Cortical and trabecular bone microarchitecture and turnover in alcohol-induced chronic pancreatitis: a histomorphometric study.