Minutes of the SEMDSA Annual General Meeting held
on Saturday the 18 April 2009 at the Wanderers Club,
Chairperson: Prof NS Levitt
Vice Chairperson: Prof DG van Zyl
Secretary/Treasurer: Prof N Crowther
Apologies: Dr S Delport, Dr J Dave, Dr I Ross, Dr L Distiller, Prof MAK Omar, Prof B Ascott-
Evans, Dr R Moore
1. The Minutes of the previous Annual General Meeting were taken as read.
2. Matters Arising
There were no matters arising out of the previous minutes.
3. Chairperson’s Report
Dinky Levitt reported that the past year had been an extremely active time for SEMDSA.
The new SEMDSA Type 2 Guidelines were finally in place and she thanked Roche Diabetes Care
for the unrestricted grant they provided for the printing of the guidelines and the sponsorship of a
meeting to develop these guidelines. Dinky also thanked the many members that had contributed to
the development of these guidelines. Currently the long version is loaded on to the website and the
short version will be made available in Z folders.
Dinky thanked Stephen Hough for his ongoing commitment to the society and especially for all the
hard work involved in moving JEMDSA to our new home MedPharm. She further confirmed that
Stephen would talk further on this matter during the course of the meeting.
SEMDSA announced that they had made available a Research Grant in Diabetes (for 2/3 years
depending on degree). The funding for this grant comes from the money given to SEMDSA by the
IDF 2006 Congress.
Dinky reported that SEMDSA had become watchdogs on several issues:
1. Insuproforte which was advertised as an oral insulin – we approached the advertising standards
committee and sent a letter of complaint to the MCC and HPCSA. The matter is being looked at
and we are awaiting a response.
2. Solal – issues pertaining to their outrageous claims when advertising. Derick wrote to the
advertising standards bureau and initially they came back claiming that they saw SEMDSA as
competitors. We have subsequently written back to them advising them that this was not correct
and we are waiting for a response. There was debate concerning this issue amongst the members
attending the AGM and it was agreed that the new committee write to the Ministry of Health and the
MCC. Perhaps we should also use the DSA to lobby on behalf of the patients.
During the course of the past year there had been much correspondence between SEMDSA and the
private endocrinologists regarding several issues. Over a period of time a schism had grown
between private and public specialists and SEMDSA was viewed as representing the public sector
alone. However, it was agreed that SEMDSA is a body for all endocrinologists. A clinical subgroup
was proposed as an interim measure to deal with issues such as the Board of Healthcare Funders
and the formal set up of this group will be discussed later on in the meeting.
Paediatric Insulin pump guidelines were published with both SEMDSA and PAEDSSA logos without
our knowledge in two publications and SEMDSA had written to those concerned. One publication
has already responded promising to put in a retraction which will appear in the next issue.
IDF Africa – Dinky reported that she had attended a meeting in Nairobi in which a UN Resolution
action plan was discussed and being implemented. This is an attempt to create a ground swell
regarding diabetes with several workshops being held in all the regions.
Dinky thanked the past chairperson, Steve Delport, for all his hard work in running the society for the
previous two years. She also thanked Shelley Harris.
SEMDSA plans to play a more active role in promoting improved control for people living with
diabetes. Groups such as DESSA, DSA and SEMDSA need to form an action group and work
closely together to achieve this goal.
Faz Mahomed had suggested that we become more involved on a provincial level to ensure
protocols are implemented and assessed.
She also pointed out that more young people were attending the annual congresses and more
young people were coming through the system as endocrinologists bearing testament to the
strength of the academic centres. We should encourage their participation as they are the future of
Finally Dinky thanked the EXCOM for all their hard work during the past year.
4. Treasurer’s Report
Nigel Crowther presented the financial statement and currently there is R1075683 in the two
5. Sub-Committees and Affiliated Societies
Amanda Went, Chairperson of DESSA reported as follows:
EDUCATION TRAINING PROGRAMME
An education task team has been formed with the mandate of developing a training programme and
a manual that can be utilized throughout South Africa. This project is now approaching completion
and is due to be launched at the DESSA AGM. It will greatly assist in the standardization of diabetes
education. The manual coupled with the designed slides will serve as a basis for the future running
of DESSA training courses. Grateful thanks to the members of the task team for their hard work on
this project and Dr Steve Delport of SEMDSA who has edited the manual.
Kwazulu Natal and Western Cape continue to have active branches with diabetes courses running
throughout the year. Gauteng has recently restarted activity in that area and there is a newly formed
branch in Mpumalanga which is hoping to stretch into Limpopo province. Areas which need
addressing include the Eastern Cape and Orange Free State.
Summary of Accounts as of 31 March 2009
RMB investment (R100,000.00 invested 23/05/09) - R109,677.19
FNB investment (R100,000.00 invested 23/05/09) - R108,727.51
FNB Business account - R4,153.51
ABSA ACCOUNT closed 6/10/2008 - R17961.64
NEC and education task team meeting - R19863.15
Detail available in financial statement
NOVO NORDISK DIABETES EDUCATOR TRAVEL GRANT
Tersia Van Niekerk of Richards Bay Kwazulu Natal was awarded the grant at the 2008 AGM. She
traveled to the USA and is due to report back on her experiences at the KZN branch meeting.
The DESSA newsletter “Diabetes Direct” made its debut at the 2008 AGM. The third edition is now
available in downloadable format from the website http://www.semdsa.org.za/dessa/information.htm
Grateful thanks to Jeannie Berg for making this possible.
DESSA Certificates are now available for diabetes educators who have completed a recognized
training in diabetes eg: RAU, CDE, DESSA, at Lilly or Novo courses AND have a MINIMUM of 5
years experience working full time in diabetes. Certificates state that the person has successfully
completed the requirement for registration with DESSA as a diabetes educator and is able to
function within the scope of practice of their particular specialty.
SCOPE OF PRACTICE
There have been many concerns raised about the scope of practice, specifically of diabetes
educators who are not registered nurses, regarding changing insulin doses, teaching and giving
insulin injections. This issue will need further consultation with stakeholders and SEMDSA.
MPHARM diabetes (Rhodes University)
Peter Hill of Rhodes university is still keen to drive this course and has been campaigning for start
up funds. He is requesting a list of interested parties.
OCCUPATION SPECIFIC DISPENSATION
This is not presently applicable for any diabetes courses. Restructuring of all nursing courses is in
process by SANC. All post basic courses will be called “Masters Certificates”(of which there are 16
specified courses) and in line with the new scopes of practice they are registered on the NQF. All
previous “legacy qualifications” will be phased out. The last intakes for such qualifications will be 30
Discussion took place regarding the OSD and recognition of diabetes educators. DENOSA is not an
avenue to pursue due to the fact that they signed in agreement currently in place with SANC.
Mention was also made of the Cardiff course which runs online for nurse educators – Lynne Starck
reported that SANC would not recognize this course. A suggestion was made that a subgroup be
formed consisting of DESSA and SEMDSA members so that this issue can be tackled together.
SEMDSA advised Amanda that they were willing to write letters for submission to SANC in order to
assist the process.
Stephen Hough reported that NOFSA had been quietly active during the past year. Their website
had been revised and that they were working on DEXA being on the prescribed minimum benefit list.
NOFSA had an excellent meeting in conjunction with SEMDSA in April last year, had held a good
densitometry course in Johannesburg in 2008 and had scheduled an advanced training course for
Updated guidelines will be forthcoming by the end of 2009.
Derick Raal reported that LASSA was celebrating their 20 anniversary this year together with Prof
Harry Seftel who had led the group who started the society. Unfortunately the number of members
has decreased over the years and this year they decided to change the format of the combined
meeting with SEMDSA in order to resurrect interest in the field of Lipidology. Thus a practical
course on Lipidology or Lipid Update will be held on the last day.
Derick confirmed that there was a great deal of value to having the meeting in conjunction with
5.4 PAEDS SA
Kuben Pillay advised the members that they had strengthened their administration last year and had
held their annual research day during the course of 2008. The group hopes to have a full session at
the congress next year as well as invite a paediatric endocrinologist to the meeting.
Kuben further advised that ISPAD was held in Durban in 2008 and was widely acclaimed.
PAEDS SA are hoping to get the Type 1 registry started by mind this year which will be web based.
They will also start a programme for prevention of DKA.
He further confirmed that the pump guidelines which were published with the PAEDS SA logo were
not endorsed by them either and that PAEDS SA will be requesting a retraction from the journals.
Growth Hormone guidelines were published by PAEDS SA and these should have been brought to
SEMDSA. Unfortunately Growth Hormone is not a prescribed minimum benefit (PMB) and it is a
constant uphill battle when prescribing.
Some members raised the question about whether PAEDS SA is large enough to have their own
research meeting. Kuben replied that the meeting consisted of approximately 30 people and that
other issues were also addressed at the meeting. It is important that it is held in order to produce
Prof Seftel advised that should they wish to contact him for advice on having treatments approved
under PMBs they were welcome to contact him.
The question of adult endocrinologists treating adolescents with Growth Hormone was raised and
Kuben advised that the group felt it was best dealt with by the paediatric endocrinologist.
6. Diabetes South Africa
Leigh-Ann Bailie reported back on behalf of DSA and advised that the group had been in existence
for the past 40 years. She confirmed that they had a wide membership and were involved in
information and education for patients. Annual membership was R100.
They are currently trying to be more pro-active in working with DESSA, CDE and other
She further advised that should you require screening to be done, the DSA would be happy to assist.
Stephen Hough advised the group that JEMDSA had severed their relationship with SAMJ due to
the extensive problems they had experienced over the past couple of years.
He further confirmed that we were extremely excited about our new publishing house (MEDPHARM)
who had just produced the first edition which was available at the congress. As JEMDSA is the
official mouthpiece of the society and its subgroups we will ensure that this excellent communication
tool is disseminated to all our members.
Currently the plans are to produce 3 issues this year with the aim for a 2 monthly edition for the
Stephen confirmed that the journal involved 12 associated sectional editors who were largely
nominated by the SEMDSA EXCOM.
Everyone at the AGM extended their thanks and congratulations to Stephen who should be
commended on his perseverance and hard work in getting the journal to where it is today.
10. SEMDSA 2009
Derick reported that it has been extremely difficult to raise funds this year to support the congress
both in terms of sponsorship of overseas speakers and social functions. He alluded to Roy’s
editorial in the current JEMDSA.
11. SEMDSA 2010
SEMDSA 2010 will take place in Durban from the 10 – 13 April 2010 and will include DESSA and
Ken advised that he thought that the pre-congress symposium held by Novo Nordisk was an
important element to the meeting and should be continued.
The current fellowship programme has also experienced funding problems – although 8 companies
committed to the R50 000 annually, one company had not come up with the money this year. Dinky
was currently in discussion with the CEO who was unaware of the issue.
SEMDSA need to finalise the amount that is required as soon as possible and then work off a base
with an annual inflation.
13. Pharmaceutical Industry and SEMDSA
Industry were supposed to nominate a representative and this has not as yet happened. On
Monday the CEOs or their representatives will attend a breakfast meeting with the EXCOM and
Heads of Department in order to provide them with feedback on SEMDSA’s activities and currently
It seems as though the perceptions existing last year have been resolved and currently the
relationship is certainly better.
14. Outreach 2008
Dinky reported that Steve Delport had run the outreach programme post the congress. This took
the form of a day long symposium entitled "Diabetes in the School Child" at Red Cross Hospital. It
was very well attended and delegates included doctors and nurses, school teachers and a few
Dinky advised that each congress committee should continue with this programme as it is important
for outlying areas.
15. Subspeciality Training
Derick reported that a meeting regarding the FCP examination would take place during the course of
this congress. He reported that the viva had been done away with and the cost to individuals writing
the examination had been reduced.
Ken reminded everyone that it was important that they ensure that the training is standardized and
that each fellow either present or write a paper which was mandatory.
Some members raised the issue of standardizing the endocrinology subspeciality with other
specialities but Ken advised the group that the College sees each speciality separately.
16. Medical Ambition
Ayesha was asked to comment on the status, but as she was not present at the last meeting, Dinky
gave feedback. Dinky reported that Novo Nordisk had held a meeting early last year in order to set
the stage by getting all the role players together with the aim of improving HbA1c targets. An interim
task force was then put together which is chaired by Jeff Wing. The idea was that a formal proposal
come out of the meeting and this would set the stage for other companies to come on board and
assist the role players in improving patient care.
Dinky reported that she had attended the last meeting,and commented favourably on the ability of
the initative to get so many role players together,. Her impression was that the initiative did not
appear to have attracted additional support from industry and questioned the make-up of the task
force (4 medical aid companies, 2 national dept of Health representatives, representatives from
private practice and no-one from public sector). She in fact advised that the representative from
SEMDSA was seen as the representative of the public sector. The initiative has great potential and
we await further information from the Chairperson of the interim task force.
17. 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.
18. Clinical Endocrinology Subgroup
Aslam Amod reported that it had become evident that a clinical endocrinology subgroup be formed
to address the issues pertaining to endocrinologists. Dinky advised that SEMDSA had worked
closely with the interim group over the past couple of months in order to address issues that needed
urgent attention, eg medical aid reimbursement, Board of Healthcare Funders and HPCSA issues
etc. The group had worked well with SEMDSA and some issues were now being addressed at a
There was a large amount of debate regarding whether the group to be formed should be:
1. A separate affiliated society;
2. A private Endocrinologist subgroup of SEMDSA;
3. A clinical Endocrinology subgroup;
It was finally agreed, after much consideration and input from everyone, that a clinical endocrinology
subgroup be formed under SEMDSA umbrella which is inclusive of both public and private
endocrinologists. The College recognizes SEMDSA as an organization and we are too small a
group of people to be fragmented.
Issues around whether the Chair of SEMDSA should always be an endocrinologist was discussed
and it was agreed that the constitution should not be changed.
The composition of the subgroup will need to be resolved by discussions led by Aslam and Dinky It
This needs to be reported back at the next SEMDSA EXCOM meeting.
19. Diabetes Programmes
Hilton Kaplan raised the issue of the various diabetes programmes being run throughout the country
by industry and organizations and advised that this was too fragmented and not standardized. He
further advised that it was very difficult to keep up with all the programmes out there and that
SEMDSA, being the umbrella body, should look at some sort of control.
A proposal was made to put a calendar on the DESSA website highlighting all the different activities
Dinky/Amanda promised to look into this matter.
19. 2009/2010 EXCOM
The following members were elected to the EXCOM:
Prof Dinky Levitt (Chairperson)
Dr Aslam Amod (Vice Chairperson)
Prof Nigel Crowther (Secretary/Treasurer)
Prof Danie van Zyl
Prof Derick Raal
Dr Fraser Pirie
Dr Jacobus van Dyk
Dr Magda Conradie
SEMDSA Travel Award
This award was made to A Coetzee from the University of Stellenbosch, Department of Medicine,
SEMDSA Diabetes Award
Influence of Catch-up Growth on Glucose Tolerance and ß-Cell Function in 7-Year-Old Children;
Results from the Birth to Twenty Study. Nigel J Crowther, Noel Cameron, Jessica Trusler, Marketa
Toman, Shane Norris, I. Peter Gray. Department of Chemical Pathology, NHLS and Department of
Paediatrics, University of the Witwatersrand Medical School. Department of Human Sciences,
Loughborough University, United Kingdom.
SEMDSA Endocrinology Award
The atypical presentation of the Metabolic Syndrome components in Black African Women: The
relationship with Insulin Resistance and the influence of regional adipose tissue distribution.
Courtney L Jennings, Estelle V Lambert, Malcolm Collins, Naomi S Levitt, Julia H Goedecke.
UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology,
University of Cape Town. SAIMR, Cape Town. Endocrine Unit, Department of Medicine, University
of Cape Town.
SEMDSA Best Oral Presentations
The clinical award was made to:
Jolene Bloch for her paper:
Insulin is often not required for long-term management after
diabetic ketoacidosis (DKA) for patients with recently diagnosed Type
2 diabetes. Results of an audit of DKA admissions.
The basic science award was made to:
Julia Goedecke for her paper:
Ethnic differences in the association between serum lipids and insulin sensitivity in South African
SEMDSA Best Poster Presentations
The clinical endocrinology award was made to:
Hennie Lombaard for his paper
Do risk factors help to identify woman from Africa with gestational diabetes mellitus?
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:
Alkesh Magan for his paper:
Tumour-induced osteomalacia. A curable condition.
Novo Nordisk Travel Grant
This award was made to:
Daksha Jivan from the Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg.
Novo Nordisk Diabetes Educators Travel Grant
This award was made to:
Thembelihle Manukuza from the Diabetes Clinic, Albert Luthuli Hospital, Durban.
Sanofi-Aventis Travel Fellowship
This award was made to:
Hester du Raan from the Department of Internal Medicine, Universitas Hospital, Bloemfontein.
Sanofi-Aventis Osteoporosis Award
This award was made to:
Kebashni Thandrayen for her paper entitled: Fracture rates in urban South African children of
different ethnic origins: The Birth to Twenty Cohort.