Combination therapy in diabetes

Type 2 diabetes is a long term and mostly lifelong disorder characterized by resistance to insulin action in the liver, the muscles and the fat cells in the body. It is also characterized by progressive reduction in the ability of the body to produce insulin, abnormalities of intestinal functioning, satiety and weight control. These abnormalities lead to elevated blood sugar levels, obesity, cholesterol abnormalities, hypertension, heart and blood vessels abnormalities and damage to the kidneys, the nerves and the retina of the eyes.

As a result of its multi-factorial causation, control is often difficult to achieve and oftentimes requires the use of multiple medications that have different mechanisms of action and will thus produce synergistic effects. Long-term use of a single medication to control blood sugar levels will thus ultimately end in failure. Most professional societies involved in diabetes care have thus emphasized the need for systematic and progressive use of combinations of various types of blood sugar lowering medications.

Metformin is often the preferred first line medication. As the disease progresses however, it will be necessary to combine it with additional medications. It is also known that a time will come when combination of oral medications will also no longer be able to keep the blood sugar levels at bay, at such times one or more injections will be required. The choice of combination therapy to be undertaken will need to take cognizance of factors such as duration of the disease, complications that are present, life expectancy, risk of hypoglycaemia, the patient's personal preferences and capacity for self-care, social support and financial capabilities.

Mental health consequences of social change

Written by Adeoye Oyewole - Nigeria

Adeoye Oyewole 

There is a popular saying that the only constant thing in life is change. It may sound novel, but it is empirically true.

I believe that the consequences of being human gives us a brain with the capacity to interact with our environment, with the ultimate goal of modifying it, resulting in social change which is an alteration in the social order of a society that includes changes in nature, social institutions, social behaviours and social relations.

This may refer to the notion of social evolution, with the philosophical idea that society moves forward through evolutionary means like a shift from feudalism to capitalism. Accordingly, social change carries the connotation of a social revolution driven by cultural, religious, economic, scientific or technological forces.

This is the consequence of globalisation of values through which weaker and dependent countries comply with certain economic conditions, thereby opening up their social and economic vaults, leading to social change.

Principles of developmental psychology are very crucial in understanding and managing change, whether at personal, national or global level. Managers of change should not just concentrate on the political and socio-economic dimensions but on the grave mental health consequences.

12 dangerous people to marry

Written by Azuka Onwuka - Nigeria

Azuka Onwuka

The easiest time to prevent a divorce or an unhappy marriage is before marriage, not after. There is no gainsaying that love can have such a drunken effect on the about-to-wed that clear danger signals become unimportant to them, while hope becomes their only commodity. After all, is it not said that love conquers all? Great! But what type of love conquers all? Agape or Eros? Why compare God-love, which is unconditional, with sexual love, which can be waver?

There are traits that some people cannot drop. It is like hoping that a right-handed spouse will one day become left-handed: a classical case of waiting for Godot!

If you are looking for a wife or a husband, please be wary of these 12 groups of people.

Those who can never apologise

They would hurt you, annoy you, disappoint you, but would never apologise, because they believe that it would belittle and demean them. When you are wrong, you apologise to them, and when you are right, you still apologise to them, hoping that that they would change. But they never do. Soon you start to feel irritated and agitated. The love and respect you felt for them start to wear out.

Those who can never say thank you

Whatever you do for them, they are never grateful. They make statements like: "Why should I say thank you when you are just doing your duty?" Some would say that their gratitude is in their heart. So, do I have to open your heart to see the gratitude inside and get it? Ingratitude is an attitude that causes irritation, frustration and unhappiness.

Such people also believe the world owes them a lot. They go around their activities with an entitlement mentality. They are difficult to please.

The Internet's impact on daily living

Written by Chukwuemeka Fred Agbata Jnr. (CFA)

Chukwuemeka Fred Agbata Jnr.

There is a huge impact of technology on our everyday life. One of the greatest blessings of technology is the internet. Many of us have already become so used to the internet that we take it for granted today.

In actual fact, the internet can be considered as one of the world's most significant inventions which has brought a number of influences on people's daily lives.

For some, it is impossible to go a single day without the internet; it has simply revolutionised the way we live, interact and operate on a daily basis. Ordering for a pizza, for instance, purchasing a television set, sharing a moment with friends, transmitting a picture via instant messaging, sending a mail and more are already common activities online.

Before the invention of the internet, if you wished to get any news, you must walk down to the newspaper stand or seek out a newspaper vendor early in the morning to be able to buy the local edition of the newspaper reporting what had occurred the previous day.

Now, one or two clicks away on your device with internet connection, (laptop, mobile phone, iPad, etc), is enough to enable you to gain access to read your local online newspaper like www.punchng.com or any other newspaper from anywhere in the world in real time as they are being updated.

Wives as masters at home

Ordinarily it would not have mattered who took control of the home in marriage or in man-woman relationship. What would have been important and paramount was to have someone take charge so that the home would not collapse. But the Bible and the Qur'an, two great holy books inspired by God and written by men put it across that men should be the head and women, purportedly created from a rib plucked from a man's body should be subservient to them. This thought was actually the prompter for my article on the origins of the King James Version of the Bible which shows clearly that 47 people authored the Holy Book. 47, all of them male!

Women in the Middle East, the cradle of three of world's most popular religions, and in Europe where these religions first assumed prominence, especially Christianity in the hands of the Greeks and Romans and Islam as the colonising religion in Spain were initially subjected to this claim. Luckily, industrial revolution changed most of the age-old prejudices and the emergence and spread of girl-child education opened up the women to their potentials and possibilities.

In traditional African societies and the agrarian Asia women helped largely on the farms and plantations as harvesters and marketers of farm produce. In most cases such women were not paid any wages. What they got in exchange was the care and protection offered by their male partners and overlords!

Converting illicit funds to transform Africa

Written by Carlos Lopes

Lopes is Executive Secretary, Economic Commission for Africa.

HOW can Africa move away from aid to trade? What should it do to attract more private equity and how can it convert the illicit financial flows to funds for domestic resource mobilization, climate change and conflict resolution - these are pertinent issues which affect the long term development of the African economies.

Financing developmental efforts in Africa has proved difficult in the past. Overreliance on overseas development assistance (ODA) was seen as the solution. Now we know better. Lessons learned from the Millennium Development Goals (MDGs) have prompted a fresh wave of thinking. Africa needs a transformative developmental framework. However, a structural transformation agenda will require an adequate, predictable, sustainable and integrated financing mechanism geared towards financing developmental goals. Also, the continent must embark on reforms to capture currently unexplored or poorly managed resources. This includes curtailing illicit financial flows and rather transforming those funds into a powerful tool for enhancing domestic resource mobilization, as a way of furthering the continent's development.

According to recent studies, from 1970 to 2008, Africa lost $854 billion to $1.8 trillion in illicit financial flows. The latest progress report of the High-level Panel on Illicit Financial Flows, where I deputize for President Mbeki, revealed that the annual average was between $50 billion and $148 billion a year (ECA, 2013). Commercial money such as tax evasion and trade and services mispricing through multinational companies, constitute the largest component followed by proceeds from criminal activities and public sector corruption. This loss undermines revenue generation and reduces the benefits from economic activities, particularly in the extractive sector.