The primary areas of

Research Are:


Phenotype of patients presenting with diabetic ketoacidosis in Cape Town. This ongoing study aims to describe the phenotype and type of diabetes in people presenting with diabetic ketoacidosis in Cape Town, to develop standardized strategies for the safe withdrawal of insulin and prediction models to aid in identifying patients that may not require lifelong insulin.


Metabolic consequences of antiretroviral therapy in HIV-infected patients.  A cross-sectional and longitudinal study have been completed and are in their final stages of analysis.  These studies were funded by the World Diabetes Foundation and the South African Department of Health.


Burden of disease (BOD): The contribution of diabetes and other chronic diseases to the overall burden of disease pattern in the South African context is being studied in collaboration with co-investigators from the BOD Group at the MRC


The H3A Diabetes Study: A multi-centre study of the prevalence and environmental and genetic determinants of type 2 diabetes in sub-Saharan Africa.


Understanding the epidemiology, health system impact and the effect on the individual of the overlap between infectious and non-communicable diseases in low- and middle-income countries. These studies are being undertaken in collaboration with the Institute of Infectious Diseases and Molecular Medicine, School of Public Health and Family Medicine, and other international members of a Worldwide University Network grant.


Health Systems Research: The Division collaborates in numerous projects being conducted by the Chronic Diseases Initiative for Africa (CDIA). These include a number of completed pragmatic randomised trials and observational studies within the primary care setting. Two trials are about to commence: 1 An individually randomised trial of an integrated health system intervention aimed at reducing type 2 diabetes risk in women after gestational diabetes in South Africa (IINDIAGO),. 2 A pragmatic individually randomised trial  to test the effectiveness of sending short message service (SMS) texts in improving health outcomes and supporting medication adherence in patients with type 2 diabetes in multiple settings (SMART 2D).


Diabetes in the older person in collaboration with the Division of Geriatrics, this study aims to develop a self-Management care programme for older people with Type 2 diabetes attending community health centres in Cape Town.


Addison’s disease: The impact of cardiovascular risk, metabolic phenotype and Addison’s disease is being investigated in collaboration with the University of Gothenburg, Sweden. We are continually researching novel ways in which to monitor adequacy of hydrocortisone replacement therapy including salivary cortisone and salivary cortisol. We continue to examine the psychological impact of having Addison’s disease.


Differentiated Thyroid carcinoma: We are currently investigating the association between known genetic mutations and clinical progression of various forms of thyroid carcinoma. We are also examining potential novel genetic associations. This will hopefully culminate in the development of a cost-effective management strategy for differentiated thyroid cancer. This has been funded by the National Research Foundation (Thuthuka grant).


Prednisolone Pharmacokinetics and Tuberculous Pericardial Effusions: We are trying to understand whether prednisolone has a beneficial impact on the survival of patients with tuberculous pericardial effusions. Through a Medical Research Council grant, we are investigating the pharmacokinetics of prednisolone and tuberculous therapy in association with inflammatory markers in patients with pericardial effusions, in the hope that we can optimise these forms of therapy in the future and identify appropriate biomarkers that will indicate disease improvement.


Coeliac disease: This condition has been thought to be relatively uncommon. We are developing a registry of patients with coeliac disease so that we can identify the genetic pre-determinants, the clinical picture, the complications and possible cardiovascular risk. This study is being conducted in collaboration with the Division of Gastroenterology.