Perspectives on Type 2 Diabetes by Zeena Nackerdien: Guest Post

Perspectives on Type 2 Diabetes by Zeena Nackerdien:

Zeena Nackerdien

Publisher: Create Space (April 20,  2015)
CategoryNon-Fiction,  Health, Type 2 Diabetes, HIV, TB, Patient Empowerment
Tour Dates: October/November, 2015
ISBN: 978-1511734837
Available in: Print & ebook,  41 Pages

The rising socioeconomic toll of diabetes, in particular the Type 2 form of the disease, is reverberating around the world. A disease that has sporadically plagued mankind for centuries seems to have increased in prevalence in tandem with rapid economic transitions, notably in countries with the highest number of diabetics such as China and the USA.

This resource guide is comprised of information about diabetes in those countries as well as in the Middle East, North Africa, and South Africa. In addition, the latest antidiabetic therapies and infectious comorbidities associated with the disease are discussed in separate chapters. Scattered throughout the guide are fictional scenarios about challenges diabetics and their doctors might face in individualizing recommended management algorithms.


Diabetes and Pernicious Anemia 

Pernicious Anaemia society members (a UK-based non-profit organization) will already be familiar with Martyn Hooper’s book,”Pernicious Anaemia: the Forgotten Disease -the causes and consequences of vitamin B12 deficiency”(1). Briefly, a complicated immune orchestra destroys cells in the stomach lining, increasing gastric pH, thereby allowing bacteria (normally suppressed by low pH) to thrive, and possibly interfere with absorption of indispensable micronutrients, including vitamin B12 (2). The net result of progressive inflammation is vitamin B12 deficiency, otherwise known as pernicious anemia (PA).

What happens when this misguided attack on the stomach lining is accompanied by a second autoimmune/comorbid disease attacking a different organ in the body? This prospect is increasingly likely, given the rise in chronic diseases in aging populations. Stomach problems that may occur

concurrently with the insidious progression from autoimmune gastritis to PA, can sometimes be a clinical signal of damage to another organ tucked behind the stomach, i.e. the pancreas. The pancreas secretes insulin, a critical hormone that assists the body in absorbing glucose and other nutrients from food. Insulin and its precursors are also targets for autoimmune attack, leading to Type 1 or “juvenile” diabetes, a condition affecting 5-10% (3) of all diabetics. Adult-onset or type 2 diabetes (more information can be found in the Diabetes Portfolio [4]), that accounts for 90% (5) of all diabetic cases, occurs as a consequence of insufficient insulin production or resistance of the body’s tissues to normal or higher amounts of this hormone.

While PA is thought of as an under- or misdiagnosed disease (present in up to 2% of the general population) (6), for a variety of reasons (2) the number of known diabetics total more than 371 million across the globe (7). Autoimmune gastritis and PA are increased up to 5-fold in Type 1 diabetics (6). Moreover, metformin, a popular, oral antidiabetic medication, may contribute to vitamin B12 deficiency (8). These points underscore the need for a holistic approach in the management of PA and co-occurring illnesses.



  1. Hooper M. Pernicious Anaemia: the Forgotten Disease – the causes and consequences

of vitamin B12 deficiency London: Hammersmith Health Books; 2012.


  1. Neumann WL, Coss E, Rugge M, Genta RM. Autoimmune atrophic gastritis-pathogenesis,

pathology and management. Nat Rev Gastroenterol Hepatol. 2013.


  1. Apple J, Aviad Mea. ASweetLife-Diabetes. 2013; Accessed July, 2013.
  2. Nackerdien Z. Diabetes Portfolio. 2013; Accessed July, 2013.


  1. International Diabetes Federation. Types of Diabetes. 2013; Accessed July, 2013.


  1. De Block CE, De Leeuw IH, Van Gaal LF. Autoimmune gastritis in type 1 diabetes: a

clinically oriented review. J Clin Endocrinol Metab. 2008;93(2):363-371.


  1. International Diabetes Federation. IDF Diabetes Atlas.

2012; Accessed July, 2013.


  1. Warner J. Peripheral Neuropathy Patients Who Take Diabetes Drug May Have Vitamin B12

Deficiency. 2009; Accessed July, 2013.




Praise for Perspectives on Type 2 Diabetes by Zeena Nackerdien:

Type 2 diabetes, characterized by the body’s progressive inability to utilize insulin, is rapidly approaching a prevalence of one in ten (9.3% in 2014) in both the U.S. and China. This silent epidemic manifests itself initally as a rise in blood sugar.
Dr. Nackerdien found herself challenged by signs of the early stages of this condition, and has produced an excellent summary of early intervention goals and guidelines. This “translation” of technical information to an understandable guideline format is a must-have for real people who find themselves on the cusp of this debilitating condition.”- Curt, Amazon Reviewer

Zeena NackerdienHIV/TB/Diabetes Resource Kit by Zeena Nackerdien:

Publisher: Create Space (April 23,  2015)
CategoryNon-Fiction,  Health, Type 2 Diabetes, HIV, TB, Patient Empowerment
Tour Dates: October/November, 2015
ISBN: 978-1511864060
Available in: ebook,  35 Pages

Who are the groups likely to be in the frontlines of either administering or receiving anti-HIV/AIDS-containing treatments for this disease and any associated comorbidities? The answer is frontline healthcare professionals, lay educators, and patients, especially in high-disease burden countries such as South Africa. While the reinvigorated national response to HIV/AIDS underscores the country’s commitment to the health crisis, the socioeconomic costs are likely to have a lasting impact on its citizens.

I have compiled a resource kit outlining some of the challenges faced in the treatment of patients with HIV, TB, and diabetes. In addition, the kit contains disease management and prevention tips suited for discussions with healthcare professionals, particularly in resource-poor settings.

About Zeena Nackerdien:Zeena Nackerdien

Zeena Nackerdien is a dual US and South African citizen. She obtained a PhD degree in Biochemistry from the University of Stellenbosch in South Africa. Zeena has been a research chemist at the National Institute of Standards and Technology in Maryland and a senior research associate at The Rockefeller University in New York.

She is the author of several publications in scientific journals and two poetry collections, “Mist Over Peace” and “Scatterlings.” As a scientist turned patient advocate and writer, she is intensely interested in building relationships with people from different cultures through story-telling and education. Zeena currently lives in Brooklyn, New York.


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Zeena Nackerdien


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