Endocrinology

A considerable amount of progress has been made in treating diabetes this year both for type 1 and type 2 diabetes. The approval of new medications and potential devices in the future have made for a bright outlook for patients.

Hormone therapy has proven a very effective option for many women during menopause but there has also been some evidence that it can increase the likelihood of bleeding disorders. A recent study looked at the link between the two.

A low-dose adrenocorticotropic hormone (ACTH) stimulation test is more sensitive in patients with cases of mild hypoadrenalism, and the high-dose test often misses secondary hypoadrenalism due to pituitary or hypothalamic dysfunction. Endocrinologists still debate test result interpretation for the low-dose test, however.

In previous studies, regular breakfast consumption has been correlated with lower BMI and improved cardiometabolic risk profile. Furthermore, evidence suggests that low-energy density, high-fiber, and high-carbohydrate foods may be more satiating when compared to their alternatives.

Although some studies have hinted at a possible role for metformin in pain management, a recent investigation found no difference in pain scores among diabetic patients who used metformin and those who did not

The Paleolithic (grain-free) diet is gathering steam among dieters and health conscious individuals alike. Proponents consume only items that, hypothetically, cavemen would have had access to. They claim that modern man can't metabolize comparatively new types of food, and our reliance on processed foods has increased rates of obesity, heart disease, and diabetes.

Diabetic kidney disease does not have the telltale signs of other conditions which can make it difficult to spot. However, with the right tests patients can get the treatments they need.

One of the newest developments in the treatment of diabetes is the GLP-1 receptor agonist. With different forms intended for different populations it continues a longstanding pattern of bringing new medications into the pool of options for doctors to choose from.

A recent study looked at whether metabolic syndrome confers a greater cancer risk than the sum of its individual components and component associations, and whether it is a useful predictor for future cancer risk.

Obesity contributes to significant morbidity and mortality among primary care patients. This paper summarizes options for pharmacological management of obesity. Medications approved for obesity are Phenteremine/Topiramate, Orlistat, Lorcaserin, Naltrexone/Bupropion, Liraglutide.

As the diabetes epidemic continues to grow doctors are being faced with the task of stopping or reversing the trend.

Study results show that the combination of metformin and glibenclamide is as effective as insulin in achieving glycemic control in women with gestational diabetes and may be a more acceptable and cost effective therapy.

Empagliflozin, a diabetes drug that controls glucose levels, may also help ameliorate erectile dysfunction in patients with type 2 diabetes mellitus.

Overt hyperthyroidism is a known risk factor for osteoporosis and fractures. More subtle alterations in thyroid function, such as those that occur in subclinical thyroid dysfunction, may also be associated with increased fracture risk and bone loss, but until recently no clinical trials have adequately explored that issue.

Small case study shows limited positive benefits in 2 children with Wolf-Hirschhorn syndrome who were treated with growth hormone.

With certain strains already proving to be resistant to treatment with antibiotics, Staphylococcus aureus is posing another major health threat.

With the global boom in type 2 diabetes mellitus, many patients have greatest access to and are well-cared for by their primary care practitioners (PCPs). For those with basic, predictable, garden-variety diabetes, PCPs are perfectly capable of helping them. It's unclear when referral to a specialist for consultation or chronic management is most sensible.

A recent review article summarized the socioeconomic consequences of Klinefelter syndrome, which is the most frequent chromosomal aberration in humans and is associated with hypogonadism and neurocognitive deficits.

Obesity rates have climbed nearly 50 percent since 1997, with as much as 30 percent of the population classified as obese. There is strong belief within the health care industry that obesity should be treated as a primary medical condition, with physicians playing a major role. Evidence suggests that patients are more likely to lose weight when they are advised by their primary care physicians to do so.

GLP-1 receptor antagonists have been associated with thyroid cancer in rodents, and in fact carry a boxed warning about the potential for cancer in humans. This leads many clinicians to ask if they should be concerned about using these drugs in patients who have or develop specific types of thyroid cancer

Sitagliptin appears to have beneficial systemic and adipose anti-inflammatory effects in combination antiretroviral therapy-treated HIV-positive adults with impaired glucose tolerance. The drug may prevent cardiovascular problems by reducing inflammation linked to heart disease and stroke in this patient population.

The results of the largest study of its kind to date indicate that new antipsychotic medications-including quetiapine, olanzapine, and risperidone-do not appear to put women at additional risk of developing gestational diabetes, hypertensive disorders, or major blood clots that obstruct circulation, all conditions that often develop during pregnancy or with the use of older antipsychotic medications.

More than 13,000 physicians and cardiovascular team members attended the ACC 2015 meeting in San Diego on March 14-16, 2015. In this issue of Cardiology Review, we focus on 6 important studies presented at ACC 2015: LEGACY, OSLER, PEGASUS, EMBRACE-STEMI, MATRIX, and CoreValve.

Mortality in patients with type 1 diabetes mellitus (T1DM) is higher than in the general population, and whether mortality improves or alters with glycemic control is unknown.

Sometimes even the most seasoned endocrinologists will encounter a patient who they have trouble finding a diagnosis. There is now an effort to use advances in science to help find answers for some of the field's most troubling questions