News & Views in 2012

Low circulating levels of vitamin D metabolites were found to be associated with development of microalbuminuria in patients with type 1 diabetes mellitus from the DCCT/EDIC study. Could interventions aimed at improving vitamin D levels be a new option for the prevention of diabetic kidney disease?

A joint task force of the American Association of Clinical Endocrinologists and the American Thyroid Association has produced updated clinical guidelines for the diagnosis and treatment of hypothyroidism in adults. The new guidelines include 52 evidence-based best practice recommendations to help clinicians provide optimal care for patients with hypothyroidism.

A large Danish study overturns the concept that postmenopausal hormone replacement therapy increases the risk of experiencing cardiovascular events. Indeed, the study shows that such therapy decreases the risk of myocardial infarction by ∼50% and mortality by ∼40%. So what is the truth?

Total thyroidectomy and subsequent radioiodine ablation improve the outcome of patients with thyroid tumours measuring >1 cm. Best practice guidelines should serve as a basis for clinical decision making in stage I thyroid cancer; however, Haymart et al. report that soft factors, unrelated to clinical presentation, affect the rate of radioiodine ablation.

A variety of gastrointestinal disorders, including Crohn's disease, ulcerative colitis and coeliac disease, are recognized risk factors for osteoporosis and osteoporotic fractures. A recent study suggests that individuals with irritable bowel syndrome might also be at increased risk of osteoporosis and osteoporosis-related fractures.

The weight of evidence indicates that bisphenol A (BPA), a widespread endocrine disruptor, might be an important risk factor for obesity and metabolic disorders. An epidemiological study shows an association between urinary BPA levels and increased body mass in children and adolescents.

Individuals with obesity who undergo bariatric surgery are much less likely to develop type 2 diabetes mellitus than are those receiving routine care, new findings reveal. Intriguingly, baseline data on surrogate measures of insulin resistance rather than BMI were predictive of the preventive effect of surgery on type 2 diabetes mellitus.

Urban traffic is a major source of ambient air pollution and induces oxidative stress, systemic inflammation and cardiovascular disease. A recent study shows that the risk of death from diabetes mellitus is increased in individuals exposed to high levels of traffic-related air pollution.

Controlled clinical trials have demonstrated a substantial reduction in all long-term complications of type 1 diabetes mellitus (T1DM) if an HbA_1c level of <7% is achieved. Long-acting insulin analogues have now been developed; however, their role in the intensive therapy of patients with T1DM is debatable.

People with or who are at risk of developing type 2 diabetes mellitus (T2DM) could prevent or reduce T2DM-related complications through physical activity. A new study shows the effects of physical activity on mortality in T2DM and another compares the effects of aerobic exercise, weight training or a combined programme on risk of T2DM.

A growing body of research is examining the potential health implications of menopausal vasomotor symptoms. A recent study found that vasomotor symptoms are associated with increased insulin resistance in middle-aged women undergoing the menopausal transition.

A recent meta-analysis provides robust data on the weight gain that is likely to be experienced by individuals who give up smoking. Weight gain 1 year after quitting was 4–5 kg; therefore, is weight gain following smoking cessation of sufficient importance to affect approaches to and success of smoking cessation?

In African countries, just as in developed nations, data now show that maternal obesity is associated with an increased risk of neonatal death. Additional consequences of maternal obesity on child health, such as reduced breastfeeding duration and an increased risk of child obesity, will probably soon become evident.

Glucocorticoids can be given during pregnancy to develop lungs of babies at risk of preterm birth but the long-term effects could be detrimental to the child. A new study shows that term-born children from mothers treated with glucocorticoids during pregnancy had increased cortisol stress responses at 6–11 years of age, which were more pronounced in girls than boys.

In 2006, New York City (NYC) passed a pioneering law restricting the use of trans fat in chain restaurants. By carefully evaluating its policy experiment, NYC demonstrated the potential power of legal approaches to combat cardiovascular disease.

Short and long menstrual cycles have been associated with an increased risk of chronic diseases. Menstrual cycle length seems to be determined by the underlying hormonal profile—but could cycle length be a reliable indicator of hormone perturbations and disease risk in healthy regularly menstruating women?

MEN1 is a syndrome with a complex nature and specific international clinical practice guidelines outlining standards of care have been developed. Genetic testing is recommended for patients with MEN1 and their families; however, the ethical, social, psychological and financial implications of such tests should be taken into account.

A recent cohort study of gastric bypass surgery at US Veterans Affairs medical centres found that health-care expenditure was not reduced in the 3 years following surgery. Several earlier studies have reported savings, but should return on investment guide decision making in chronic disease management?

The US Preventive Services Task Force has concluded that screening adults for obesity and offering them intensive, multicomponent behavioural interventions is beneficial. Although welcome, given the current obesity epidemic, are the recommendations too little too late?

Clinicians are responsible for selecting a suitable second-line treatment for patients with type 2 diabetes mellitus when metformin monotherapy fails. New evidence could aid clinicians in deciding between one of the most commonly used second-line agents, glimepiride, and the recently approved dipeptidyl peptidase 4 inhibitor linagliptin.