Volume 11 Issue 8, August 2015

A recent study indicates that type 1 diabetes mellitus is associated with vascular brain lesions that affect cognition and might represent a target for preventive measures. This commentary discusses methods to ascertain vascular contributions to cerebral dysfunction in diabetes mellitus and indicates that we might only be seeing the tip of the iceberg.

A new study suggests that an energy-dense dietary pattern that is high in saturated fat and low in fibre is associated with cardiovascular risk factors, but not incident cardiovascular disease, among people with severe obesity, which highlights the need for obesity prevention. Analysis of dietary patterns can bolster the evidence base for prevention-oriented dietary recommendations.

Smoking cessation is associated with weight gain and an increased risk of developing type 2 diabetes mellitus (T2DM). A recent paper published in The Lancet Diabetes & Endocrinology suggests that weight gain and worsening glycaemia levels also occur when patients with established T2DM stop smoking, which highlights the need for careful monitoring of patients who stop smoking.

Attempts to prevent type 1 diabetes mellitus have been limited to interventions in patients who have already lost immune tolerance to pancreatic β cells. However, in a new report, orally administered insulin initiates immune protection in young children at increased risk of the disease.

Paracetamol is the most frequently used medication during pregnancy. Among concerns about its prenatal use, the association with failure of the testes to descend in neonates is the latest. A new study investigating the origin of this malformation reports that paracetamol can reduce testosterone levels in host mice transplanted with human fetal testis tissue.

Whole-exome sequencing (WES) can effectively sequence >90% of the coding DNA in an individual, and reveal potential disease-causing genetic variants. In this Review, de Bruin and Dauber discuss the use of WES in the field of endocrinology, how this technique can reveal new insights into both rare and common disorders, and its future use in a clinical environment.

Bariatric and metabolic surgeries are increasingly being used to treat patients with obesity, which is a major public health challenge. In this Review, Gema Frühbeck discusses the current body of evidence related to the outcomes of bariatric and metabolic surgery. Frühbeck suggests that a paradigm shift in eligibility and success criteria is required. She proposes that patient selection and follow-up should no longer focus solely on weight and BMI.

Disorders of sex development (DSDs) are caused by a broad range of genetic changes, but can be difficult to diagnose. In the past few years, advances have been made in molecular diagnostics that could affect the diagnosis of DSDs. This Review analyses the contribution of molecular biology techniques to the diagnosis and management of DSDs, as well as discussing advances in these techniques.

Increased intake and reduced expenditure of energy results in obesity and must be appropriately controlled to prevent this disease state. In this Review, Denis Richard discusses how the central nervous system and peripheral signals from the gut interact to control energy homeostasis and thermogenesis of brown adipose tissue in states of obesity.