Volume 14 Issue 2, February 2018

The risk of death from cardiovascular causes in people with type 2 diabetes mellitus remains around twice that in the general population, with heart failure a common event. In 2017, results from cardiovascular outcome trials in people with diabetes mellitus showed that some drugs have dual utility — reducing cardiovascular risk and improving glycaemic control.

Nutraceuticals are gaining legitimacy and their potential clinical role is expanding. Data from 2017 provides evidence for their possible use in type 2 diabetes mellitus, the metabolic syndrome, obesity, dyslipidaemia and osteoporosis. Ongoing high-quality research in this area might justify future selective implementation of nutraceuticals into general health practice.

Studies of rare growth disorders taken together with large-scale genetic studies of adult height variability have uncovered a large genetic network regulating childhood growth. Advances in technology and experimental model systems will help decipher the molecular mechanisms of this complex network and lead to novel treatment approaches for growth disorders.

Extracellular danger-associated molecular patterns signal to NOD-like receptors, but the exact signalling pathways remain unclear. The inflammasomes, a subgroup of these receptors, translate danger signals into inflammatory responses by maturing IL-1 and IL-18. In 2017, researchers reported novel functions of the mutual interaction between metabolism and the inflammasomes in health and disease.

The artificial pancreas — the automated closed-loop control of diabetes mellitus — made its first outpatient strides in 2011. In 2017, the results of long-term clinical trials on the artificial pancreas were published, the first hybrid commercial artificial pancreas system was approved and the artificial pancreas was tested under increasingly demanding conditions. Thus, artificial pancreas technology is here to stay.

Targeting thermogenesis in brown fat and skeletal muscle to expend energy and reduce fat mass is a promising therapeutic strategy for treating obesity and related metabolic diseases. Here, Betz and Enerbäck discuss the different molecular pathways regulating thermogenesis in these organs and discuss how they can be therapeutically exploited.

The global epidemic of type 2 diabetes mellitus (T2DM) and its complications is a major threat to public health. This Review provides an updated view of the global epidemiology of T2DM and the dietary, lifestyle and other risk factors for T2DM and its complications.

This Review focuses on the adverse effect of nonalcoholic fatty liver disease (NAFLD) on the risk of chronic vascular complications of diabetes mellitus. The putative pathophysiological mechanisms by which NAFLD might contribute to the development and progression of chronic vascular complications of diabetes mellitus are also discussed, and the principles of NAFLD treatment are critically evaluated.

Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by hypercalcaemia and elevated or inappropriately normal serum levels of parathyroid hormone. Here, Walker and Silverberg review the pathogenesis, diagnosis and management of PHPT, focusing on recent advances in the field.