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Prevailing guidelines advocate a low-salt diet to mitigate progression of renal and cardiovascular disease in patients with diabetes mellitus. However, two recent cohort studies in patients with type 1 and type 2 diabetes mellitus associate lower salt intake with increased rates of end-stage renal disease, cardiovascular death and all-cause mortality.
A recent study of health outcomes among Asian Americans and Pacific Islanders with diabetes mellitus demonstrates that use of broad racial categories can mask important differences in risks among ethnic subgroups and emphasizes the importance of appropriate classifications as a strategy for improving our understanding of health outcomes among ethnic minority groups.
Advances in the development of bone-modifying agents have led to the approval of new drugs for the prevention and treatment of skeletal-related events in patients with bone metastases from breast cancer. In light of these advances, the American Society of Clinical Oncology has published a guideline update.
Painful diabetic neuropathy is a common complication of diabetes mellitus. Based on strong evidence, recently published guidelines suggest that pregabalin should be offered as first-line therapy in patients with painful symptoms. Nevertheless, other agents and nonpharmacological therapies may also be effective for the treatment of painful diabetic neuropathy.
Prior assessment of fracture risk with clinical risk factors can lead to better targeted use of BMD measurements, particularly in patients aged <65 years without a previous fracture. The updated statement by the US Preventive Services Task Force on screening for osteoporosis adopts FRAX® to implement this approach.
Automated closed-loop insulin delivery, also referred to as the 'artificial pancreas', has been an important but elusive goal of diabetes treatment for many decades. This Review discusses the design of an artificial pancreas, its components and clinical results, as well as the advantages and disadvantages of different types of automated closed-loop systems and potential future advances.
Treating pregnant women with antithyroid drugs puts the fetus at risk of overtreatment and subsequent development of fetal hypothyroidism and goiter formation, which might have serious implications for the fetus. This article reviews the reported cases of fetal goiter formation and aims to clarify if and how such cases could have been prevented, and how to react when prevention has failed.
New antidiabetic agents enable many patients with type 2 diabetes mellitus (T2DM) to achieve target HbA1clevels. However, a range of factors can interfere with the ability of some patients to reach metabolic targets. This Review discusses the current therapies for patients with T2DM and assesses the relative benefits and risks of surgical treatment of overweight and obese patients with T2DM.
Several studies have demonstrated that reactivation of telomerase in the presence of short telomeres is one of the most common features of human cancers. This Review focuses on the alterations of the telomerase complex that are associated with cancers of the endocrine system, particularly the possible diagnostic, prognostic and therapeutic applications of telomerase.
Clinically nonfunctioning pituitary tumors are common in tertiary endocrine practice. Although it is widely accepted that patients with these adenomas require long-term surveillance after surgery, a consensus on postoperative monitoring and treatment strategies is lacking. This Perspectives article aims to emphasize what is known about the follow-up of nonfunctioning pituitary adenomas and to point the way forward to future areas of research in this field.
