Volume 9 Issue 11, November 2013

Despite >30 years of experience with, and marked improvements in, insulin pumps for treatment of type 1 diabetes mellitus, use of these devices in paediatrics has remained controversial. However, a recent report provides convincing new evidence of the long-term benefits of pump therapy in children and adolescents.

The unprecedented increase in the prevalence of obesity has been followed by a rapid rise in bariatric surgery. Bone has been linked with fat metabolism. Thus, if weight loss increases the risk of osteoporosis, understanding the effect bariatric surgery has on bone health is vital. Two recent articles contribute to this area of research.

The association of type 2 diabetes mellitus with an increased risk of cardiovascular disease has been extensively documented, but the origins of this association remain largely in the realm of hypotheses. With surprisingly few insights into mechanisms of increased cardiovascular disease risk, efforts to shed new light on this important question are welcome.

An imbalance between angiogenic and antiangiogenic factors in pregnancy has been suggested as a risk factor for the subsequent development of pre-eclampsia. A new study in pregnant women with type 1 diabetes mellitus indicates that these factors may be used as predictive biomarkers for pre-eclampsia.

In routine primary care, clinicians are slow to intensify glycaemic management in patients with type 2 diabetes mellitus (T2DM), despite access to an increasing number of therapeutic resources. This so-called clinical inertia is troubling and could explain why we are failing to meet targets for diabetes control in many patients.

Osteoporotic fractures in older men (>50 years of age) are common and associated with considerable mortality and morbidity. This Review discusses the pathophysiology, diagnosis and treatment of osteoporosis in men and highlights controversies and recommendations from the 2012 Endocrine Society clinical practice guideline on the topic.

Many autoimmune diseases share a large proportion of their genetic background with other autoimmune diseases, which could result in common drug targets for several diseases. This Review focuses on the latest insights into the genetic factors that contribute to a range of autoimmune diseases.

K_ATPchannels have a key role in the regulation of blood glucose homeostasis. This Review outlines their role in the regulation of insulin and glucagon release, which decrease and increase blood glucose levels respectively, under both physiological conditions and in disease states such as diabetes mellitus and hyperinsulinism.

Glucocorticoids are involved in the regulation of many physiological processes and are essential to the systemic response to stress. This Review outlines recent insights into the mechanisms that influence glucocorticoid sensitivity in health and disease and discusses possible strategies to modulate glucocorticoid sensitivity and improve the outcomes of glucocorticoid therapy.