Comment

Studies uncovering the cellular mechanisms of adaptation to varying oxygen levels were recognized with the 2019 Nobel Prize in Physiology or Medicine. Here, we focus on the remarkable parallels between the pathways regulating oxygen availability and those driving rare neuroendocrine tumours, phaeochromocytomas and paragangliomas, and discuss the translational implications of this connection.

Thyroid status and serum cholesterol levels are intimately linked. Hypothyroidism causes hypercholesterolaemia, which is thought to be resolved after treatment with levothyroxine and normalization of thyroid-stimulating hormone. However, some studies indicate that hypercholesterolaemia persists despite treatment, requiring more frequent use of statins.

In the pursuit of understanding metabolic control and energy balance, peripheral nerve communication between adipose tissues and the brain has been largely ignored. This Comment discusses the need for additional research that focuses on the role of adipose peripheral nerve function in the maintenance of energy balance.

The relationship between type 2 diabetes mellitus (T2DM), insulin resistance and central obesity is not uniformly applicable to populations worldwide. In this Comment, we discuss the challenge of establishing waist circumference thresholds to predict T2DM in Africa.

For a person with type 1 diabetes mellitus, lifelong insulin treatment is the only therapeutic option. However, increased blood levels of glucose are just a symptom of impaired β-cell function. Approaching the centenary of the first insulin injection, broadening of international therapeutic guidelines to improve diagnostics, as well as monitor and preserve β-cell function, is warranted.

Emerging evidence demonstrates that an increasing number of novel medications have considerable potential to induce adrenal insufficiency. This condition might lead to acute adrenocortical insufficiency, which is potentially fatal; however, the condition could be avoided if clinicians are more aware of the new findings and their implications.

The Chinese Famine has been widely interpreted as an important contributor to subsequent epidemics of type 2 diabetes mellitus. Our re-examination of available studies challenges this apparent relationship. The definition of famine exposure and control selection needs more attention in future studies to better understand this potential association.

Type 2 diabetes mellitus is common, disabling and expensive, despite improved glucose-lowering management and guidelines. Its dominant cause is weight gain, with ectopic fat accumulation in vital organs, reflected by a large waist circumference. Addressing the underlying cause, by low-calorie formula diets and integrated support for long-term weight-loss maintenance, produces remissions in almost half the treated population.

A male hormonal contraceptive would be a welcome addition to current family planning efforts. Herein, we summarize efforts to develop such a contraceptive, with a focus on contraceptive efficacy studies and new compounds that might offer advantages in terms of route of administration and longer half-lives compared with older compounds.

Despite incontrovertible evidence of the harmful effects of endocrine disruptors, a sound public health policy is still absent. Meanwhile, the press has revealed the hindering role of industry lobbyists and conflicts of interest among members of the regulatory bodies. Here, we identify another hindrance; one that stems from current experimental research practices.

Bariatric surgery is an effective treatment for severe obesity, but it can have unintended negative psychosocial consequences, including an increased risk of alcohol use disorder. A greater understanding of the psychosocial effects of bariatric surgery will probably improve treatment outcomes.