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The management of adrenal tumours has evolved over the past few decades. Here, the surgical management of adrenocortical tumours is discussed, including controversies surrounding the different techniques.
Acromegaly usually occurs owing to a growth-hormone-secreting adenoma in the pituitary gland, which leads to metabolic and anatomical changes in the patient. This Expert Consensus Document outlines the current recommendations for the treatment of acromegaly as determined by the Acromegaly Consensus Group in March 2013.
This Review highlights the importance of insulin in the treatment of type 2 diabetes mellitus (T2DM), with a focus on individualized treatment that achieves glycaemic targets. The authors also outline challenges regarding insulin treatment in different populations of patients with T2DM, and how to overcome barriers to insulin therapy.
Advances in the field of genetics have enabled the discovery of numerous loci associated with type 2 diabetes mellitus (T2DM). This Review examines current knowledge about T2DM genetic risk prediction, the effect of lifestyle intervention according to genetic risk and the role of genetic counselling to support behavioural modification.
This Review describes the progress that has been made towards classification of adrenocortical tumours to date based on key genomic approaches. In addition, the potential for the development and use of various molecular tools to personalize the management of patients with adrenocortical tumours is discussed.
The newly appreciated heterogeneity in type 1 diabetes mellitus implies that a personalized approach could be used to treat this disease; treatments that modify the immune system might be ideally suited to this purpose. This Review discusses the current knowledge on immune regulation and dysfunction in humans that could be used to develop new therapies.
This Review discusses paradigm shifts in the treatment of hypothyroidism and their influence on clinical practice—a far from trivial issue, given the number of affected patients. Although levothyroxine monotherapy remains the standard treatment for hypothyroidism, the latest guidelines indicate that levothyroxine plus liothyronine combination therapy might be considered in specific circumstances.
Vitamin D receptor and enzymes that metabolize vitamin D are expressed in male reproductive organs. This Review highlights the role of vitamin D in male reproduction. Effects of vitamin D signalling on semen quality, estrogen responsiveness and the development of testicular germ cell tumours are discussed.
This Review discusses the molecular mechanisms through which metformin acts on metabolism, mainly focussing on liver gluconeogenesis, and on tumourigenesis. In addition, the authors review the potential implications of new discoveries about the molecular targets of metformin for the development of antidiabetic and anticancer therapies.
