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The results of two independent, observational studies suggest that antidiabetic medications might have differential effects on cancer risk in patients with diabetes mellitus. Should these findings influence our approach to diabetes treatment?
Women with gestational diabetes mellitus have a substantial risk for progression to a permanent diabetic state, according to researchers in the UK. Could early identification of women at high risk for disease progression lead to improved intervention and preventative measures?
Although low-grade inflammation of adipose tissue is thought to be central to the development of insulin resistance in individuals with obesity, the underlying cause of this inflammatory state remains elusive. A new study by Kos and colleagues suggests that the glycoprotein SPARC limits adipose-tissue expansion and promotes inflammation and insulin resistance.
The incidence of type 2 amiodarone-induced thyrotoxicosis (AIT) is increasing. A new study provides evidence that glucocorticoid therapy is safe, effective and associated with prompt restoration of euthyroidism in previously untreated type 2 AIT. The outcome of initial combined glucocorticoid and thionamide therapy can also help differentiate between type 1 and type 2 AIT.
Graves ophthalmopathy is a disfiguring and often incapacitating disease that is difficult to treat. A meta-analysis has compared the efficacy and tolerability of available treatment modalities and shows, among other findings, that intravenous pulse corticosteroid therapy is the most efficacious treatment when immunosuppression is indicated.
The use of bariatric surgery for the treatment of morbid obesity has increased dramatically over the past decade, which has raised concerns about safety, efficacy and cost-effectiveness. A new study by the Longitudinal Assessment of Bariatric Surgery consortium has assessed the safety of these increasingly frequent procedures.
Long-term adverse consequences of excess circulating glucocorticoids are gaining increasing recognition. The results of a study in children with endogenous Cushing syndrome now show that hypertension can persist even in remission, and raise important issues for the long-term management of these children's health, and potentially for the many children treated with glucocorticoids.
Screening of patients with paraganglioma revealed a high prevalence of germ line mutations in genes encoding subunits of the succinate dehydrogenase complex, according to a new study. Should gene testing become a routine part of the clinical management of patients with paraganglioma?
Agranulocytosis is the most severe adverse effect of antithyroid drug therapy. The findings of a novel study from Japan suggest that this complication occurs more frequently if higher rather than lower starting doses of the thionamide drug methimazole are prescribed. Has the time come to reassess current therapy regimens?
Pregnancy can exacerbate endocrinopathies and obscure their diagnosis in patients with parathyroid or thyroid disease. A large, population-based study published in Archives of Surgery demonstrates that pregnant women carry an increased risk of surgical complications, longer hospitalization and higher costs from parathyroid and thyroid surgery than nonpregnant patients.
Much attention has focused on the increasing prevalence of childhood type 2 diabetes mellitus. However, considerable evidence suggests that the incidence of childhood type 1 diabetes mellitus is also increasing. The results of a multicenter registration study from Europe confirm this alarming trend, which has important health-care implications.
Vitamin D deficiency is widespread among women with breast cancer. Guidelines currently recommend daily supplementation with 400 IU vitamin D3; however, attainment of a circulating level of 25-hydroxyvitamin D defined as sufficient (that is, ≥75 nmol/l) might not be possible with this level of supplementation, according to data published in the Journal of Clinical Oncology.
Diabetes mellitus is associated with cognitive decrements and alterations on brain imaging. However, important questions remain concerning risk factors and mechanisms for cerebral damage in patients with this condition. Data from two new studies shed new light on the relationship between hypoglycemia and cognitive dysfunction in older people with type 2 diabetes mellitus.
Numerous risk-group stratification, staging and scoring systems exist to stratify patients with differentiated thyroid cancer into prognostic risk groups that guide patient management decisions. The tumor–node–metastasis staging system is the most widely adopted despite its relative complexity, but could a simplified, quantitative alternative to the system provide superior prognostic value?
Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. Recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation, might have a role in the treatment of symptomatic patients.
A question often asked by health-care providers is whether metformin has added benefits if continued after patients with type 2 diabetes mellitus switch to insulin. Beneficial effects on macrovascular end points observed in response to sustained metformin therapy argue in favor of this approach, according to new research from The Netherlands.
Intensive insulin therapy is extensively used to lower blood glucose concentrations in critically ill patients hospitalized within the intensive care unit. The discovery by the NICE-SUGAR study investigators that tight glucose control in this setting might actually increase mortality has generated considerable discussion about the wisdom of this approach.
Uncertainty exists about the best approach to manage levothyroxine dosage in women with hypothyroidism, once they become pregnant. The etiology of an individual's hypothyroidism might be a key determinant of the optimal time and duration of dose adjustments, say the authors of a retrospective review published in the journal Thyroid.
Exposure of the fetus to low levels of thyroid hormones for extended periods during pregnancy can lead to irreversible brain damage and potential delays in neurological and behavioral development. What are the exact mechanisms behind this abnormality, and can prompt initiation of maternal iodine supplementation prevent this adverse effect?
