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Impaired glucose tolerance is a prediabetic condition that is a major risk factor for subsequent development of type 2 diabetes mellitus. As type 2 diabetes mellitus has become common among obese adolescents, options for the management of children with impaired glucose tolerance are discussed in this Viewpoint.
Patients defined as overweight or obese on the basis of BMI have reduced mortality and cardiovascular risk when compared with their normal-weight counterparts. The authors of this Viewpoint propose that these paradoxical results might reflect how obesity is currently measured and highlight the importance of differentiating between body fat and lean mass.
Achieving biochemical remission and tumor shrinkage in acromegaly can prove difficult despite a range of available therapies. Pegvisomant seems to be useful to attain the former but certain adverse effects have raised concern. This Review rounds up the evidence on the safety and efficacy of this drug, summarizes risks and benefits and suggests therapeutic approaches.
Type 1 diabetes mellitus is a chronic process of many years, during which insulin production slowly decreases. This key feature makes the disease a potential candidate for treatment but also for prevention against symptoms becoming clinically overt. This Review discusses issues of diagnosis and risk stratification, and the development of prevention strategies.
Cushing's syndrome is no longer considered rare, but making a diagnosis remains challenging. Traditional tests yield variable results. Measurement of late-night serum cortisol levels can deliver excellent sensitivity and specificity but blood samples must be taken during a hospital stay. Here, Carroll et al. put forward the case for late-night salivary cortisol measurement as a simple alternative test.
The patient described in this article had a history of hereditary primary hyperparathyroidism, which is usually treated surgically. When the patient developed a recurrent parathyroid adenoma she refused surgery and in this Case Study the authors describe, for the first time, the use of the calcimimetic cinacalcet in a patient with hereditary primary hyperparathyroidism.
