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Use of the second-generation (atypical) antipsychotic agents has led to concerns about possible adverse metabolic effects, including an increased risk of diabetes mellitus. The potential mechanisms underlying treatment-emergent diabetes mellitus, and strategies for effective management of affected individuals, are explored by the author of this Viewpoint.
FDA approval of inhaled insulin offered the possibility of a new direction in diabetes care. Nonetheless, within a year of coming to market, the first inhaled insulin product was withdrawn by the manufacturer. Here, Mitri and Pittas examine the factors behind the failure of inhaled insulin to be adopted by patients and clinicians.
In addition to well-characterized hepatic effects, a large body of evidence now suggests that chronic infection with hepatitis C virus (HCV) can lead to endocrine dysfunction. The authors of this Review evaluate the data supporting a link between hepatitis C virus infection and the endocrine system, and discuss potential pathophysiological mechanisms.
Calcitonin is produced by the parafollicular C cells and represents the classical clinical marker for medullary thyroid carcinoma. Here, the authors describe how measurement of basal and stimulated serum calcitonin levels can be used for screening, differential diagnosis, prognostic assessment, and follow-up monitoring in patients with medullary thyroid carcinoma.
The passage of thyroid hormones from the maternal circulation to the fetal circulation is important for normal fetal development. This Review discusses the changes in maternal and fetal thyroid hormone levels during pregnancy and the factors modulating transplacental thyroid hormone supply to the fetus, as well as pathological situations in which the placenta cannot optimize fetal thyroid hormone levels.
Emotional stress might affect thyroid function by causing immunological perturbations and also via neural pathways. This article demonstrates a case in which both the onset of Graves disease and later exacerbations of hyperthyroidism were triggered by stressful events, and discusses management strategies for patients with stress-related Graves disease.
