Volume 5 Issue 5, May 2009

A clinical review of studies on bisphosphonate therapy for pediatric osteoporosis has revealed that they increase BMD, but whether they also improve fracture rates or functions of daily life is unclear. Can the findings of this clinical review help inform clinicians whether, when and how to use these agents in children?

Hypoglycemia is the major barrier to good glycemic control in patients with diabetes mellitus. Furthermore, randomized controlled trials have emphasized the grave risks associated with severe hypoglycemia in patients with long-standing type 2 diabetes mellitus, and hypoglycemia has also been recognized as a complication of bariatric surgery. New Endocrine Society guidelines on adult hypoglycemic disorders are, therefore, extremely pertinent.

Controversy surrounds the skeletal consequences of altered thyroid function. According to the latest report from the Tromsø population survey, however, variations of serum TSH concentration that remain within the normal range do not greatly influence BMD.

Pediatric obesity is a global phenomenon in danger of spiraling out of control. New guidelines from the Endocrine Society offer expert opinion on the prevention and management of this challenging health-care problem.

Clinical investigation of enlarged, local lymph nodes after surgery for papillary thyroid carcinoma is problematic. Use of the fine-needle aspiration thyroglobulin assay could help to identify patients whose disease has progressed to lymph-node metastasis.

Increases in rates of bariatric surgery are staggering, and many obese individuals who undergo such procedures are women of reproductive age. So, how does the surgery affect women's fertility and pregnancy outcomes thereafter? A new systemic review aimed to find out.

Sleep curtailment, which has become a common behavior in modern society, and sleep disorders, such as obstructive sleep apnea, might have detrimental effects on endocrine functions and glucose metabolism. This review discusses the role of sleep loss and poor-quality sleep in the development of obesity and diabetes mellitus, and highlights the importance of screening for sleep problems in patients with endocrine and metabolic disorders.

Incretin-based drugs have several advantages over commonly used antidiabetic agents, including a glucose-dependent mechanism of action and no risk of weight gain. However, their long-term efficacy, safety and durability are yet to be established. This Review summarizes the available data on the mechanisms of action of currently used and emerging incretin-based agents.

Glucose control does not have a clear cardiovascular benefit in people with established, long-duration diabetes mellitus; however, it reduces the risk of diabetes-related eye disease and kidney disease, myocardial infarction and mortality in those with recent-onset diabetes mellitus. Here, the author discusses the relationship between blood glucose level and cardiovascular disease and compares the cardiovascular effects of various glucose-lowering drugs and strategies.

Carcinoid tumors are characterized by their ability to secrete hormones, such as serotonin, tachykinins and other mediators that might contribute to carcinoid syndrome. The authors of this Review describe the incidence and prevalence of carcinoid tumor related fibrosis, which is a major complication of this syndrome, and explore the role of potential causative agents.

Gastroparesis is a complication of diabetes mellitus that is associated with prolonged periods of suboptimal glycemic control. This article describes a patient who had diabetic gastroparesis that was unresponsive to conventional treatments. Her severe vomiting was successfully controlled by use of the antiemetic drug aprepitant for 4 months before a gastric electrical stimulation device was fitted.