US ENDOCRINOLOGY – VOLUME 6 – SUMMER 2010

Welcome to this edition of European Endocrinology, which once again seeks to examine and discuss some of the most pertinent issues and developments relating to our area of medicine. This edition includes excellent and insightful coverage of the ghrelin system and cardiovasculature, non-alcoholic fatty liver disease (NAFLD) in children, acromegaly, total thyroidectomy in thyroid cancer […]

The Indian economist Amartya Sen wrote in 2001 that, ‘gender inequality has many faces’.1 Despite rapid progress in many parts of the world, the many faces of inequality between women and men, girls and boys remain widespread and have critical implications for the spreadand management of diabetes.

The incidence of type 2 diabetes continues to increase at epidemic proportions,1 while vascular and renal diabetic complications have huge socioeconomic consequences. The etiology of this disease is multifactorial and an increasing amount of evidence points to environmental and lifestyle factors rather than genetic abnormalities as the most important predisposing factors.2,3 Type 2 diabetes is […]

The pathogenesis of type 2 diabetes includes pancreatic β-cell dysfunction and insulin resistance; most importantly in hepatocytes, myocytes, and adipocytes. Type 2 diabetes is well known to be a progressive disorder1 characterized by deteriorating capacity for insulin release and action. Both defects are recognizable early on and present even in non-diabetic offspring of patients with […]

Diabetes is a complex metabolic disease that affects multiple organ systems in the body. Diabetes-induced complications in the kidneys, eyes, cardiovascular and peripheral nervous system have been well established. Diabetes-related complications in the central nervous system (CNS) are now being increasingly recognized and investigated. Diabetes is reaching epidemic proportions globally and with people living longer […]

There is currently a global pandemic of obesity and diabetes. Worldwide, the number of people with diabetes is estimated to be 285 million and is projected to reach 438 million in 2030.1 Approximately 10% of the US adult population have diabetes.2 Type 2 diabetes results in considerable morbidity and mortality, primarily the result of the […]

Individuals with type 2 diabetes suffer from increased morbidity and mortality secondary to both macrovascular (heart attack, stroke and amputation)1 and microvascular (retinopathy, nephropathy and neuropathy)2 complications. Hyperglycaemia is the major risk factor for microvascular complications. Many studies, e.g. the Diabetes Control and Complications Trial (DCCT)3 and the UK Prospective Diabetes Study (UKPDS),4 have documented […]

The Development of Self-monitoring of Blood Glucose The advent of home-based capillary self-monitoring of blood glucose (SMBG) was initially heralded as a major advance in the treatment of individuals with diabetes. There was much anticipation that this technology would revolutionize diabetes care, allowing for dramatic improvements in glucose control and a reduction in its devastating […]

Introduced into patient-directed self–management in the early 1980s, self-blood glucose monitoring (SBGM) is now recognized as integral to standard of care diabetes treatment for all age groups.1 Indeed, along with the development of stable and reproducible glycated hemoglobin (HbA1c) assays, SBGM made possible the achievement of intensive therapy and the design and conduct of the […]

Type 1 diabetes is one of the most common endocrine problems in childhood and adolescence and its incidence is increasing.1,2 Of the estimated 480,000 children with type 1 diabetes worldwide, nearly a quarter come from the European region, with a steeper increase in incidence in some of the Central and Eastern European countries.3 While type […]

For decades, small for gestational age (SGA) has been inconsistently defined as a birth weight or length below the 10th, 5th, or 3rd percentile, making uniform assessment of the consequences of being born SGA difficult.

Pediatric endocrinologists aspire to provide the best care for children including improving outcomes in growth hormone deficiency (GHD). The challenging issues are sometimes simple ones, such as which children should be seen in the endocrine clinic for evaluation of their growth, or standards for diagnosis of GHD, or methods of delivering standard therapy for GHD.1 […]

Specialty Drugs— Evolving Terminology and Context

Only 1.8% of all thyroid cancers develop in children or adolescents, but the incidence appears to be increasing.1–3 The majority of differentiated thyroid cancers (DTCs) in children are papillary thyroid cancers (PTCs), including the follicular, tall-cell, columnar, diffuse sclerosing, and encapsulated variants.4Follicular thyroid cancer (FTC) is less common and includes the subtypes of Hürthle-cell (oncocytic), […]

Subclinical hypothyroidism comprises elevated serum thyroidstimulating hormone (TSH) in the context of normal peripheral thyroid hormone concentrations.1 Although this definition is highly dependant on methods for TSH measurement and the definition of the upper limit of normal reference values, many publications have come out in recent years concerning the long-term consequences of subclinical hypothyroidism and […]