US ENDOCRINE DISEASE – VOLUME 2 ISSUE 1 – SUMMER 2006

Diabetes is a silent killer that today kills one person every 10 seconds. It is a global drama with devastating human, social and economic impacts. New data recently released by the International Diabetes Federation (IDF) indicates that more than 230 million people worldwide are living with diabetes, and that this number is sadly expected to […]

Prevalence of Diabetes Still Rising in the US

Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals: a randomized controlled trial Heilbronn L K, de Jonge L, Fr isard M I, et al., Pennington C ALERIE Team JAMA (2006);295(13): pp. 1,539–1,548.

Each year the International Diabetes Federation (IDF) emphasises a theme of worldwide importance to people living with diabetes and to health professionals working with people who have diabetes. In 2005 that theme was the diabetic foot. This year it is diabetes in disadvantaged and vulnerable groups. These campaigns aim to increase awareness of diabetes in […]

Behavioral and psychosocial aspects of health problems have proven to be critically important. Seven of the 10 leading causes of death in the US are related to unhealthy behavior, such as smoking, overeating, and excessive alcohol consumption. In addition, psychological problems (such as depression) and social problems (such as family conflicts) have adverse effects on […]

High glucose levels during pregnancy increase the chance that a baby will be born with birth defects. High glucose levels have the most significant effect early in pregnancy, possibly before a woman knows she is pregnant. Therefore, if a woman with diabetes discovers she is pregnant, it is a medical emergency. Lowering her blood sugar […]

Diabetes continues to increase at an alarming rate worldwide and is now a major cause of death, with mortality risk twice that for individuals without the disease.1 Most people with type 2 diabetes are started on lifestyle change and oral antidiabetic agents that address one or more of the physiologic defects that lead to hyperglycemia.Type […]

The era of strict diabetes control requires a timely use of insulin. While there are many types of insulin available and sometimes difficulties in understanding the differences among those in that specific category, it is essential to be well aware of how basal insulin works, the possible differences and advantages, disadvantages, and cost. Patients with […]

Many patients with diabetes do not follow, or are unable to follow, provider recommendations for self-management as closely as is needed. This is often due to feeling overwhelmed, confused, or discouraged by the ‘job’ of diabetes. These patients may be young or old, male or female, or have type 1, type 2 or gestational diabetes.

People with poor glucose control are more likely to suffer from complications of diabetes such as ischemic heart disease and microvascular disorders such as renal and eye disease. They are also more likely to die from a diabetes-related cause. Good glucose control is vitally important and it is best accomplished when doctors and patients work […]

Approximately 20.8 million Americans (14.6 million diagnosed and 6.2 million undiagnosed) have diabetes mellitus (DM) and in 2002 it was the sixth leading cause of death, emphasizing the need for improved treatment. However, iatrogenic hypoglycemia precludes reaching and maintaining euglycemia. During the Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS), […]

Diabetes mellitus has become one of the great epidemics of the 21st century. It is estimated that 150 million adults worldwide are affected and that this number will double by 2025. Cumulative risk for developing diabetes in individuals born in 2000 in the US is 38% for females and 33% for males. Diabetes is the […]

Diabetes mellitus is a condition characterized biochemically by increased blood glucose concentrations and associated with both small blood vessel complications in the eyes (retinopathy), kidneys (nephropathy), and peripheral nerves (neuropathy) and large blood vessel complications of the heart (causing heart attacks), head and neck (causing strokes), and legs (leading to gangrene and amputations). Diabetic retinopathy […]

This brief article on the role of glucagon in type 2 diabetes mellitus is intended to review the facts, to integrate these facts into what has been called the ‘glucagon logic’,1 to analyse the mechanisms that might explain the hyperglucagonaemia of type 2 diabetes and to discuss whether inhibiting glucagon release or antagonising the effects […]

Changes in lifestyle and eating behavior in humans over the last century have contributed significantly to the epidemic of obesity and an associated dramatic increase in the incidence of diabetes worldwide (Zimmet, Alberti et al. 2001).Type 2 diabetes accounts for more than 90% of all diabetes cases, and is characterized by impaired insulin action in […]

In January of 2006 the US Food and Drug Administration (FDA) approved the first inhaled human insulin preparation and delivery system, Exubera®. Although many alternate routes of insulin delivery have been studied over the past years, this is the first non-injectable insulin system to become a reality.

The inhaled insulin, Exubera®, was recently approved for the treatment of type 1 and type 2 diabetes. This article will review the delivery systems for inhaled insulin, the kinetics of inhaled insulin, clinical trials in type 1 and type 2 diabetes, and safety considerations for inhaled insulin. Delivery of Inhaled Insulin

Current Indications for Statin and Fibrate Therapy The evidence of cardiovascular protection afforded by statins has recently extended beyond patients with hypercholesterolemia.With the publication of several trials,1-7 bold extrapolations of the power of statin therapy in cardiovascular prevention have been offered:

Individuals with both type 1 and type 2 diabetes mellitus (DM) are known to be at high risk for developing coronary artery disease (CAD). The risk is two to three times greater in those with DM compared with those without, and is especially high in women with DM. An additional problem in individuals with DM […]

High levels of plasma triglycerides, more accurately called triglyceride-rich lipoproteins, as a cardiovascular (CV) risk factor have long been a focus of discussion. Historically, a central question has been whether high triglycerides are independently related to the development of CV disease (CVD).

Diabetic kidney disease is rapidly becoming the major cause of end-stage renal disease in the US and the number of patients with diabetic kidney disease is increasing at an epidemic rate worldwide. It is widely accepted that the principal cause of all diabetic complications is increased blood sugar.

In the past 15 years, the clinical appreciation of the impact of pituitary disorders has accelerated at a gratifying, yet dangerously expeditious, manner, leaving little time for the advancing knowledge and proper medical practice guidelines to percolate through the medical/patient/public sector and so allow for uniform improvement in understanding and patient care.

Acromegaly is an uncommon disorder characterized by excess secretion of growth hormone (GH), resulting in the classical growth of bone and soft tissues, multi-system involvement with multiple comorbidities, and heightened risk of premature mortality. GH is produced by the somatotroph cells of the pituitary gland in a pulsatile fashion. Circulating GH stimulates hepatic secretion of […]

Prolactin Prolactin is a polypeptide hormone produced and secreted by the adenohypophysis. This hormone is in the family with growth hormone and human placental lactogen; in fact, they are sufficiently homologous to suggest a common ancestral gene.

The thyroid gland, located in the front of the neck just below the larynx, secretes hormones that control metabolism. These hormones are thyroxine (T4) and triiodothyronine (T3). Hypothyroidism, also known as an underactive thyroid, occurs when the thyroid gland does not make enough of the thyroid hormones. People with this condition will have symptoms associated […]

In 1603 Paracelsus described endemic cretinism. Over 150 years later, in 1878, Ord proposed the term myxedema to describe the clinical features of the “‘cretinoid’ affection occasionally observed in middle-aged women”. In 1883, Emil Theodor Kocher reported myxedema after thyroidectomy. This led to a 1909 Nobel Prize in Medicine “for his work on the physiology, […]

Male androgen deficiency has become a burgeoning area of public and commercial interest. Male androgen deficiency (commonly called male hypogonadism) is a common and important endocrinological syndrome defined by signs and symptoms of androgen deficiency plus low serum testosterone levels. Klinefelter syndrome, the most common congenital form of male hypogonadism, occurs in one in 500 […]

Sexual medicine in the year 2006 is receiving the attention of the medical community, not because we have been convinced that there are 150 million men worldwide with erectile dysfunction (ED), and not because we are concerned that ED has enormous implications for quality of life, but rather because of the new overwhelming evidence that […]

Sexual thoughts and fantasies are a joy of life. Sexual desire is fun and a vital part of good health. It is a much appreciated basis for relationships between women and their partners. Sexual apathy is anguishing and distressing; it is a common complaint heard by gynaecologists. In older women, androgen production and sexual desire […]

Male androgen deficiency has become a burgeoning area of public and commercial interest. Male androgen deficiency (commonly called male hypogonadism) is a common and important endocrinological syndrome defined by signs and symptoms of androgen deficiency plus low serum testosterone levels. Klinefelter syndrome, the most common congenital form of male hypogonadism, occurs in one in 500 […]

Sexual thoughts and fantasies are a joy of life. Sexual desire is fun and a vital part of good health. It is a much appreciated basis for relationships between women and their partners. Sexual apathy is anguishing and distressing; it is a common complaint heard by gynaecologists. In older women, androgen production and sexual desire […]

Diabetes mellitus is a condition characterized biochemically by increased blood glucose concentrations and associated with both small blood vessel complications in the eyes (retinopathy), kidneys (nephropathy), and peripheral nerves (neuropathy) and large blood vessel complications of the heart (causing heart attacks), head and neck (causing strokes), and legs (leading to gangrene and amputations). Diabetic retinopathy […]

Approximately 20.8 million Americans (14.6 million diagnosed and 6.2 million undiagnosed) have diabetes mellitus (DM) and in 2002 it was the sixth leading cause of death, emphasizing the need for improved treatment. However, iatrogenic hypoglycemia precludes reaching and maintaining euglycemia. During the Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS), […]

Prolactin Prolactin is a polypeptide hormone produced and secreted by the adenohypophysis. This hormone is in the family with growth hormone and human placental lactogen; in fact, they are sufficiently homologous to suggest a common ancestral gene.

Behavioral and psychosocial aspects of health problems have proven to be critically important. Seven of the 10 leading causes of death in the US are related to unhealthy behavior, such as smoking, overeating, and excessive alcohol consumption. In addition, psychological problems (such as depression) and social problems (such as family conflicts) have adverse effects on […]

Acromegaly is an uncommon disorder characterized by excess secretion of growth hormone (GH), resulting in the classical growth of bone and soft tissues, multi-system involvement with multiple comorbidities, and heightened risk of premature mortality. GH is produced by the somatotroph cells of the pituitary gland in a pulsatile fashion. Circulating GH stimulates hepatic secretion of […]

Changes in lifestyle and eating behavior in humans over the last century have contributed significantly to the epidemic of obesity and an associated dramatic increase in the incidence of diabetes worldwide (Zimmet, Alberti et al. 2001).Type 2 diabetes accounts for more than 90% of all diabetes cases, and is characterized by impaired insulin action in […]

Sexual medicine in the year 2006 is receiving the attention of the medical community, not because we have been convinced that there are 150 million men worldwide with erectile dysfunction (ED), and not because we are concerned that ED has enormous implications for quality of life, but rather because of the new overwhelming evidence that […]

Diabetes mellitus has become one of the great epidemics of the 21st century. It is estimated that 150 million adults worldwide are affected and that this number will double by 2025. Cumulative risk for developing diabetes in individuals born in 2000 in the US is 38% for females and 33% for males. Diabetes is the […]

Diabetic kidney disease is rapidly becoming the major cause of end-stage renal disease in the US and the number of patients with diabetic kidney disease is increasing at an epidemic rate worldwide. It is widely accepted that the principal cause of all diabetic complications is increased blood sugar.