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 and resistance to thyroid hormone; however, not surprisingly, the discussion of diabetes and its complications comprises much of the content.
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 and resistance to thyroid hormone; however, not surprisingly, the discussion of diabetes and its complications comprises much of the content.
The number of people with diabetes is increasing at an alarming rate and represents one of the biggest public health challenges of the 21st century. This will unfortunately mean more diabetic complications unless we live up to the challenges of managing diabetes effectively. This edition of European Endocrinolgy has a diabetes focus, addressing the rapidly evolving developments in the field and bringing together contributions on important topics of current interest in diabetes. The topics covered include diabetes prevention, early diagnosis of diabetes and pre-diabetes, self-management in diabetes, new reatments in type 2 diabetes and a focus on acute (hypoglycaemia in type 2 diabetes) and chronic (neuropathy and NAFLD) complications of diabetes.
Data from the DECODE Study group suggest that more than half of Europeans may have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) during their lifetime. The average risk of developing type 2 diabetes increases from 0.7% in those with normal glucose tolerance to 5–10% per year in those with IFG or IGT. Those with both are twice as likely to develop diabetes as those with either. Therefore, the case for prevention of diabetes is strong.
There is now good evidence for lifestyle interventions in reducing new-onset type 2 diabetes and improving metabolic control. However, such beneficial lifestyle modifications remain very difficult to achieve for many of our patients within the context of our current diabetic clinics, which primarily focus on pharmacological interventions. Trento and Porta have developed a model to deliver diabetes care in group education sessions that improve clinical outcomes, patient quality of life and clinician satisfaction while optimising use of the limited resources of busy clinics. Their educational methodology, discussed in this issue, has inspired the development of the DESMOND (Diabetes Education for Self Management Ongoing and Newly Diagnosed) programme in the UK.
The availability of glucagon-like peptide-1 (GLP-1) analogues and dipeptidyl peptidase-4 (DPP-4) inhibitors has increased our armamentarium of drugs for the management of type 2 diabetes. The former agents have a favourable impact on weight loss, reducing hypoglycaemia and, in the case of liraglutide, blood pressure as well. In this issue, new treatments for type 2 diabetes are discussed, and hypoglycaemia, often the most feared acute complication of diabetes, is also examined.
Taken together, the topics covered in this issue represent a valuable update on recent advances in the field of diabetes management, along with very useful insights into the other endocrine disorders discussed herein. European Endocrinology would like to thank all those involved: our editorial board and media partners for their continuing support and helpful guidance and, in particular, the individual authors for their time and commitment in providing such an interesting selection of articles. We are certain you too will find this edition another enjoyable and useful read.
