Category Archives: Endocrinology

Endocrinology

New Diabetes Care Standards; Near 40% Ditch T2D Meds; Zepbound Hits Shelves – Medpage Today

The American Diabetes Association released its 2024 installment of the Standard of Care in Diabetes, featuring updates on screening, obesity drugs, new technology, and teplizumab (Tzield). (Diabetes Care)

Almost 40% of adults with type 2 diabetes discontinued their second-line medication within a year of starting it. (American Journal of Managed Care)

Patients' adherence to semaglutide for obesity was higher compared with previous weight-loss drugs, including naltrexone-bupropion (Contrave) and phentermine-topiramate (Qsymia), a retrospective study found. (Obesity)

Tandem Diabetes Care launched updated t:slim X2 insulin pump software for use with the Dexcom G7 continuous glucose monitor.

A New York Times investigation suggested that Bellevue Hospital in New York performed a high volume of bariatric surgeries on vulnerable individuals, including prisoners and other inappropriate patients.

The FDA established the new Genetic Metabolic Diseases Advisory Committee to focus on "complicated issues" related to genetic metabolic disease drug development.

In a secondary analysis of EMPA-KIDNEY, empagliflozin (Jardiance) cut the risk of kidney disease progression in those with a wide range of non-diabetic disease. (Lancet Diabetes & Endocrinology)

Nations should increase taxes on alcohol and sugar-sweetened beverages as a way to incentivize healthier behaviors, the World Health Organization said.

Eli Lilly's tirzepatide (Zepbound), the rebranded weight-loss version of its diabetes drug, is now available in pharmacies, less than a month after FDA approval. (Forbes)

The U.S. Supreme Court declined to hear a case challenging a 2018 Washington state law banning conversion therapy for minors, an approach the American Medical Association said "is not based on medical and scientific evidence." (NPR)

Bempedoic acid cut down on LDL cholesterol, high-sensitivity C-reactive protein, plus risk of cardiovascular events in people with diabetes, according to a prespecified CLEAR Outcomes trial analysis. (Lancet Diabetes & Endocrinology)

Exposure to the endocrine-disrupting perfluoroalkyl substances was tied to changes in bone mineral density in adolescents and young adults. (Environmental Research)

Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, shes worked at the company since 2015.

See more here:

New Diabetes Care Standards; Near 40% Ditch T2D Meds; Zepbound Hits Shelves - Medpage Today

Endocrinology

Save Your Heart, Save Your Life – University of New Mexico

The most important reason that I appreciate this award is that it gives me an opportunity to talk to many people that I normally never talk to and tell them that theres no reason to die of a heart attack, Schade said. I can theoretically save a few lives by getting people to understand that they can do something about it.

Schade, who serves as chief of the Division of Endocrinology & Metabolism, has been at UNM since the 1970s and has been the principal investigator on multiple large multicenter clinical studies involving diabetes and cardiovascular research. He has nearly 700 peer-reviewed publications.

In recent years, he has focused on the direct connection between diabetes and heart disease.

The problem with diabetes is not everybody is in good glucose control, Schade says. In those cases, elevated blood sugar damages the nerves, kidneys and lining of the blood vessels including those supplying the heart. The talk will really be about preventing heart disease in everybody, and particularly in diabetic patients, he says.

Schade cited four major risk factors for heart disease: diabetes, smoking, hypertension and high cholesterol. Some diabetic patients have all four, and of course they die at an early age, he says. Meanwhile, the societal costs of heart disease are staggering, claiming nearly 600,000 lives in the U.S. every year.

If you have a heart attack and you pay for all the nurses and all the doctors and all the medications and then you follow the patient, its $100,000, he says. In New Mexico, there are 6,000 calls to the emergency med service every month for chest pain.

With emeritus professor R. Philip Eaton, MD, Schade helped persuade the New Mexico Legislature in 2021 to mandate that health insurance plans cover the cost of coronary artery calcium scans, which cost about $150.

The non-invasive CT scan accurately predicts a persons risk of suffering a heart attack by identifying the presence of calcium-containing plaques in the inner lining of the blood vessels.

Weve sent a letter to Washington to try to get Medicare to cover the cost of a calcium scan, Schade says. Medicare doesnt cover it, even though Medicaid does.

Should a coronary artery calcium scan detect evidence of silent heart disease, lifestyle changes coupled with medication therapy can actually reverse the damage in the arteries, he says. Im trying to get the message out that you can do something to prevent it.

Schade is hoping for a big audience with whom to share his message of health empowerment.

This is a talk for everybody and everybody will enjoy it, Schade says. It will mean something to everybody, because everybody has a heart.

Continued here:

Save Your Heart, Save Your Life - University of New Mexico

Endocrinology

Working to fill the gaps in transgender health care – The Boston Globe

CONCORD, N.H. Health care for transgender people has become a hot button political issue, and providers in New England say the political debate around gender-affirming care makes their jobs harder.

Dr. Frances Lim-Liberty, a pediatric endocrinologist, and Jessica Smith, an endocrinology nurse practitioner and program coordinator for the states only pediatric and adolescent trans health program at Dartmouth Health, spoke with the Globe about the care they provide. The program has grown steadily since it began in 2014, and now serves about 500 young people from New Hampshire, Vermont, and Northern Massachusetts.

Lim-Liberty and Smith addressed the most-common myths surrounding trans health care, how this care helps young people, and how terrified patients are of losing access to it.

Q: You say theres no lower age limit about when youll start seeing patients at the clinics. When it comes to families with younger children, why are they seeking care?

Get N.H. Morning Report

A weekday newsletter delivering the N.H. news you need to know right to your inbox.

Lim-Liberty: Many have questions. They want to know how to support their kids. They are seeking therapists and mental health specialists who understand childhood and gender identity development.

We spend a lot of time counseling. The biggest gender affirming medical care we provide is guiding the family to resources, answering questions about puberty, where to find gender neutral clothing, where to find an understanding hairdresser. We have support groups, and a library with books and educational guides. Were trying to fill the gaps.

Q: What kinds of medical care do you offer?

Smith: If someone is thinking about medical affirmation, they first meet with a social worker, a psychologist, an endocrine provider, and therapists. Theres a team ready before we start.

Lim-Liberty: We are really careful in our approach. By the time were ready to start a puberty blocker or estradiol or testosterone, weve had many conversations and discussions.

Q: How do you talk to parents who might not understand gender affirming health care?

Smith: Usually those kids are really hurting by the time they see us. We try to engage parents by bringing in the mental health team and talking about the importance of treatment and what thats going to look like. When we have a young person struggling with distress related to gender dysphoria, we have to treat that in the same way we treat any other medical diagnosis. Outcomes are good.

Lim-Liberty: The most important part is sorting out the myths theyve heard, and the biases that they hold.

Q: What are some of the most common myths you encounter?

Lim-Liberty: That gender is a binary. Were all raised in a binary world. We have them start to think about gender as a spectrum and talk about what its like to have aspects of both masculinity and femininity.

Smith: We spend a lot of time talking about the fact that gender identity isnt easily influenced. Its normal that their teenager is hanging out with other trans kids. They find each other naturally, in the way athletes find each other and become friends.

Q: Theres a lot of talk about puberty blockers. What are they and when are they used?

Smith: Theres a big spread of disinformation about puberty blockers. Folks who have an anti-trans agenda are trying to use this as a scare tactic to say we are harming young people and thats absolutely false.

Puberty blockers have been used in pediatric endocrinology for decades to treat precocious puberty so there is a very good amount of data demonstrating safety and efficacy. We use puberty blockers to pause puberty for young people who are exploring their gender identity.

These are completely reversible medications. If a young person wants to stop the blocker and go through their natal puberty, we can do that safely with no bad outcomes. If somebody decides to transition from a puberty blocker to gender affirming hormone therapy, we can also do that.

Lim-Liberty: Theres lots of studies showing positive impacts on mental health: dropping depression rates, dropping suicidality and suicidal ideation. Jess and I experience that every day when were in the transgender clinic. We see these kids change, we see them blossom, we see them become the people that they talk about wanting to become at that first visit. We see them go from being reserved and quiet to being interested in activities or opening up about something they really like.

Q: The New Hampshire legislature considered a bill this session that would restrict the kind of care you can provide. Whats it like to be doing this work now given the political climate?

Lim-Liberty: Its very hard to be told that your work is wrong. Its very hard to be told that the trans kids you take care of every day shouldnt exist. Never have I, in any of the other endocrine conditions or diseases, had to defend someone for being who they are.

I dont like fighting legislation. Thats not not my training. Thats not something that I learned in medical school. While Im honored to do that, its also robbing me of the clinical work I need to be doing here. Its not fair to our kids.

We want our program to grow, and when we dont have the time and the resources to do that because were in Concord explaining that what were doing is best practice medicine, its I dont even have the right word: maddening, frustrating, unfair.

Smith: Gender affirming care is life saving work, And to have folks without an ounce of medical training saying we are harming children certainly that impacts us, but it has an incredible impact on our patients who are already marginalized and at risk. Theyre terrified they are going to lose care: What happens if New Hampshire bans gender affirming care? Where do we go? What do we do? We have to realize the impact this has on the trans community.

Read the original post:

Working to fill the gaps in transgender health care - The Boston Globe

Endocrinology

Obesity is gateway to fatal diseases: Chandigarh hosts discussion on diabetes, endocrinology – The Indian Express

Obesity is not just a cosmetic disorder; it has its roots in the bodys endocrinological system. If ignored, it becomes the reason for many other irreversible health problems.

You have exhausted your monthly limit of free stories.

To continue reading,simply register or sign in

You need a subscription to read on. Start today at special Founders Day pricing.

This premium article is free for now.

Register to continue reading this story.

This content is exclusive for our subscribers.

Subscribe to get unlimited access to The Indian Express exclusive and premium stories.

This content is exclusive for our subscribers.

Subscribe now to get unlimited access to The Indian Express exclusive and premium stories.

This was one of the main issues discussed in a two-day continuing medical education (CME) that began in Chandigarh Saturday (April 15) on various aspects of diabetes and endocrinology. Sweet Diabetes Foundation is organising the CME to empower doctors by keeping them aware of international trends in treating advanced diabetes. More than 400 experts are participating in the CME and 25 doctors and health experts took part in the keynote session.

Dr Sachin Mittal, one of the leading endocrinologists of India and founder of Sweet Diabetes Foundation, spoke in detail about the lethal combination of diabetes and obesity, which he terms diabesity.

Diabetes, obesity, and heart disease have become common problems, even among the young. As per International Diabetes Federation, in India, 7.7 lakh people above 18 have diabetes, and the numbers are rising rapidly. Obesity is also increasing alarmingly across all age groups, including children and young adults. Chandigarh is fast emerging as the obesity capital of India, and its high time we focus on diet and healthy lifestyle to address the issue of childhood obesity, said Dr Mittal.

As per the Indian Council for Medical Research, Chandigarh (13.6 per cent) has the highest prevalence of obesity (among adults) compared to the rest of the country (11.8 per cent). Besides Indians being a high-risk group, a sedentary lifestyle and bad dietary habits are the major factors behind this rise.

Noted speakers also included Dr Saptarishi Bhattacharya, who talked about new-age treatments for obesity while talking about healthy diet parameters. Olympic gold medallist Abhinav Bindra will join the CME as the chief guest on the concluding day, April 16.

First published on: 16-04-2023 at 13:08 IST

See the original post:

Obesity is gateway to fatal diseases: Chandigarh hosts discussion on diabetes, endocrinology - The Indian Express

Endocrinology

Do You Have an Under-active Thyroid? This 90-Second Quiz Helps … – The Healthy

If youve ever suspected that your metabolism is a little sluggish, you might also wonder whether you have an under-active thyroid. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), around 5% of Americans aged 12 years or older have an underactive thyroid, or hypothyroidism. Thyroid experts like Dr. David S. Cooper, MD, MACP, with the division of endocrinology, diabetes, and metabolism at the Johns Hopkins University School of Medicine, suggest that the number of American adults experiencing mild hypothyroidism may be even higherpossibly closer to 10%.

Symptoms of an underactive thyroidcan be vague, and many hypothyroid symptoms can be confused with other medical conditions. So while the most reliable method of diagnosing an under-active thyroid is to see a licensed healthcare provider who runs lab workmaybe repeatedlysigns of hypothyroidism can start with a few main clues.

And note how important this can be. An under-active thyroid doesnt just cause frustrating questions about whether your body is utilizing calories as efficiently as it could. More severe cases of hypothyroidism can cause frustrating symptoms and pose health risks, in particular for cardiovascular health. Depending on how low your thyroid hormone levels are, medical treatment might be called for.

The Healthy @Readers Digest partnered with endocrinologists to develop a quiz that will help you determine whether its time to talk to your doctor about getting tested for hypothyroidism.

GetThe Healthy @Readers Digestnewsletterfor wellness insights delivered to you daily

Dr. Cooper says that in general, if you experience several of the symptoms we asked about that can be linked with hypothyroidism, speak with your licensed doctor. In most cases, your doctor can determine whether you have hypothyroidism using a routine blood test that measures levels of thyroid stimulating hormone (TSH).

That said, Dr. Cooper says its important to remember that many of the symptoms that can be associated with hypothyroidism can be caused by other conditions. Many of these symptoms are also experienced by people who are perfectly healthy, he adds. Dry skin is one example. Also according to Dr. Cooper, severe hypothyroidism tends to be fairly rare in the United States.

Dr. Cooper says that if your TSH levels are only a little higher than normal, and youre not experiencing any troublesome or severe symptoms, you may not need to start taking thyroid hormone replacement medications. But medically speaking, he says healthy levels of TSH tend to sit between 0.5 and 4, and people that have TSH levels of 10 or higher typically require treatment.

According to the experts, most health risks associated with hypothyroidism are related to severe or prolonged hypothyroidism, not mild cases. But Dr. Desai explains, untreated hypothyroidism can have long-term effects, ranging from mild conditions to life-threatening conditions.Hypothyroidism has been linked to infertility [and an] increased risk of miscarriages, she says. It has been associated with birth defects, including impaired mental development.

Dr. Desai adds that hypothyroidism can also cause elevated cholesterol levels, which can increase your risk of heart disease. She further explains that hypothyroidism can impact mental health, as it can lead to depression and can cause cognitive slowing. Hypothyroidism can also cause your thyroid gland to grow in size, which leads to the formation of a goiter, or enlarged thyroid gland.

Dr. Desai concludes by saying that in very severe cases of long untreated hypothyroidism, you can experience myxedema coma, which is a life-threatening condition that requires hospitalization.

Sources

See the original post:

Do You Have an Under-active Thyroid? This 90-Second Quiz Helps ... - The Healthy

Endocrinology

Science Update: Children born to women with COVID-19 could be at … – National Institute of Child Health and Human Development

Infants born in 2020 through mid-2021 to women with COVID-19 weighed less at birth, but grew at a faster rate than a comparable group born to women who did not have COVID-19, according to a study funded by the National Institutes of Health. Previous studies have found that preterm infants and other infants who are small or underweight at birth and who undergo catch-up growth in the first year are at higher risk for later life obesity, heart disease, high blood pressure and diabetes, compared to infants born at normal weight. The authors called for additional studies of infants whose mothers had COVID-19 during pregnancy to learn if they have increased health risks later in life.

The study was conducted by Andrea Edlow, M.D., and Lindsay Fourman, M.D., of Massachusetts General Hospital, and colleagues. It appears in The Journal of Clinical Endocrinology and Metabolism. NIH funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with additional support from the National Heart, Lung, and Blood Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institute of Allergy and Infectious Diseases.

According to the U.S. Centers for Disease Control and Prevention, in 2020, pregnant women comprised 9% of reproductive aged women with COVID-19. Compared to nonpregnant females of similar age, pregnant people with COVID-19 are more likely to experience severe disease, more likely to be admitted to an intensive care unit, and more likely to need mechanical ventilation to help them breathe. Mothers with COVID-19 are more likely than those without the infection to give birth preterm and to have hypertensive disorders of pregnancy. Moreover, placentas from pregnancies complicated by COVID-19 are often inflamed at the junction between the maternal and fetal parts of the placenta and contain higher amounts of immune cells from mother and fetus.

Despite these ill effects, pregnant people with COVID-19 are unlikely to pass the virus on to their babies. However, few studies have been conducted on the potential long-term effects that may be experienced by children born to mothers with COVID-19 during pregnancy.

For the current study, researchers compared weight, length, and body mass index (BMI) at birth, 2 months, 6 months, and 12 months of 149 babies born to mothers with COVID-19 during pregnancy to those of 127 babies born to mothers without any symptoms of COVID-19. For each infant, researchers calculated a z-score for each of the three measures. Z-scores are a comparison measure of an individual to a formal standardin this case, average weight, length, and body measurements compiled as growth charts by the World Health Organization.

At birth, infants born to mothers with COVID-19 and those born to mothers without COVID-19 did not differ in average z-scores for length. However, those exposed to COVID-19 during pregnancy had an average birth weight z-score that was 30% lower than those not exposed and a BMI z-score that was 35% lower than that of the unexposed infants. By 12 months, infants exposed to COVID-19 in the uterus had a 53% greater gain in BMI z-score than the infants not exposed to COVID-19.

Although preterm infants often have a similar pattern of accelerated growth in comparison to term infants, the authors did not find preterm birth to be the cause of the rapid growth they saw in their study, as the z-scores considered gestational age at birth, and the study did not include enough preterm infants to account for the difference.

In fact, the difference between the two groups persisted, even after researchers statistically compensated for factors known to influence infant size, such as the mothers age and BMI.

The pattern of catch-up growth seen in infants exposed to COVID-19 during pregnancy may place them at risk for heart disease and other obesity-related illnesses later in life. The findings underscore the need to prevent COVID-19 in pregnant people using such protective measures as vaccination and wearing masks indoors, before and during pregnancy.

Ockene, MW, et al. Accelerated longitudinal weight gain among infants with in utero COVID-19 exposure. The Journal of Clinical Endocrinology & Metabolism. 2023.

See more here:

Science Update: Children born to women with COVID-19 could be at ... - National Institute of Child Health and Human Development