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Clinical Diabetes and Endocrinology

Meng H Tan, Ravi Iyengar, Kara Mizokami-Stout, Sarah Yentz, Mark P MacEachern, Li Yan Shen, Bruce Redman, Roma Gianchandani
Background: Since 2011 six immune checkpoint inhibitors (ICI) have been approved to treat patients with many advanced solid tumor and hematological malignancies to improve their prognosis. Case reports of their endocrine immune-related adverse events [irAEs]) are increasingly published as more real-world patients with these malignancies are treated with these drugs. They alert physicians of a drug's AEs (which may change during a drug's life cycle) and contribute to post-marketing safety surveillance...
2019: Clinical Diabetes and Endocrinology
Azita Ganji, Meysam Moghbeli
Background: Celiac disease (CD) is an autoimmune disorder related to the gluten and can be also associated with some other endocrine disorders such as type 1 diabetes and thyroid disease. Gluten exposure in CD may have especial role in developing other auto immune disorder. Case presentation: We reported two familial cases with celiac disease who were on a gluten free diet (GFD) and hyperthyroidism and type 1 diabetes were appeared following a regular diet. Their autoimmune disorders were ameliorated after avoidance of dietary gluten...
2018: Clinical Diabetes and Endocrinology
Ved V Gossain, Mohammad El-Rifai, Preethi Krishnan, Bhavini Bhavsar
Background: Cortisol resistance syndrome is a very rare condition characterized by high cortisol levels, but without any clinical features of Cushing's syndrome. Our objective is to present such a case. Case presentation: A 41 year old female presented with mild hirsutism and elevated urinary cortisol levels. Plasma cortisol levels were elevated and were not suppressed by conventional doses of dexamethasone on multiple occasions, but decreased following administration of higher doses of dexamethasone...
2018: Clinical Diabetes and Endocrinology
Anjan K Saha, Naresh Gunaratnam, Rashmi Patil, Monica Choo, Devika P Bagchi, Ekta Jhaveri, Jennifer Wyckoff, Ganeika Bahu, Ulysses Balis, Paul Clyde, William H Herman
Sri Lanka is experiencing a rapid increase in the number of people with diabetes mellitus (DM) due to population growth and aging. Physician shortages, outdated technology, and insufficient health education have contributed to the difficulties associated with managing the burden of disease. New models of chronic disease management are needed to address the increasing prevalence of DM. Medical students, business students, and faculty members from the University of Michigan partnered with the Grace Girls' Home, Trincomalee General Hospital, and Selvanayakapuram Central Hospital to identify and train diabetes-focused medical assistants (MAs) to collect and enter patient data and educate patients about their disease...
2018: Clinical Diabetes and Endocrinology
Asnakew Achaw Ayele, Yohannes Kelifa Emiru, Sofonyas Abebaw Tiruneh, Belete Achamyelew Ayele, Alemayehu Digssie Gebremariam, Henok Getachew Tegegn
Background: Limited data are available regarding the level of adherence and barriers to dietary recommendations in individuals with type 2 diabetes in Africa including Ethiopia. Therefore, this study aimed at assessing the level of dietary adherence and its barriers among patients with type 2 diabetes in northwest Ethiopia. Methods: A prospective hospital-based cross-sectional study was conducted from August to October 2017 at Debre Tabor General Hospital, Northwest Ethiopia...
2018: Clinical Diabetes and Endocrinology
Ka Kit Wong, Barry L Shulkin, Milton D Gross, Anca M Avram
Objective: To evaluate the success rate of therapeutic administration of a single calculated 131 I activity for eliminating hyperthyroidism due to Graves' disease. Methods and materials: Patients with Graves' hyperthyroidism underwent pinhole thyroid imaging, 24-h radioactive iodine uptake (RAIU) measurements and clinical examination and received a calculated 131 I activity of 0.2 mCi per estimated gram of thyroid tissue, adjusted for the 24-h RAIU. The goal of RAI treatment was to achieve hypothyroidism within 3-6 months of 131 I administration...
2018: Clinical Diabetes and Endocrinology
Sarah D Kowitt, Katrina E Donahue, Edwin B Fisher, Madeline Mitchell, Laura A Young
Background: Diabetes management is influenced by a number of factors beyond the individual-level. This study examined how neighborhood social disorganization (i.e., neighborhoods characterized by high economic disadvantage, residential instability, and ethnic heterogeneity), is associated with diabetes-related outcomes. Methods: We used a multilevel modeling approach to investigate the associations between census-tract neighborhood social disorganization, A1c, and self-reported use of acute or emergency health care services for a sample of 424 adults with type 2 diabetes...
2018: Clinical Diabetes and Endocrinology
Júnia Ribeiro de Oliveira Longo Schweizer, Antônio Ribeiro-Oliveira, Martin Bidlingmaier
The measurement of circulating concentrations of growth hormone (GH) is an indispensable tool in the diagnosis of both GH deficiency and GH excess. GH is a heterogeneous protein composed of several molecular isoforms, but the physiological role of these different isoforms has not yet been fully understood. The 22KD GH (22 K-GH) is the main isoform in circulation, followed by 20KD GH (20 K-GH) and other rare isoforms. Studies have been performed to better understand the biological actions of the different isoforms as well as their importance in pathological conditions...
2018: Clinical Diabetes and Endocrinology
Ariel Barkan, Roma Gianchandani, Meng H Tan
No abstract text is available yet for this article.
2018: Clinical Diabetes and Endocrinology
Inbal Uri, Simona Grozinsky-Glasberg
Background: Neuroendocrine tumors (NETs) are rare neoplasms, with an estimated annual incidence of ~ 6.9/100,000. NETs arise throughout the body from cells of the diffuse endocrine system. More than half originate from endocrine cells of the gastrointestinal tract and the pancreas, thus being referred to as gastroenteropancreatic NETs (GEP NETs). The only treatment that offers a cure is surgery, however most patients are diagnosed with metastatic disease, and curative surgery is usually not an option...
2018: Clinical Diabetes and Endocrinology
Elisabeth Joye Petr, Tobias Else
Background: Pheochromocytomas and Paragangliomas (PCC/PGL) are rare endocrine tumors that are mostly benign, but often hormone producing, causing significant morbidity and mortality due to excess catecholamine secretion and cardiovascular crises. It is estimated that 30% of PCC/PGL are due to germline mutations, including Neurofibromatosis type 1 ( NF1 ). There is little published data describing the phenotype of NF1-associated PCC/PGL and there are no established recommendations for PCC/PGL screening in NF1...
2018: Clinical Diabetes and Endocrinology
Palak Choksi, Amy Rothberg, Andrew Kraftson, Nicole Miller, Katherine Zurales, Charles Burant, Catherine Van Poznak, Mark Peterson
Background: The long-term effect of weight reduction on skeletal health is not well understood. The purpose of this study was to examine the impact of an intensive medical weight loss intervention using very low energy diet (VLED) (~ 800 cal/day) that result in significant changes in body weight, on total body bone mineral density (BMD) over 2 years. Methods: We examined the impact of VLED-induced weight loss on BMD and FFM (Fat-free Mass) after 3-6 months and again while in weight maintenance at 2 years in 49 subjects...
2018: Clinical Diabetes and Endocrinology
Corey J Lager, Ronald J Koenig, Richard W Lieberman, Anca M Avram
Background: Malignant struma ovarii is an ovarian teratoma containing at least 50% thyroid tissue which has the potential to metastasize and produce thyroid hormone. Given its rarity, management strategies are not well-established. We report a case of metastatic malignant struma ovarii discovered during pregnancy with lessons for evaluation and management. Case presentation: A 30-year-old woman who was two months pregnant was discovered to have struma ovarii with over half of the struma comprised of papillary thyroid cancer...
2018: Clinical Diabetes and Endocrinology
Palak Choksi, Karl J Jepsen, Gregory A Clines
Dual-energy X-ray absorptiometry (DXA) was the first imaging tool widely utilized by clinicians to assess fracture risk, especially in postmenopausal women. The development of DXA nearly coincided with the availability of effective osteoporosis medications. Although osteoporosis in adults is diagnosed based on a T-score equal to or below - 2.5 SD, most individuals who sustain fragility fractures are above this arbitrary cutoff. This incongruity poses a challenge to clinicians to identify patients who may benefit from osteoporosis treatments...
2018: Clinical Diabetes and Endocrinology
S Ghosal, B Sinha
Background: Therapy for Type 2 diabetes (T2D) has been transformed by the introduction of newer agents like Glucagon like Peptide Receptor Agonists (GLP-1RA) and Sodium-glucose linked transporter inhibitors (SGLT2i). However with co-initiation of SGLT2i and GLP-1RA in the DURATION 8 trial an improvement in HbA1c was noted but the beneficial effect was not equal to the sum of its parts. In view of this we proceeded to test the hypothesis that sequential addition of GLP-1RA therapy to metformin and SGLT-2i may be more beneficial...
2018: Clinical Diabetes and Endocrinology
M H Cummings, D Cao, I Hadjiyianni, L L Ilag, M H Tan
Background: To identify baseline/clinical characteristics associated with clinically meaningful responses to insulin glargine 100 U/mL (IGlar) in insulin-naive people with type 2 diabetes mellitus (T2DM). Methods: Individual participant data were pooled from 3 randomized trials to compare baseline characteristics and clinical outcomes associated with 24-week response to IGlar in combination with non-insulin antihyperglycemic agents in participants with T2DM. Responders were defined as achieving endpoint HbA1c target < 53 mmol/mol (< 7%) and/or ≥ 11 mmol/mol (≥ 1%) HbA1c reduction from baseline...
2018: Clinical Diabetes and Endocrinology
Rodrigo J Valderrábano, Maria I Linares
Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice...
2018: Clinical Diabetes and Endocrinology
I Hodish
Insulin replacement therapy is mostly used by patients with type 2 diabetes who become insulin deficient and have failed other therapeutic options. They comprise about a quarter of those with diabetes, endures the majority of the complications and consumes the majority of the resources. Adequate insulin replacement therapy can prevent complications and reduce expenses, as long as therapy goals are achieved and maintained. Sadly, these therapy goals are seldom achieved and outcomes have not improved for decades despite advances in pharmacotherapy and technology...
2018: Clinical Diabetes and Endocrinology
Pearl G Lee, Jinkyung Ha, Caroline S Blaum, Kimberlee Gretebeck, Neil B Alexander
Background: The Community Healthy Activities Model Program for Seniors (CHAMPS) survey, summarized into weekly caloric expenditures, is a common physical activity (PA) assessment tool among older adults. Specific types of PA reported in the CHAMPS have not been systematically analyzed. We applied latent class analysis to identify the patterns of PA among sedentary older adults with diabetes reported in the CHAMPS survey. Methods: Latent class models of PA were identified using the CHAMPS survey data reported by 115 individuals aged ≥60 years with type 2 diabetes whom volunteered for a clinical study of PA...
2018: Clinical Diabetes and Endocrinology
Melis Sahinoz, Shafaq Khairi, Ashley Cuttitta, Graham F Brady, Amit Rupani, Rasimcan Meral, Marwan K Tayeh, Peedikayil Thomas, Meredith Riebschleger, Sandra Camelo-Piragua, Jeffrey W Innis, M Bishr Omary, Daniel E Michele, Elif A Oral
Background: Juvenile dermatomyositis (JDM) is an auto-immune muscle disease which presents with skin manifestations and muscle weakness. At least 10% of the patients with JDM present with acquired lipodystrophy. Laminopathies are caused by mutations in the lamin genes and cover a wide spectrum of diseases including muscular dystrophies and lipodystrophy. The p.T10I LMNA variant is associated with a phenotype of generalized lipodystrophy that has also been called atypical progeroid syndrome...
2018: Clinical Diabetes and Endocrinology
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