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Clinical Medicine Insights. Endocrinology and Diabetes

Alex Dombrowsky, Benjamin Borg, Rongbing Xie, James K Kirklin, Herbert Chen, Courtney J Balentine
Introduction: Hyperparathyroidism significantly decreases quality of life, yet elderly patients are underdiagnosed and undertreated even though parathyroidectomy offers definitive cure with minimal morbidity. The purpose of this study is to determine why older patients with hyperparathyroidism are not appropriately diagnosed and referred for parathyroidectomy. Methods: We reviewed charts for a random sample of 25 patients aged 75 and older who had hyperparathyroidism and were referred for surgical evaluation, and 25 who were not referred...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Samreen Siddiqui, Swati Waghdhare, Sundaramoorthy Gopi, Amit Bhargava, Manju Panda, Venkatesan Radha, Viswanathan Mohan, Shweta Dubey, Sujeet Jha
Background: GCK gene variants have been reported to be associated with gestational diabetes mellitus (GDM) in the Caucasian population. There are no reports exploring this association in the Indian population. Methods: This cross-sectional study included subjects from Max Super Speciality Hospital, New Delhi, India, over a span of 6 months. Females diagnosed with GDM as per the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria were enrolled...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Ayman A Al Hayek, Asirvatham A Robert, Mohamed A Al Dawish
Background: To identify the skin-related complications in adolescents with type 1 diabetes (T1D) using the insulin pump therapy (IPT). Methods: A total of 64 T1D adolescents (between ages 13 and 19) using the insulin pump were included in this cross-sectional study. They had visited the Diabetes Clinic at Diabetes Treatment Center, Prince Sultan Military Medical City, Saudi Arabia, for treatment from January 2018 to March 2018. Data on the prior and present skin-related complications, for a 6-month interval, were gathered via a closed/structured questionnaire...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Constantine E Kosmas, Delia Silverio, Christiana Tsomidou, Maria D Salcedo, Peter D Montan, Eliscer Guzman
There is extensive evidence showing that insulin resistance (IR) is associated with chronic low-grade inflammation. Furthermore, IR has been shown to increase the risk for cardiovascular disease (CVD), even in nondiabetic patients, and is currently considered as a "nontraditional" risk factor contributing to CVD by promoting hypertension, oxidative stress, endothelial dysfunction, dyslipidemia, and type 2 diabetes mellitus. However, chronic kidney disease (CKD) is also considered a state of low-grade inflammation...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Jennifer D Goldman
Type 2 diabetes mellitus (T2DM) is characterized by multiple metabolic abnormalities and current approaches to treatment involve a stepwise approach, frequently involving the use of combination therapy. The addition of the sodium-glucose cotransporter-2 (SGLT2) inhibitor, empagliflozin, to metformin therapy has been shown to be effective and well tolerated in patients with T2DM and is 1 of the several recommended treatment options. The publication of the EMPA-REG OUTCOME study, which showed that empagliflozin is associated with cardiovascular (CV) and renal benefits, has resulted in changes in treatment guidelines for T2DM...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Alexandria D McDow, Rebecca S Sippel
Asymptomatic primary hyperparathyroidism is a very common endocrine condition, yet management of this disease process remains controversial. Primary hyperparathyroidism can lead to a myriad of symptoms which not only decreases the quality of life of patients but also increases the risk of cardiovascular disease, osteoporosis, and kidney stones. Parathyroidectomy is the only known cure for the disease. This review explores the definition of asymptomatic primary hyperparathyroidism, the burden of disease, and the overwhelming benefits of parathyroidectomy...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Ishmael Kyei
Background: Graves disease (GD) has increased in prevalence over the past decade in Africa. Despite this, the condition is not well described, especially in sub-Saharan Africa. Objective: We have described the clinical characteristics and associated factors of GD in a cohort of patients attending a resource-limited setting tertiary hospital. Methods: Patients were examined thoroughly and systematically tested for the degree of clinical and biochemical thyroid status...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Souha S Elabd, Maswood M Ahmad, Sameer Q Qetab, Mussa Hussain Almalki
Cerebrospinal fluid (CSF) rhinorrhea is rarely reported as the first presenting feature of giant invasive macroprolactinomas. Cerebrospinal fluid rhinorrhea is usually reported as a complication of trauma, neurosurgical, and skull-based procedures (such as pituitary surgery or radiations), and less frequently after medical treatment with dopamine agonists (DAs) for macroprolactinomas. This phenomenon results from fistula creation that communicates between the subarachnoid space and the nasal cavity. Meanwhile, pneumocephalus is another well-recognized complication after transsphenoidal surgery for pituitary macroadenomas...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Mussa Hussain Almalki, Ibtihal Hussen, Shawana A Khan, Abdulrahman Almaghamsi, Fahad Alshahrani
Background: During Ramadan, Muslims fast from dawn until dusk for one lunar month every year. Most of the Muslim patients with diabetes are unaware of the potential complications that can occur while fasting, such as hypoglycemia. The aim of this study is to assess the the patient education level and patients' overall awareness of any possible complications that could occur while fasting during Ramadan and to determine how these patients deal with these complications. Methods: We conducted a cross-sectional study and surveyed diabetic patients about their diabetes-related knowledge over a period of 4 months from the outpatient clinic at the Obesity, Endocrine, and Metabolism Center at King Fahad Medical City...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Abdallah Ahmed Gunaid
Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR) and/or diabetic macular edema (maculopathy) (DME) and overt diabetic nephropathy (macroalbuminuria) were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Jill Layton, Xiaochen Li, Changyu Shen, Mary de Groot, Leslie Lange, Adolfo Correa, Jennifer Wessel
The relationship between genetic risk variants associated with glucose homeostasis and type 2 diabetes risk has yet to be fully explored in African American populations. We pooled data from 4 prospective studies including 4622 African Americans to assess whether β-cell dysfunction (BCD) and/or insulin resistance (IR) genetic variants were associated with increased type 2 diabetes risk. The BCD genetic risk score (GRS) and combined BCD/IR GRS were significantly associated with increased type 2 diabetes risk...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Ayman A Al Hayek, Asirvatham A Robert, Mohamed A Al Dawish
Background/objectives: In the current era of modern technology and the development of smart devices such as the flash glucose monitoring (FGM) systems, patients can easily monitor their glucose levels more frequently without any inconvenience. In this study, we evaluate the effect of FreeStyle Libre FGM system on glycemic control, hypoglycemia, health-related quality of life (QoL), and the fear of hypoglycemia (FOH) among children and young people with type 1 diabetes (T1D). Design and methods: A prospective study was conducted at the Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between January 2017 and May 2017 on 47 (aged 13-19 years) registered patients with T1D who used conventional finger-pricking method for self-testing the glucose...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Roberto Negro, Eupremio Luigi Greco, Giacomo Greco
Background: It is postulated that the ability of dipeptidyl peptidase-4 inhibitors (DPP-4-i) to increase circulating endothelial progenitor cells (EPCs) may be at least partly mediated by active stromal cell-derived factor 1α (SDF-1α) (a pivotal mediator of stem cell mobilization from the bone marrow). As other DPP-4-i were demonstrated to increase EPC concentrations, in this study, we sought to investigate the ability of the DPP-4-i alogliptin in modifying EPCs and SDF-1α, in patients with good and poor diabetes control...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Luca Foppiani, Serena Panarello, Marco Filauro, Maria Concetta Scirocco, Stefano Cappato, Andrea Parodi, Simona Sola, Giancarlo Antonucci
A hypertensive man with chronic kidney disease (CKD) secondary to polycystic disease was hospitalized for symptoms related to hypoglycemia. Fasting test elicited symptomatic hypoglycemia after 12 hours, which was associated with inappropriately unsuppressed normal insulin and C-peptide levels. Neither ultrasonography (US) nor magnetic resonance imaging detected any pancreatic tumor. Endoscopic ultrasonography (EUS) showed a small isoechogenic nodule suspect for neuroendocrine tumor in the pancreatic head...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
(no author information available yet)
[This corrects the article DOI: 10.1177/1179551417710209.].
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Mukta Wyawahare, Revathy Neelamegam, Saranya Vilvanathan, R Soundravally, A K Das, C Adithan
BACKGROUND: Genetic polymorphisms of the angiotensin-renin pathway have been thought to influence the development of diabetic nephropathy. However, there are conflicting results regarding this association in previous studies on populations with varying ethnicity. AIMS: Primary aim was to compare the frequency of distribution of angiotensin-converting enzyme (ACE) gene (insertion/deletion [I/D]) polymorphism in Tamilian Indian type 2 diabetic individuals with and without microalbuminuria...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Maria M Pineyro, Jimena Pereda, Pamela Schou, Karina de Los Santos, Soledad de la Peña, Benedicta Caserta, Raul Pisabarro
Mature cystic teratoma is the most common kind of ovarian germ cell tumor. Malignant transformation is uncommon, with thyroid cancer rarely found. Papillary thyroid microcarcinoma has rarely been described as associated with ovarian teratomas. We report a case of a 34-year-old woman who presented with abdominal pain and an ovarian mass. After surgery, the patient was diagnosed with a follicular variant papillary thyroid microcarcinoma that arose within a mature cystic ovarian teratoma. Based on the small size of the primary lesion and patient preferences, no further treatment was performed...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Ayman Abdullah Al Hayek, Asirvatham Alwin Robert, Ghazi Alshammari, Husain Hakami, Mohamed Abdulaziz Al Dawish
BACKGROUND/OBJECTIVES: A high incidence of hypogonadism in men with type 2 diabetes (T2D) has been globally reported. This study aimed to determining the frequency of hypogonadism and related risk factors among men with T2D in a single-site hospital in Saudi Arabia. DESIGN AND METHODS: A cross-sectional study was performed on 157 men with T2D (between 30 and 70 years of age). Using a prestructured questionnaire, the demographic features of these patients were gathered and their medical records were referred to gather information regarding the duration of the diabetes, smoking habits, and the presence of retinopathy, neuropathy, and nephropathy...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Chutintorn Sriphrapradang, Kitjapong Choopun, Atchara Tunteeratum, Thanyachai Sura
Mutations in the VHL, RET, SDHB, and SDHD genes are responsible for von Hippel-Lindau (VHL) disease, multiple endocrine neoplasia type 2 (MEN2), and familial paraganglioma, respectively. However, genotype-phenotype correlation data are lacking in Southeast Asia. A retrospective medical chart review was performed on patients referred to the genetics service. We found 35 patients diagnosed with clinical syndromes (16 VHL, 9 MEN2, 9 paragangliomas, and 1 neurofibromatosis type 1). In patients with VHL, 5 known VHL mutations were identified: p...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
Maswood M Ahmad, Mohammed Almohaya, Mussa H Almalki, Naji Aljohani
Parathyroid cyst (PC) is a very rare condition. A case of intrathyroidal PC is being reported here in a 53-year-old woman who presented to the endocrine clinic with slowly progressive painless left anterior neck swelling for 1 year with no symptoms of thyroid or parathyroid dysfunction and no compressive symptoms. Ultrasound of the thyroid showed a well-defined cystic lesion measuring 4.7 × 3.6 cm in maximum diameter with internal echoes within the cyst located in the left lobe of the thyroid gland. Fine needle aspiration revealed colorless clear fluid with a high concentration of parathyroid hormone...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
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