Endocrinology, Diabetes, and Metabolism Commons^™

The Cardioprotective Effects Of Adiponectin In Diabetes., Tara Kazemi, Yuanjie Mao, Tina Zhang

Ambulatory and Primary Care Articles

PURPOSE OF REVIEW: Adiponectin, a hormone secreted by adipocytes, plays a crucial role in maintaining metabolic balance and supporting cardiovascular health. Although it is known for its protective effects, such as improving insulin sensitivity, reducing inflammation, and maintaining endothelial function, there are paradoxical associations between high adiponectin levels and increased cardiovascular mortality-referred to as the "adiponectin paradox"-which complicates its clinical interpretation. This review explores the cardioprotective effects of adiponectin in both type 1 and type 2 diabetes, focusing on its potential to regulate glucose metabolism and prevent cardiovascular complications.

RECENT FINDINGS: By reviewing key studies, the article evaluates adiponectin's diverse …

Metabolic Dysfunction-Associated Steatotic Liver Disease In People With Type 1 Diabetes., Brynlee Vermillion, Yuanjie Mao

Ambulatory and Primary Care Articles

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a significant comorbidity in individuals with type 1 diabetes (T1D), despite its historical association with type 2 diabetes. This review focuses on summarizing current findings regarding the role of insulin resistance in the development of MASLD in T1D, as well as examining the relationship between MASLD and diabetes-related complications. We will also briefly discuss the prevalence, diagnostic challenges, associated complications, and potential mechanisms underlying MASLD in T1D. Although insulin resistance is well established in MASLD among those with type 2 diabetes, its role in T1D requires further clarification. Emerging markers, …

Subclinical Hyperthyroidism Presenting As Urinary Frequency And Polyuria: A Case Report., Hameed H Salah, Elizabeth M Pines

Ambulatory and Primary Care Articles

Hyperthyroidism may present with a variety of symptoms including urinary frequency. This report discusses a case of subclinical hyperthyroidism presenting as generalized weakness, urinary frequency, polyuria, and intermittent diarrhea. However, this elderly patient had a complex past medical history including multinodular nontoxic thyroid goiter with tracheal deviation and multiple recent admissions for aspiration pneumonia, making the diagnosis of subclinical hyperthyroidism less obvious. The patient was managed with intravenous fluids and discharged on propranolol with recommendations to follow-up with endocrinology. This case demonstrates the importance of keeping hyperthyroidism on the differential for urinary frequency and polyuria without other clear etiologies.

Obesity, Metabolic Health, And Diabetic Complications In People With Type 1 Diabetes., Yuanjie Mao, Jen-Tzer Gau, Ning Jiang

Ambulatory and Primary Care Articles

AIM: The concept of metabolically healthy obesity (MHO) has not been studied in type 1 diabetes (T1D). By analysing datasets from the DCCT/EDIC study, we compared the development of diabetic complications by obesity and metabolic health over 30 years of follow up.

MATERIALS AND METHODS: Insulin resistance was calculated by estimated glucose disposal rate (eGDR). The participants (n = 1127) were then divided into four groups based on time-weighted mean body mass index and mean eGDR: metabolically healthy non-obesity (MHN, n = 874), metabolically unhealthy non-obesity (MUN, n = 66), MHO (n = 146) and metabolically unhealthy obesity (MUO, n …

Levothyroxine-Associated Thyrotoxicosis And Hyperbilirubinemia On Preoperative Screening Evaluation., Carly J Suriano, Ian P Erkkila, Thomas M Vara

Surgery Articles

BACKGROUND: Levothyroxine is a commonly prescribed medication for treatment of hypothyroidism in the United States. This drug is titrated based on weight and serial laboratory evaluation and is often very well tolerated with few adverse effects. Levothyroxine-associated liver injury and cholestatic disease are regarded as rare phenomena. We report an additional case of levothyroxine-associated hepatic dysfunction with resolution upon decreased dosage and continued tolerance of the medication.

CASE PRESENTATION: We report a case of a 60-year-old male presenting for preoperative clearance for umbilical hernia repair with previous history of thyroidectomy for multinodular goiter. Laboratory work-up suggested thyrotoxicosis-associated hepatic dysfunction secondary …

Sleep Architecture Changes In Diabetes., Yuanjie Mao

Ambulatory and Primary Care Articles

Data on the relationship between sleep architecture and diabetes are limited. However, some evidence suggests that slow-wave sleep (SWS) plays a crucial role in maintaining normal glucose homeostasis and influences insulin secretion capacity. Diabetes is often associated with reduced SWS, even in the absence of sleep-disordered breathing. Notably, selective suppression of SWS-without reducing total sleep time-can lead to significant increases in insulin resistance, decreased glucose tolerance, and a higher risk of diabetes. Given the growing interest in non-pharmacological lifestyle interventions, such as modifying sleep architecture, it is important to understand how sleep patterns differ in individuals with diabetes and whether …

A Systematic Guideline By The Aspn Workgroup On The Evidence, Education, And Treatment Algorithm For Painful Diabetic Neuropathy: Sweet., Dawood Sayed, Timothy Ray Deer, Jonathan M Hagedorn, Asim Sayed, Ryan S D'Souza, Christopher M Lam, Nasir Khatri, Zohra Hussaini, Scott G Pritzlaff, Newaj Mohammad Abdullah, Vinicius Tieppo Francio, Steven Michael Falowski, Yussr M Ibrahim, Mark N Malinowski, Ryan R Budwany, Natalie Holmes Strand, Kamil M Sochacki, Anuj Shah, Tyler M Dunn, Morad Nasseri, David W Lee, Leonardo Kapural, Marshall David Bedder, Erika A Petersen, Kasra Amirdelfan, Michael E Schatman, Jay Samuel Grider

Neuroscience Articles

INTRODUCTION: Painful diabetic neuropathy (PDN) is a leading cause of pain and disability globally with a lack of consensus on the appropriate treatment of those suffering from this condition. Recent advancements in both pharmacotherapy and interventional approaches have broadened the treatment options for PDN. There exists a need for a comprehensive guideline for the safe and effective treatment of patients suffering from PDN.

OBJECTIVE: The SWEET Guideline was developed to provide clinicians with the most comprehensive guideline for the safe and appropriate treatment of patients suffering from PDN.

METHODS: The American Society of Pain and Neuroscience (ASPN) identified an educational …

A Phase Ii Study Of Bevacizumab And Temsirolimus In Advanced Extra-Pancreatic Neuroendocrine Tumors., Sonia M Abuzakhm, Vineeth Sukrithan, Briant Fruth, Rui Qin, Jonathan Strosberg, Timothy J Hobday, Thomas Semrad, Diane Reidy-Lagunes, Hedy Lee Kindler, George P Kim, Jennifer J Knox, Andreas Kaubisch, Miguel Villalona-Calero, Helen Chen, Charles Erlichman, Manisha H Shah

Oncology Articles

We assessed the efficacy and safety of combining bevacizumab with temsirolimus in patients with advanced extra-pancreatic neuroendocrine tumors. This NCI-sponsored multicenter, open-label, phase II study (NCT01010126) enrolled patients with advanced, recurrent, or metastatic extra-pancreatic neuroendocrine tumors. All patients were treated with temsirolimus and bevacizumab until disease progression or unacceptable toxicity. Temsirolimus 25 mg was administered i.v. on days 1, 8, 15, and 22 and bevacizumab 10 mg/kg i.v. on days 1 and 15 of a 4-week cycle. Discontinuation of temsirolimus or bevacizumab did not require discontinuation of the other agent. The primary endpoints were objective response rate and 6-month progression-free …

Diabetic Ketoacidosis Diagnosis In A Hospital Setting., Amber M Healy, Mallory Faherty, Zeryab Khan, Naveen Emara, Cody Carter, Andrew Scheidemantel, Musa Abu-Jubara, Robert Young

OhioHealth Research Institute Articles

CONTEXT: Diabetic ketoacidosis (DKA) is an endocrine emergency that can occur in people with diabetes. Its incidence is estimated to be 220,340 hospital admissions each year. Treatment algorithms include fluid resuscitation, intravenous (IV) insulin infusion, and scheduled electrolyte and glucose monitoring. The misdiagnosis of DKA in the setting of hyperglycemic emergencies results in overtreatment and unnecessary increases in healthcare utilization and costs.

OBJECTIVES: The aims of this study were to determine how often DKA is overdiagnosed in the context of other acute hyperglycemic emergencies, to describe the baseline characteristics of patients, to determine the hospital treatments for DKA, and to …

Nursing Perspectives On The Use Of Continuous Glucose Monitoring In The Intensive Care Unit., Eileen R Faulds, Kathleen M Dungan, Molly Mcnett, Laureen Jones, Norma Poindexter, Matthew Exline, Jillian Pattison, Francisco J Pasquel

Nursing Articles

BACKGROUND: The COVID-19 pandemic necessitated rapid implementation of continuous glucose monitoring (CGM) in the intensive care unit (ICU). Although rarely reported, perceptions from nursing staff who used the systems are critical for successful implementation and future expanded use of CGM in the inpatient setting.

METHODS: A 22-item survey focused on CGM use was distributed to ICU nurses at two large academic medical centers in the United States in 2022. Both institutions initiated inpatient CGM in the spring of 2020 using the same CGM+point of care (POC) hybrid protocol. The survey employed a 1- to 5-point Likert scale regarding CGM sensor …

Cardiovascular/Stroke Risk Stratification In Diabetic Foot Infection Patients Using Deep Learning-Based Artificial Intelligence: An Investigative Study., Narendra N Khanna, Mahesh A Maindarkar, Vijay Viswanathan, Anudeep Puvvula, Sudip Paul, Mrinalini Bhagawati, Puneet Ahluwalia, Zoltan Ruzsa, Aditya Sharma, Raghu Kolluri, Padukone R Krishnan, Inder M Singh, John R Laird, Mostafa Fatemi, Azra Alizad, Surinder K Dhanjil, Luca Saba, Antonella Balestrieri, Gavino Faa, Kosmas I Paraskevas, Durga Prasanna Misra, Vikas Agarwal, Aman Sharma, Jagjit S Teji, Mustafa Al-Maini, Andrew Nicolaides, Vijay Rathore, Subbaram Naidu, Kiera Liblik, Amer M Johri, Monika Turk, David W Sobel, Martin Miner, Klaudija Viskovic, George Tsoulfas, Athanasios D Protogerou, Sophie Mavrogeni, George D Kitas, Mostafa M Fouda, Mannudeep K Kalra, Jasjit S Suri

Heart and Vascular Articles

A diabetic foot infection (DFI) is among the most serious, incurable, and costly to treat conditions. The presence of a DFI renders machine learning (ML) systems extremely nonlinear, posing difficulties in CVD/stroke risk stratification. In addition, there is a limited number of well-explained ML paradigms due to comorbidity, sample size limits, and weak scientific and clinical validation methodologies. Deep neural networks (DNN) are potent machines for learning that generalize nonlinear situations. The objective of this article is to propose a novel investigation of deep learning (DL) solutions for predicting CVD/stroke risk in DFI patients. The Preferred Reporting Items for Systematic …

Cardiovascular Risk Stratification In Diabetic Retinopathy Via Atherosclerotic Pathway In Covid-19/Non-Covid-19 Frameworks Using Artificial Intelligence Paradigm: A Narrative Review., Smiksha Munjral, Mahesh Maindarkar, Puneet Ahluwalia, Anudeep Puvvula, Ankush Jamthikar, Tanay Jujaray, Neha Suri, Sudip Paul, Rajesh Pathak, Luca Saba, Renoh Johnson Chalakkal, Suneet Gupta, Gavino Faa, Inder M Singh, Paramjit S Chadha, Monika Turk, Amer M Johri, Narendra N Khanna, Klaudija Viskovic, Sophie Mavrogeni, John R Laird, Gyan Pareek, Martin Miner, David W Sobel, Antonella Balestrieri, Petros P Sfikakis, George Tsoulfas, Athanasios Protogerou, Durga Prasanna Misra, Vikas Agarwal, George D Kitas, Raghu Kolluri, Jagjit Teji, Mustafa Al-Maini, Surinder K Dhanjil, Meyypan Sockalingam, Ajit Saxena, Aditya Sharma, Vijay Rathore, Mostafa Fatemi, Azra Alizad, Vijay Viswanathan, Padukode R Krishnan, Tomaz Omerzu, Subbaram Naidu, Andrew Nicolaides, Mostafa M Fouda, Jasjit S Suri

Heart and Vascular Articles

Diabetes is one of the main causes of the rising cases of blindness in adults. This microvascular complication of diabetes is termed diabetic retinopathy (DR) and is associated with an expanding risk of cardiovascular events in diabetes patients. DR, in its various forms, is seen to be a powerful indicator of atherosclerosis. Further, the macrovascular complication of diabetes leads to coronary artery disease (CAD). Thus, the timely identification of cardiovascular disease (CVD) complications in DR patients is of utmost importance. Since CAD risk assessment is expensive for low-income countries, it is important to look for surrogate biomarkers for risk stratification …

The Cardiovascular Outcomes, Heart Failure And Kidney Disease Trials Tell That The Time To Use Sodium Glucose Cotransporter 2 Inhibitors Is Now., Michael E Johansen, Christos Argyropoulos

Heart and Vascular Articles

Sodium glucose contrasporter 2 inhibitors (SGLT2i) were initially introduced as a novel class of modestly effective antiglycemics. Over the last 5 years, multiple members of this class have been examined for their cardiovascular safety, effects on heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD) in diverse populations with or without diabetes type 2. The plethora of studies and outcomes examined make it difficult for the practitioner to track the entirety of the evidence. SGLT2i improve cardiorenal outcomes and have a beneficial risk benefit ratio across populations with cardiovascular disease, HFrEF and kidney disease. In this quantitative …

Hnf1Β Diabetes Or Maturity-Onset Diabetes Of The Young Type 5 With Rare Hnf1Β Mutation: A Case Report., Autumn L Haynes, Amber M Healy

Ambulatory and Primary Care Articles

No abstract provided.

Endocrinologists' Opinions Of Diabetology As A Primary Care Subspecialty., Amber M Healy, Jay H Shubrook, Frank L Schwartz, Doyle M Cummings, Almond J Drake, Robert J Tanenberg

Ambulatory and Primary Care Articles

IN BRIEF This study was conducted to ascertain the opinions of endocrinologists about diabetes care as it relates to the health care provider workforce. A survey was administered to endocrinologists in the Planning Research in Inpatient Diabetes and Planning Research in Outpatient Diabetes (PRIDE/PROUD) group and given to attendees of the American Diabetes Association (ADA) Scientific Sessions special interest group whose focus was primary care. The majority of respondents agreed that there is a need for more providers to be trained to take care of patients with diabetes and that more trained providers are needed, and almost half agreed that …

Cutaneous Manifestations Of Diabetes Mellitus., Michelle Duff, Olga Demidova, Stephanie Blackburn, Jay Shubrook

Ambulatory and Primary Care Articles

No abstract provided.