The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 4 16a
Copyright © 2005 by The Endocrine Society
Endocrinology & Metabolism News April 2005
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Endocrine Discovery
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In 28 women with treated hypothyroidism, addition of a daily 5 µg T3 dose with a 25 µg per day reduction in T4 in a blinded crossover trial produced no change in quality-of-life and psychometric tests, but more than one half of patients still preferred combination treatment, which suppressed TSH to the low range in 10 patients.
(Ann Int Med [March 15] 2005;142:412–424)[Abstract/Free Full Text]
Lifestyle and metformin delayed development of type 2 diabetes by 11 and 3 years, respectively, and reduced the incidence of diabetes by 20% and 8%, respectively, compared with a placebo intervention. Survival was improved by 0.5 and 0.2 years. The cost was much less for lifestyle than metformin intervention, $1,100 versus $31,300 per quality-adjusted life-year.
(Ann Int Med [Mar. 1, 2005] 142:323)[Abstract/Free Full Text]
Lactic acidosis did not occur in more than 7,000 metformin-treated diabetes patients who were prospectively followed for 12 months in the Comparative Outcomes Study of Metformin Intervention Versus Conventional (COSMIC) Approach Study.
(Diabetes Care [Mar. 2005] 28:539)[Abstract/Free Full Text]
Diet for overweight and increased exercise decreased development of diabetes in nonsmokers, but not smokers (hazard ratios 0.82; CI, 0.68 to 0.98, and 1.26; CI, 1.10 to 1.45, respectively) among 11,827 men who initially had no diabetes or impaired glucose tolerance. Weight gain after smoking cessation may have limited the impact of lifestyle interventions.
(Ann Int Med [Mar. 1, 2005] 142:313)[Abstract/Free Full Text]
In 10 obese patients with type 2 diabetes, a low-carbohydrate diet for 2 weeks caused a spontaneous reduction in caloric intake, which accounted entirely for the weight loss observed. Patients showed improved insulin sensitivity, and lower 24-hour blood glucose profiles, hemoglobin A1c, triglyceride, and cholesterol levels. Long-term benefits of the diet are, however, unclear.
(Ann Int Med [March 15] 2005;142:403)[Abstract/Free Full Text]
A Cochrane Review of 22 trials of pharmacotherapy for weight loss in patients with type 2 diabetes found fluoxetine, orlistat, and sibutramine can achieve weight loss over 12 to 57 weeks, but the magnitude of weight loss is modest and long-term health benefits are uncertain. (http://www.cochrane.org/cochrane/revabstr/ab004096.htm)
Acromegaly is associated with greater large bowel length and loop complexity, making colonoscopy technically challenging, and increasing potential risk of complications.
(Clin Endocrinol [Mar. 2005] 62:323)[CrossRef][Medline]
Menopausal hormone therapy increased the incidence of new urinary incontinence in the Women’s Health Initiative study.
(JAMA [Feb. 23, 2005] 293:935)[Abstract/Free Full Text]
Celiac disease was present in 5% of patients with hyperthyroid Graves disease compared with 1% of euthyroid controls.
(Clin Endocrinol [Mar. 2005] 62:303)[CrossRef][Medline]
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Endocrine Practice
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An assessment of diabetes care quality at 30 U.S. academic medical centers found annual testing rates for HbA1c, blood pressure, and cholesterol were high (97%, 97%, and 88%, respectively); but many fewer patients met therapeutic goals for these measures (34%, 33%, and 65%, respectively) or had their treatment regimes altered to achieve them (40%, 10%, and 6%, respectively).
(Diabetes Care 28:337–442, 2005)[Abstract/Free Full Text]
ADA will not endorse new EPA guidelines for safe community needle disposal because of its inconvenience and cost. (For more information, see: www.epa.gov/epaoswer/other/medical/sharps.htm. To learn about your state’s laws relating to syringe disposal, see: www.cdc.gov/needledisposal/. To find out about disposal options in your area, contact the Coalition for Safe Community Needle Disposal at 1-800-643-1643 or www.safeneedledisposal.org/dispcenters.php.)
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Endocrine Policy
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NIH is requesting that investigators submit electronic versions of publications arising from NIH-funded research to the National Library of Medicine, beginning May 2, 2005. This new public access policy applies to all NIH grants, agreements, contracts, and awards. (For additional information, see http://grants.nih.gov/grants/guide/notice-files/NOT-OD-05–022.html.)
A Genetics and Public Policy Center survey found that two thirds of Americans support the use of genetic testing to avoid having a child with a life-threatening disease, or to test embryos to determine whether they would be a good match to provide cells for a sick sibling; but most believe it would be wrong to use genetic testing to select the gender or other non-health-related genetic characteristics of a child. (For more information, see http://www.dnapolicy.org.)
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Endocrine Education & Training
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APDEM encourages all endocrinology fellowship programs to register with the Electronic Residency Application System (ERAS) before the April 30, 2005 deadline. Fellowship candidates for July 2007 will use the ERAS system, beginning next autumn. To register, visit the ERAS website at www.aamc.org/eras.
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Milestones in Endocrinology
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Fifty years ago, Zollinger and Ellison reported "Primary peptic ulceration of the jejunum associated with islet-cell tumors.
(Ann Surg 1955;142:709)[Medline]
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In the Journal 50 Years Ago
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Conversion of thyroxine to 3-5’3’ triiodothyronine in vivo. Rosalind Pitt-Rivers, John B. Stanbury, and Betty Rapp.
J Clin Endocrinol Metab 1955;15:616–620
. "It appears, therefore, that the thyroid gland is not essential for the formation of triiodothyronine, and that some other organ is able to perform a partial deiodination of thyroxine".
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In the Journal 25 Years Ago
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Induction of immunoreactive somatomedin C in human serum by growth hormone. Kenneth C. Copeland, Louis E. Underwood, Judson J. Van Wyk.
J Clin Endocrinol Metab 1980;50:690–697.[Abstract/Free Full Text]
"After a typical im dose of hGH, SM-C was found to rise in hypopituitary patients on chronic therapy after an 8-h-delay. Between 16–28 h, SM-C reached the normal adult range and, by 48 h, had nearly returned to basal levels."
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Footnotes
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Readers are encouraged to suggest items for Endocrinology and Metabolism News by email (sherman{at}endo-society.org). Submissions will be considered based on their significance and timeliness.
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