2016 Endocrine Society Guidelines: CENTRAL Adrenal Insufficiency

Adrenal Insufficiency (AI) is defined by low cortisol production.  It could be due to failure, infection, injury, bleeding or inflammation of the adrenal glands, or from limited production of ACTH hormone by the pituitary.  

Adrenal Insufficiency as a result of low ACTH is called “central” or “secondary”. These guidelines were developed by Endocrine Society to address specifically Central AI. They were released in November 2016.

Please find below excerpts with slightly modified wording for easier and succinct reading.

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Diabetes drug, risk of pancreatitis and pancreatic cancer

Initial analysis of TECOS trial showed that Januvia/Sitagliptin does not increase the risk of cardiovascular disease, heart failure and death from any cause. 

Further investigation, just published in Diabetes Care reveals that Januvia has slight tendency to protect from pancreatic cancer but cause more pancreatitis, although these contributions were not statistically convincing. Important to be aware that baseline pancreatic cancer or pancreatitis are rare and multifactorial. 

About 15,000 patients with type 2 diabetes and cardiovascular disease were randomized to receive Sitagliptin or placebo for 3 years.

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2017 ATA Guidelines: Thyroid & Pregnancy (part 1)

ATA has “developed evidence-based recommendations to inform clinical decision making in the management of thyroid disease in pregnant and postpartum women. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with these disorders”

Part 1 of recommendations are listed with slightly modified wording for easier and succinct reading:

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NASH can raise risk of colorectal cancer

Non-alcoholic fatty liver disease, NAFLD or NASH is a manifestation of advanced obesity. It can lead to liver inflammation, cirrhosis and even malignancy. This association study suggests it can also increase the risk of colorectal cancer. The bigger the severity of liver disease, the higher the chance of colorectal carcinoma. A group of 26,000 asymptomatic patients were analyzed.

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Obesity 2017

A great review article on the current state of obesity. Increased adiposity or high BMI is a cause or great contributor to multiple of conditions; such as metabolic syndrome, insulin resistance, diabetes, hypertension, high cholesterol, osteoarthritis, impaired renal function, kidney stones, gout and even cancer.