693 results match your criteria: "Center for Endocrinology Diabetes Arthritis & Rheumatism CEDAR Superspeciality Healthcare[Affiliation]"

Importance: Chronic kidney disease (CKD) is an often-asymptomatic complication of type 2 diabetes (T2D) that requires annual screening to diagnose. Patient-level factors linked to inadequate screening and treatment can inform implementation strategies to facilitate guideline-recommended CKD care.

Objective: To identify risk factors for nonconcordance with guideline-recommended CKD screening and treatment in patients with T2D.

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Article Synopsis
  • Diabetes complications, like retinopathy and neuropathy, occur more frequently in individuals of African ancestry, partly due to G6PD deficiency which is associated with malaria resistance and lowers HbA1c levels by affecting red blood cell lifespan.
  • A study discovered a specific variant (rs1050828-T) linked to G6PD deficiency that increases the risk of diabetes complications, showing that glucose levels influence retinopathy risk significantly.
  • The findings suggest that adjusting diabetes management based on glucose levels or genetic factors could improve diagnosis and treatment, potentially reducing complications for those with G6PD deficiency.
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Knowledge, Attitudes, and Practices about Hyperuricemia and Gout in Community Health Workers and Patients with Diabetes.

Healthcare (Basel)

May 2024

Department of Endocrinology & Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Article Synopsis
  • - The study investigated the knowledge and attitudes about hyperuricemia and gout among community health workers and diabetic patients in Chenghua District, Chengdu, between August 2021 and January 2022, using two questionnaires.
  • - Results indicated that community health workers had a moderate level of knowledge (average score of 17.74/30) while about half of general practitioners were unaware of key facts, such as target serum uric acid levels and treatment for gout.
  • - Among diabetic patients, only 32.3% were aware of hyperuricemia and 60.8% about gout, with many misconceptions, including the belief that hyperuricemia always leads to gout (87.8%) and that
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Objective: Data are scant on the impact of metformin use in gestational diabetes mellitus/diabetes in pregnancy on long-term outcomes in children and mothers beyond 5 years of childbirth. This systematic review and meta-analysis aimed to evaluate the long-term impact of metformin use in pregnancy on children and their mothers.

Methods: Electronic databases were searched for studies evaluating metformin compared with insulin for managing gestational diabetes mellitus/diabetes in pregnancy.

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Introduction: We aimed to investigate the association between the onset of type 2 diabetes (T2D) and dementia incidence rates (IR) in the population with impaired glucose tolerance (IGT) identified in primary care in New Zealand (NZ) over 25 years.

Methods: Tapered matching and landmark analysis (accounting for immortal bias) were used to control for potential effects of known confounders. The association between T2D onset and 5- and 10-year IR of dementia was estimated by weighted Cox models.

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Article Synopsis
  • The study aimed to assess whether elevated fasting plasma glucose (FPG) levels in the first trimester can predict the development of gestational diabetes mellitus (GDM) later in pregnancy, as well as associated adverse events.
  • It analyzed data from 16 studies involving over 115,000 pregnancies and found that FPG levels above 5.1 mmol/L (92 mg/dL) significantly increased the risk of GDM and several pregnancy complications including pre-eclampsia and large-for-gestational-age infants.
  • However, the research had limitations, such as a lack of diverse studies reporting on higher FPG thresholds, particularly at 6.1 mmol/L (110 mg/dL).
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  • The study aimed to examine the prevalence of hypogonadism (HG) in men with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) while also assessing its effects on these conditions.
  • It involved 312 male participants who were evaluated for testosterone levels and compared across various clinical measures related to their rheumatic diseases.
  • Results indicated varying rates of testosterone deficiency—24.1% in RA, 17.5% in AS, and 31.8% in PsA—with HG linked to higher body mass index and metabolic indicators, but without significant differences in testosterone and hormone levels across the rheumatic disease groups.
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Evidence-based definition of hypoprolactinemia in European men aged 40-86 years: the European male ageing study.

Rev Endocr Metab Disord

December 2024

Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, , Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (IDIS), Santiago de Compostela, CB06/03, Spain.

Empirical evidence for a low normal or reference interval for serum prolactin (PRL) is lacking for men, while the implications of very low PRL levels for human health have never been studied. A clinical state of "PRL deficiency" has not been defined except in relation to lactation. Using data from the European Male Ageing Study (EMAS), we analyzed the distribution of PRL in 3,369 community-dwelling European men, aged 40-80 years at phase-1 and free from acute illnesses.

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Article Synopsis
  • The study investigates the relationship between metformin use and the incidence of gout in adults with pre-diabetes, aiming to clarify how metformin affects gout risk.
  • Researchers conducted a cohort study with 25,064 pre-diabetic individuals, comparing 1,154 metformin users to 13,877 non-users, and found that metformin users had a lower incidence rate of gout.
  • The findings suggest that starting metformin may help reduce the risk of developing gout in people with pre-diabetes, highlighting its potential benefits beyond blood sugar management.
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Background: Whether circulating sex hormones modulate mortality and cardiovascular disease (CVD) risk in aging men is controversial.

Purpose: To clarify associations of sex hormones with these outcomes.

Data Sources: Systematic literature review to July 2019, with bridge searches to March 2024.

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Background: Hyperuricemia is frequently observed in patients with type 2 diabetes (T2D) and is associated with increased risk of gout and cardiovascular disease (CVD). Empagliflozin lowers serum urate levels by enhancing its urinary excretion.

Objective: To compare initiators of empagliflozin vs dipeptidyl peptidase-4 inhibitor (DPP4i) and initiators of empagliflozin vs glucagon-like peptide-1 receptor agonist (GLP-1RA) with respect to the risk of incident gout events.

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Objectives: To determine if physiotherapists can deliver a clinically effective very low energy diet (VLED) supplementary to exercise in people with knee osteoarthritis (OA) and overweight or obesity.

Methods: 88 participants with knee OA and body mass index (BMI) >27 kg/m were randomised to either intervention (n=42: VLED including two daily meal replacement products supplementary to control) or control (n=46: exercise). Both interventions were delivered by unblinded physiotherapists via six videoconference sessions over 6 months.

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The role of blood testing in prevention, diagnosis, and management of chronic diseases: A review.

Am J Med Sci

October 2024

Division of Community Endocrinology, Department of Medicine, Albany Medical Center, Albany, NY, USA. Electronic address:

Blood tests are vital to prevention, diagnosis, and management of chronic diseases. Despite this, it can be challenging to construct a comprehensive view of the clinical importance of blood testing because relevant literature is typically fragmented across different disease areas and patient populations. This lack of collated evidence can also make it difficult for primary care providers to adhere to best practices for blood testing across different diseases and guidelines.

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Importance: Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are a revolutionary treatment for type 2 diabetes (T2D) with cardiovascular, kidney, and serum urate-lowering benefits.

Objective: To compare risk of incident gout and rate of recurrent flares between patients with T2D initiating SGLT2i vs sulfonylurea, most common second-line glucose-lowering therapy, when added to metformin monotherapy.

Design, Setting, And Participants: This sequential, propensity score-matched, new-user comparative effectiveness study using target trial emulation framework included adults with T2D receiving metformin monotherapy in a Canadian general population database from January 1, 2014, to June 30, 2022.

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Association between sex hormones and gout: An analysis of the UK Biobank cohort.

Steroids

July 2024

Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China. Electronic address:

Article Synopsis
  • This study examined the link between sex hormones and gout in a group of 448,836 individuals without gout at the start, using Cox regression models to analyze the data.
  • Researchers found that higher levels of total testosterone (TT) were associated with a significantly lower risk of gout in males, while free testosterone (FT) and bioavailable testosterone (BAT) were linked to a higher risk of the disease.
  • The study suggests that different active states of testosterone can impact gout risk differently, with FT and BAT potentially increasing the risk, contrasting with the protective effect of TT.
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Prandial Insulins: A Person-Centered Choice.

Curr Diab Rep

June 2024

Department of Endocrinology, Indraprastha Apollo Hospitals, Sarita Vihar, Mathura Road, Delhi, 110076, India.

Purpose Of Review: Postprandial hyperglycemia, or elevated blood glucose after meals, is associated with the development and progression of various diabetes-related complications. Prandial insulins are designed to replicate the natural insulin release after meals and are highly effective in managing post-meal glucose spikes. Currently, different types of prandial insulins are available such as human regular insulin, rapid-acting analogs, ultra-rapid-acting analogs, and inhaled insulins.

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Article Synopsis
  • The study investigates the role of bisphosphonates (BP) in treating hypertrophic osteoarthropathy (HPOA) through a case and systematic literature review.
  • A total of 45 patients with either primary or secondary HPOA were analyzed, revealing that 88.3% experienced pain improvement after BP treatment, especially within days for secondary HPOA.
  • Despite the promising results, the study highlights the need for more randomized controlled trials, as the current data comes mostly from case reports and secondary outcomes were not consistently reported.
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Use of Fracture Risk Assessment Tool in clinical practice and Fracture Risk Assessment Tool future directions.

Womens Health (Lond)

March 2024

Division of Endocrinology and Diabetes, Department of Internal Medicine, Maine Medical Center, Scarborough, ME, USA.

Fracture Risk Assessment Tool is a free, online fracture risk calculator which can be used to predict 10-year fracture risk for women and men over age 50 years. It incorporates seven clinical risk factors and bone density to give a 10-year risk of major osteoporotic fracture and hip fracture. This dynamic tool can be used with patients at the bedside to help guide treatment decisions.

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Article Synopsis
  • - Aging negatively affects the adaptive immune system, leading to fewer diverse T cells and an increase in inflammatory T cell types, which are linked to chronic diseases and higher mortality rates.
  • - B cells play a significant role in the aging process of T cells by reducing naive T cells and promoting harmful T cell subsets, as shown through various experimental models and single-cell analysis.
  • - Targeting these age-related changes in T cells with CD20 monoclonal antibody treatment could help improve immune function and healthspan, with insulin receptor signaling identified as a key mechanism behind B cell effects on T cell dysfunction.
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Background: A significant number of patients face the issue of weight gain (WG) or inadequate weight loss (IWL) post-bariatric surgery for obesity. Several studies have been published evaluating the role of glucagon-like peptide-1 receptor agonists (GLP1RA) for weight loss post-bariatric surgery. However, no systematic review and meta-analysis (SRM) till date has evaluated the efficacy, safety and tolerability of GLP1RA in this clinical scenario.

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  • A case-control study assessed the relationship between dietary branched-chain amino acids (BCAAs) and rheumatoid arthritis (RA) risk and severity, involving 95 RA patients and 190 matched controls.
  • Higher dietary BCAA intake was linked to a significantly increased risk of developing RA, with specific amino acids like leucine and isoleucine showing strong associations.
  • However, the intake of BCAAs did not correlate with the severity of RA symptoms, indicating that while they may play a role in the onset of the disease, they do not affect its progression.
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Effects of Supplemental Vitamin D3, Omega-3 Fatty Acids on Physical Performance Measures in the VITamin D and OmegA-3 TriaL.

J Clin Endocrinol Metab

December 2024

Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.

Context: Declining muscle strength and performance in older adults are associated with falls, fractures, and premature death.

Objective: This work aimed to determine whether supplementation with vitamin D3 or omega-3 fatty acids vs placebo for 2 years improves physical performance measures.

Methods: VITamin D and OmegA-3 TriaL (VITAL) was a double-blinded, placebo-controlled randomized trial of supplemental vitamin D3 and/or omega-3 fatty acids vs placebo in the prevention of cancer and cardiovascular disease in 25 871 US adults.

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  • Osteoporosis has traditionally been seen as a women's disease, but recent evidence highlights its significant impact on men, necessitating more balanced research and guidelines for both genders.
  • An international working group has developed GRADE-assessed recommendations focusing on diagnosing, monitoring, and treating osteoporosis in men, based on a thorough review of current research.
  • Key areas of focus include understanding bone densitometry interpretations, treatment thresholds, and evaluating the economic impact of interventions, while future research needs to explore the effectiveness of various osteoporosis medications.
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Clinical image: tophus in the sternoclavicular joint.

Ann Rheum Dis

August 2024

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai, China

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