Endocrine

White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

March 20, 2013
White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

By Lauren Foster

Faculty Peer Reviewed

Hypertension is a pervasive chronic disease affecting approximately 65 million adults in the United States, and a significant cause of morbidity and mortality . Antihypertensives are widely prescribed due to their effectiveness in lowering blood pressure, thereby reducing the risk of cardiovascular events. However, the phenomenon of the “white coat effect” may be a complicating factor in the diagnosis and management of hypertensive patients. It is well established that a considerable number of people experience an elevation of their…

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What Is Andropause? Is Testosterone Supplementation the Answer in Older Men?

September 20, 2012
What Is Andropause? Is Testosterone Supplementation the Answer in Older Men?

By Kylie Birnbaum

Faculty Peer Reviewed

Women have long bemoaned menopause and its physiological, psychological, and sexual effects. Fortunately, hormone replacement therapy has provided relief for symptomatic women. Less attention is paid to men, who also experience declines in their sex hormones. Decreased testosterone may explain many symptoms experienced by elderly men, such as poor sexual function and libido, decreased bone mineral density, fatigue, and decreased muscle mass and strength. Should physicians treat elderly men with testosterone replacement therapy?

Late-onset hypogonadism, or “andropause,” is the…

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A Study of Cultural Complications in the Management of Diabetes

April 18, 2012
A Study of Cultural Complications in the Management of Diabetes

By Kimberly Jean Atiyeh

Faculty Peer Reviewed

Ms. KS is a 49- year-old Bangladeshi woman with a history of diabetes mellitus and non-adherence to medical treatment or follow up, who was reluctantly brought to the Bellevue ER by her family for nausea, vomiting, and fevers for one day. Her most recent hospitalization was 9 months prior for epigastric discomfort in the setting of uncontrolled diabetes with a hemoglobin A1C of 12.4%. On arrival, her physical exam was significant for tachypnea, tachycardia, and dry mucus membranes.…

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Bariatric Surgery: A Cure for Diabetes?

October 20, 2011
Bariatric Surgery: A Cure for Diabetes?

By Amy Dinitz

 Faculty Peer Reviewed

 The lifetime risk of developing diabetes for persons born in 2000 is around 35% and the NHANES database has suggested a greater than fourfold increase in prevalence over the last three generations.  While bariatric surgery has become the most effective treatment for obesity, it has also been found to be an extremely effective treatment for type 2 diabetes.  It was initially thought that the weight loss experienced by patients after bariatric surgery was responsible for improved glycemic control.  However,…

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Subclinical Hypothyroidism: To Screen or Not to Screen?

August 17, 2011
Subclinical Hypothyroidism: To Screen or Not to Screen?

By Addie Peretz, MD

Faculty Peer Reviewed

Despite the ease of screening for hypothyroidism with hormone assays and the availability of thyroxine replacement therapy, no recommendations regarding routine screening for hypothyroidism in adults are universally accepted. The American Academy of Family Physicians and the American Association of Clinical Endocrinologists recommend periodic assessment of thyroid function in older women.  The American Thyroid Association advocates for more frequent earlier screening, recommending measurement of thyroid stimulating hormone (TSH) beginning at age 35 and every 5 years…

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Ramadan, Fasting, and Diabetes

February 25, 2011
Ramadan, Fasting, and Diabetes

By Sana Shah, Class of  2011

Faculty Peer Reviewed

The Islamic faith is characterized by five central pillars: the public declaration of one’s faith, five daily prayers, an annual tax to the poor, a pilgrimage to Mecca, and annual fasting. Muslims fast together during the month of Ramadan, which is the ninth month of the Islamic lunar calendar and will next occur from August 1st-30th, 2011. The month begins 10 to 11 days earlier each year in the…

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From The Archives – Deciphering Fact from Fiction in Hypoglycemia

January 6, 2011
From The Archives – Deciphering Fact from Fiction in Hypoglycemia

Please enjoy this post from the Clinical Correlations archives first posted March 26, 2009

By: Melissa Price, MD

Faculty Peer Reviewed

A 42 year-old male phlebotomist with a history of anxiety presented to the emergency room complaining of four hours of dizziness and diaphoresis. He denied taking any medications. His vitals were stable, his physical exam was significant for a lethargic, diaphoretic young man without focal findings, and his fingerstick value was 43mg/dL. His chest X-ray, EKG, and laboratory…

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Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

April 14, 2010
Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

Michael Chu MD

Faculty peer reviewed

Case:

A 44-year old female presented to the emergency room with complaints of a lower extremity rash and swelling.  The patient had been in her usual state of health when she presented to her primary care physician with complaints of palpitations, weight loss and insomnia.  Lab tests were performed and she was given a diagnosis of hyperthyroidism.  She was started on propranolol and methimazole, which the patient took intermittently due to…

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How Do You Advise the Balding Patient?

January 13, 2010
How Do You Advise the Balding Patient?

Sagar Mungekar

Faculty Peer Reviewed

The incidence of male pattern hair loss can reach almost 100% in some ethnic groups.1, 2 While treatment of the condition is usually deferred to dermatologists, it is often the primary care physician (PCP) who is first approached for advice. Several medical and surgical treatments exist for male pattern hair loss. Herbal supplements and products on infomercials make cursory non-FDA-approved claims of hair growth. Minoxidil, once developed for hypertension, is available over the counter…

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Continuous Glucose Monitors

December 2, 2009
Continuous Glucose Monitors

Ilena George

Faculty peer reviewed

Are continuous glucose monitors the answer for better glucose control in diabetes?

A poorly controlled type 2 diabetic who is non-compliant with his at-home glucose monitoring comes to Bellevue’s Adult Primary Care Clinic requesting a prescription for a needle-less glucose monitor…

Self-monitoring of glucose levels is a necessary evil of diabetes treatment. As the prospect of numerous needle-sticks each day in perpetuity is daunting to patients, researchers have been developing non- or minimally-invasive methods to measure blood sugar in hopes…

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What is the Role of Drug Therapy in Treating Obesity?

November 19, 2009
What is the Role of Drug Therapy in Treating Obesity?

Arlene Chung

Faculty Peer Reviewed

Despite the high prevalence of obesity1 and its associated morbidity2 and mortality 3,4, it represents one of the most difficult chronic conditions to treat. Barriers include a metabolically toxic environment, a history of ill-fated weight-loss regimens, and a general view of obesity as primarily a social, not a medical problem. 5 Deep down, the belief that obesity really is the result of gluttony and sloth probably persists. However, as we learn more about the…

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Breaking News: FDA issues new warning for Exenatide (Byetta®)

November 5, 2009
Breaking News: FDA issues new warning for Exenatide (Byetta®)

Kanika Ballani, Pharm.D.
Diana Hubulasvili, Pharm.D.

 Developed by Amylin Pharmaceuticals, Exenatide (Byetta®) is an incretin mimetic that is used as an adjunctive therapy with metformin, a sulfonylurea or a thiazolidinedione to improve glycemic control in type 2 diabetic patients. Mechanistically, Exenatide mimics the actions of endogenous incretin hormone, glucagon-like peptide (GLP-1), causing an increase in insulin secretion which slows gastric emptying and leads to a decrease in food intake. On November 3rd 2009, the FDA issued a safety warning on Exenatide associating…

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