Endocrine

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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Obesity 2.0: More Than Just the Extra Weight

February 9, 2012
Obesity 2.0: More Than Just the Extra Weight

By Aviva Regev

Faculty Peer Reviewed

Introduction

Few people these days are unaware of the “obesity epidemic,” with its inception here in the United States and its steady, insidious spread around the globe. The numbers are truly staggering: in 2008, the World Health Organization estimated that 1.5 billion adults–over 20% of the earth’s population–were overweight, and 500 million of those were classified as obese, with a body mass index greater than 30. In the United States, over a third of the population is overweight, and…

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When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

February 1, 2012
When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

By Joseph Larese

Faculty Peer Reviewed

Hemoglobin A1C (HbA1c) is an invaluable tool for monitoring long-term glycemic control in diabetic patients. However, many clinicians managing diabetics have encountered the problem of HbA1c values that do not agree with fingerstick glucose logs. Before suspecting an improperly calibrated glucometer or poor patient record keeping, it is useful to consider the situations in which HbA1c may be spuriously elevated or depressed. These issues are best understood after reviewing how HbA1c is defined and measured–topics fraught with considerable confusion.…

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Male Hormonal Contraception

January 20, 2012
Male Hormonal Contraception

By Kaley Myer, Class of 2012

Faculty Peer Reviewed

As a female, I like the idea of males taking hormonal contraceptives. In a semi-sadistic way, I relish the idea of a man taking a pill every day to prevent impregnation of my gender. Traditionally, contraception has been a female responsibility, from diaphragms to oral contraceptive pills to intrauterine devices. Male condoms, coitus interruptus, and the more permanent vasectomy require male participation, but these methods do not dominate the contraceptive market. Indeed, couples are encouraged to…

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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…

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Metabolic Syndrome: Fact or Myth?

September 30, 2011
Metabolic Syndrome: Fact or Myth?

By Vicky Jones, MD

A 40-year-old female presented to her primary care provider with a chief complaint of weight gain over the past year.  She wants to be fully evaluated for any kind of medical disorder that could have caused it.  She has been seen by multiple specialists but no one can give her a “straight diagnosis”.  Their advice is for her to lose weight.  She insists she never had problems with her weight in the past and has no known medical disorders. Her physical…

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You Don’t Look Diabetic:Diabetes in Non-Obese South Asians–Is There a Molecular or Genetic Basis for Increased Insulin Resistance?

August 24, 2011
You Don’t Look Diabetic:Diabetes in Non-Obese South Asians–Is There a Molecular or Genetic Basis for Increased Insulin Resistance?

By Adelaide Hearst, MD

Faculty Peer Reviewed

Diabetes is a nationwide epidemic in the United States, affecting 23.6 million people, over 7% of the population. But all diabetics may not be created equal. In the US, Asians are 1.6 times more likely that non-Hispanic whites to have diabetes, even after adjusting for body-mass index (BMI), age, and sex. Asians have high rates of type 2 diabetes and coronary artery disease, and increased risk for metabolic syndrome compared to non-Hispanic whites.  Spend a day at…

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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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The Heart in Acromegaly

September 1, 2010
The Heart in Acromegaly

By Ari Pollack, MD

Faculty Peer Reviewed

The onset of acromegaly is subtle, and its progression is usually very slow. In fact, the usual interval from the onset of symptoms until diagnosis is about twelve years. The manifestations of acromegaly result from excessive secretion of growth hormone (GH), which targets the liver, resulting in stimulation of hepatic secretion of insulin-like growth factor-1 (IGF-1), which causes many of the clinical manifestations of acromegaly.  The most common cause of acromegaly is…

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Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

May 21, 2010
Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

By Rachel Edlin, MD

Faculty peer reviewed

A 29-year-old female patient with a history of iron deficiency anemia and heavy menstrual periods comes into the clinic for a regular visit. She is tired of iron supplementation and its associated constipation. As she is currently on oral contraceptive pills, you recommend using these to reduce her menstrual period to four times a year. She asks, “Is that really safe?”

Is menstruation necessary?

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