Endocrine

From The Archives: Metabolic Syndrome: Fact or Myth?

May 22, 2014
From The Archives: Metabolic Syndrome: Fact or Myth?

Please enjoy this post from the archives dated September 30, 2011

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 …

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Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

April 10, 2014
Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

By Karin Katz, MD and Loren Wissner Greene, MD, MA

Peer Reviewed

In 1964, Dr. Arnold Kadish used real-time glucose monitoring to adjust insulin infusion in a patient with diabetes and introduced the concept of a closed-loop system of insulin delivery. A decade later, several research groups developed closed-loop systems that linked glucose monitors with insulin pumps and determined how much insulin to deliver based on calculations from a set of algorithms . These big, bulky machines depended on intravenous routes of glucose sensing …

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Down-And-Out With Diabetes: Caring For The Homeless Diabetic Patient

August 23, 2013
Down-And-Out With Diabetes: Caring For The Homeless Diabetic Patient

By Sara Gallant

Faculty Peer Reviewed

Each year in the US, an estimated 2.3–3.5 million individuals are homeless . Homelessness has a complicated association with poor health. People at risk for losing their home tend to have heavier disease burdens. In New York City, 6.3% of a subset of newly homeless people had diabetes mellitus, compared to 1.9% of the same age group in the general US population . In return, homelessness poses unique challenges to receiving and adhering to treatment for diabetes. The rewards …

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Is There Evidence to Support a Vegetarian Diet in Common Chronic Diseases?

June 20, 2013
Is There Evidence to Support a Vegetarian Diet in Common Chronic Diseases?

By Christopher Graffeo

Faculty Peer Reviewed

In the age of prevention, primary care is more empowered than ever to educate patients on reducing their risk for common chronic diseases by promoting behavior modifications early in the natural history. In the clinic, this means a focus on hyperlipidemia, hypertension, and diabetes—risk factors that play synergistic roles in causing a wide array of diseases with tremendous morbidity and mortality. Given the large number of risk factors that co-exist for so many patients, astute clinicians are aiming for …

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Should I Add Sugar or Splenda to My Coffee?

June 6, 2013
Should I Add Sugar or Splenda to My Coffee?

By Reda Issa

Faculty Peer Reviewed

As a medical student, I adjusted to waking up at 6 AM every day – with the help of coffee, of course. Living in New York City and its fast-paced routine requires that extra kick those beans provide. So, should I add sugar or Splenda to my coffee? Half a century ago this question did not exist, but obesity was not a word in the Merriam-Webster then. Today, we have to think more carefully.

Non-sucrose based sweeteners can be …

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Too Much of a Good Thing: The Evidence Behind the Need for a Bisphosphonate Holiday

May 9, 2013
Too Much of a Good Thing: The Evidence Behind the Need for a Bisphosphonate Holiday

By Jenna Piccininni

Faculty Peer Reviewed

Bisphosphonates are a relatively new medication having only been approved to treat osteoporosis in the US since 1995 . In addition, large placebo controlled trials have, at most, 10 years of follow-up data. Thus, there are still questions regarding the long-term use of these agents. There are a few well-established side effects of bisphosphonates including rare osteonecrosis of the jaw and more common esophageal irritation. However, several more recent case reports suggest a correlation between prolonged bisphosphonate use and …

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In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

April 17, 2013
In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

By David G. Rosenthal and Robert Gianotti, MD

Faculty Peer Reviewed

Case: A 33-year-old man comes to your clinic complaining of worsening acne over the last 6 months. You note a significant increase in both BMI and bicep circumference. After several minutes of denial, he reveals that he has been using both injectable and oral anabolic steroids. He receives these drugs from a local supplier and via the Internet. He confides that his libido has dramatically increased and he feels increasingly pressured at work, describing …

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The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

April 4, 2013
The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

By Michael Crist

Faculty Peer Reviewed

Until recently, little thought was given to the important role played by the duodenum, jejunum, and ileum in glucose homeostasis. The involvement of the gut in glucose regulation is mediated by the enteroinsular axis, which refers to the neural and hormonal signaling pathways that connect the gastrointestinal (GI) tract with pancreatic beta cells. These pathways are largely responsible for the increase in insulin that occurs during the postprandial period. In 1964 McIntyre and colleagues first reported the phenomenon of …

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