Endocrine

The Utility of GlycoMark ™: 1,5 Anhydroglucitol as a Marker for Glycemic Control

September 16, 2009
The Utility of GlycoMark ™: 1,5 Anhydroglucitol as a Marker for Glycemic Control

David R. Friedmann MD

Faculty Peer Reviewed

Hemoglobin A1 (Hb A1c) is the standard method for monitoring diabetic patients’ long-term glycemic control by indicating average blood glucose levels over a period of two months, or half of the average life span of red blood cells. A new biochemical marker GlycoMarkTM is a test that measures serum levels of 1,5-anhydroglucitol (1,5-AG), a monosaccharide derived from ingestion of food, slightly different in structure from glucose. The test has been available in…

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Deciphering Fact from Fiction in Hypoglycemia

March 26, 2009
Deciphering Fact from Fiction in Hypoglycemia

Commentary by Melissa Price, MD PGY3

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 results, with the exception of plasma glucose, were within normal limits.

Why is this…

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Class Act: AGE-RAGE: What we know about the pathophysiology of diabetic neuropathy.

December 26, 2008
Class Act: AGE-RAGE: What we know about the pathophysiology of diabetic neuropathy.

Commentary by Regina Mysliwiec, NYU Medical Student

Faculty Peer Reviewed

G.L. is a 62 year-old African-American male with a six year history of Type 2 Diabetes with variable glucose control and a progressive one year history of burning pain in a unilateral T10 distribution. The pain began at his right abdomen, then spread first to his umbilicus and finally ventrodorsally to his spine. His most recent HgbA1c is 8.0.

One does not have to be a medical student in New York…

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Meeting Perspectives: The ADA Scientific Sessions: Advances in the Pharmacologic Management of Type 2 Diabetes Mellitus

September 25, 2008
Meeting Perspectives: The ADA Scientific Sessions: Advances in the Pharmacologic Management of Type 2 Diabetes Mellitus

Commentary by  Howard Furst MD and Mitchell Charap MD

We will focus our review of the 2008 ADA meetings on new data regarding the GLP-1 analogues and the DPP 4 inhibitors. Before describing the clinical data, we will review the basic science that led to interest in these new classes of drugs for the treatment of diabetes mellitus.

Background
Incretins are peptides released from the gastrointestinal tract in response to nutrient ingestion. They enhance glucose-dependent insulin secretion from the pancreas and aid in…

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Grand Rounds: Thyroid Disease and the Heart

September 24, 2008
Grand Rounds: Thyroid Disease and the Heart

 Commentary by Sarika Modi MD, PGY-2  

Dr. Irwin Klein MD, Professor of Medicine and Cell Biology, of North Shore University Hospital, gave grand rounds on “Thyroid Disease and the Heart” on September 17, 2008.  He began his talk by giving an overview of the broad spectrum of cardiac manifestations seen in hyperthyroidism.  Palpitations are seen in 90% of patients with hyperthyroidism.  Atrial fibrillation is seen in 5-15%, especially in the elderly.  In fact, as Dr Klein pointed out, former president George Bush Senior was…

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Breaking News: Revenge of the Gila Monster?

August 20, 2008
Breaking News: Revenge of the Gila Monster?

Commentary by Rachana Jani MD, PGY-2

As recently reported in ShortCuts, Byetta recently made headlines after the suggestion of a mortality benefit for patients taking the drug in a small subset of the Accord study.  So is this the new golden drug for diabetics? Perhaps not. This week, the FDA updated a previous alert warning providers about the risks of pancreatitis in patients taking Byetta. Last October, the FDA first issued an alert after there had been 30 postmarketing reports of acute pancreatitis in patients who had recently been started on…

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FRAX: A Brand New Tool For the Management of Osteoporosis

August 13, 2008
FRAX: A Brand New Tool For the Management of Osteoporosis

Commentary by Judith Brenner MD, Associate Editor, Clinical Correlations. Reviewed by Valerie Peck MD, NYU Division of Endocrinology.

An 81 year old Caucasian woman with a history of diabetes and hypertension who was admitted to the orthopedic service with a hip fracture after falling in her home.

This is a typical story and represents the end stages of osteoporosis. It is the myocardial infarction of the bone world. Like cardiovascular disease, prevention and identification of at-risk individuals is the most…

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Class Act: Polycystic Ovarian Syndrome 2.0

August 1, 2008
Class Act: Polycystic Ovarian Syndrome 2.0

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. These posts focus on evidenced based answers to clinical questions related to patients seen by our students in the clinics or on the wards. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Marty Wolff MS-4, and Susan Zweig MD, Clinical Instructor, NYU Division of Endocrinology

NH is a 32 year-old obese Hispanic female with a history of…

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A Brief Glance at the Relationship between Varicocele and Infertility

March 19, 2008
A Brief Glance at the Relationship between Varicocele and Infertility

Commentary by Melissa Freeman MD, PGY-2

A 30 year-old male resident presents to his primary care physician for a routine physical examination. A small, nontender left-sided scrotal mass is felt. The patient states that this asymptomatic mass has been present for one year and was evaluated by a prior physician who felt that further work-up was unnecessary. He is sent for a testicular ultrasound which reveals a grade II varicocele. His testosterone level was low and he later had a semen analysis which…

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How do you approach male patients with osteoporosis?

February 28, 2008
How do you approach male patients with osteoporosis?

Commentary by Carrie Mahowald MD 

Case: GS, a 65 year old man with only a history of severe OA, is seen in pre-op clinic for medical clearance before his hip replacement. On his pre-op x-ray, an incidental finding of a lumbar vertebral compression fracture is noted. After his hip replacement, how would you work him up for osteoporosis?

Osteoporosis, defined as low bone mass and the deterioration of bone micro-architecture which leads to the compromise of bone strength and the increased risk…

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Grand Rounds: “Insulin Resistance: Implications for Obesity, Type 2 Diabetes”

February 26, 2008
Grand Rounds: “Insulin Resistance: Implications for Obesity, Type 2 Diabetes”

Commentary by Melissa Freeman MD, PGY2

This week’s Grand Rounds was delivered by Dr. Gerald Shulman, M.D., Ph.D., F.A.C.P. Professor of Internal Medicine and Cellular & Molecular Physiology and Investigator at the Howard Hughes Medical Institute of Yale University School of Medicine. Dr. Shulman has been a pioneer in unraveling the molecular mechanisms of insulin resistance.

For many years, Dr. Shulman and his colleagues have employed nuclear magnetic resonance spectroscopy (MRS) on muscle and liver cells to make noninvasive cellular discoveries. C13…

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A New Path for the ACCORD (The Action to Control Cardiovascular Risk in Diabetes) trial: Does Being Sweeter Save Lives?

February 8, 2008
A New Path for the ACCORD (The Action to Control Cardiovascular Risk in Diabetes) trial: Does Being Sweeter Save Lives?

Commentary by Melissa Freeman MD, Endocrinology Section Editor

The ACCORD trial is an ongoing 5-year, North American, randomized study that began in 2001 to evaluate potential interventions to decrease cardiovascular (CV) events in adults living with DM2.  The trial enrolled 10,251 adults, aged 40- 82, with DM2 for 10 or more years, and a history of CV disease or two CV risk factors in addition to DM2. All participants were randomized at enrollment into intensive versus standard glucose control. In addition, participants were…

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