Endocrine

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 solar calendar and may occur during different …

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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 results, with the exception of plasma …

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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 a functional pituitary adenoma. The effects …

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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?

Monthly menstruation is not the historical norm. Compared with modern women, women in prehistoric …

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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 intolerance of side effects, which she perceived as …

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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 as a scalp treatment. Finasteride and …

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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 physiology of energy balance, appetite regulation, …

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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 it with the …

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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 Japan since the early 1990s but …

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Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

June 4, 2009
Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

Michael Chu MD

Please also see the clinical vignette presented before Grand Rounds on the 21st of May.

The Medical Grand Rounds presentation on May 21, 2009 titled “Primary Aldosteronism, Beyond Conn’s Syndrome” was delivered by Dr. William F. Young M.D., Professor of Medicine at the Mayo Clinic College of Medicine. Dr. Young’s talk began with the index case of hyperaldosteronism that was described by Dr. Jerome Conn in the 1950’s, through the advances in the diagnosis of hyperaldosteronism, and on to present day treatment …

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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 previously healthy patient suddenly …

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