Endocrine

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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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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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…

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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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Class Act: Soy and Breast Cancer – What’s the Connection?

November 26, 2008
Class Act: Soy and Breast Cancer – What’s the Connection?

Commentary by Alexis Melnick, NYU School of Medcine Class of 2009

Faculty peer reviewed

With the increasing popularity of soy foods in the American diet, there has been considerable debate over the link between soy and the risk of cancer, particularly cancer of the breast. The interest in this association stems from soy-containing isoflavones, soybean-derived compounds with chemical structures similar to estrogens that act as weak partial agonists at estrogen receptors. Initial data supported the chemopreventive potential of soy and were based on several findings: the…

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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 Byetta. Though…

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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 powerful tool clinicians have…

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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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