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Foreword Abd Tahrani
Abd Tahrani is a National Institute for Health Research (NIHR) Clinician Scientist at the University of Birmingham (UOB), and a Honorary
Consultant Endocrinologist and the lead for weight management research and diabetic neuropathy services at Heart of England NHS
Foundation Trust, Birmingham, UK. He gained his MD in 1998, MRCP (UK) in 2003, MMedSci from Keele University in 2008, CCT in diabetes
and endocrinology in 2012 and a PhD in 2012 from the UOB.
W elcome to the autumn edition of European Endocrinology. This issue features topical articles that have been
selected for their evaluation of current practices, as well as case studies and research that directly affect
endocrinologists and other practitioners involved in the care of patients with endocrine disorders.
We begin with three articles that emphasise the importance of continuous glucose monitoring (CGM) in patients with type
1 diabetes (T1D). In the first, Chaugule et al. calculated the cost of CGM for patients with T1D and impaired awareness
of hypoglycaemia in North West London. They concluded that the introduction of CGM for these patients would have a
minimal budgetary impact. In the second, which involved an online survey, Parkin et al. found that UK patients with T1D
derive considerable benefit from CGM but are largely unsupported by the healthcare system in terms of funding and
guidance. A commentary by Oliver further discusses CGM implementation and funding policies in the UK.
This year represents several landmarks in the history of the dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin.
In recognition of this fact, we feature a number of articles describing its clinical use. Foley and Ahrén present a detailed
review of the clinical development of vildagliptin for patients with type 2 diabetes (T2D). Mathieu et al. review data from
clinical trials, observational studies and post-marketing surveillance investigating the safety and tolerability of vildagliptin.
In recent years, the management of T2D has developed beyond glucose lowering alone to a more holistic approach,
encompassing cardiovascular safety. Strain and Paldánius discuss the evolving role of vildagliptin within this conceptual
change. Finally, in an editorial, Del Prato considers the use of vildagliptin across the whole spectrum of T2D, from those
with newly diagnosed diabetes to elderly patients who have lived longer with T2D than without it.
Other aspects of T2D are also discussed in this issue. Cardiovascular risk reduction has become a major focus of the
treatment of T2D. Anderson and Marrs review the results of cardiovascular outcome trials to date and how they are
influencing therapeutic decision-making. Beta-cell failure is a commonly used term to describe beta-cell dysfunction in T2D.
Kalra and Gupta suggest a revised terminology, beta-cell insufficiency, which better reflects the complex pathophysiology
underlying T2D. Diabetic macular oedema is a common consequence of T2D and its treatment represents an ongoing
challenge. Ziemssen et al. present the results of a benefit-risk analysis of one-year data from a number of phase III studies
investigating the efficacy and safety of ranibizumab treatment.
Finally, in a case study, Monteiro et al. describe an unusual presentation of thyrotoxicosis with thyroid storm criteria
in an elderly patient with a history of T2D. This condition is often misdiagnosed in elderly patients due to a lack of
European Endocrinology would like to thank all authors who contributed their expertise to this edition. A special thanks
goes to our Editorial Board for their advice and guidance. We are also grateful to media partners for their ongoing support.
We hope that you find these articles useful and thought provoking.
TOU CH MED ICA L MEDIA