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Foreword Linda Siminerio, PhD, RN, CDE, is Associate Professor at the University of Pittsburgh School of Medicine and Nursing and Executive Director of the University of Pittsburgh Diabetes Institute in Pittsburgh, Pennsylvania, US. A nationally recognized expert and innovator in the fields of self-management education and healthcare delivery models, Dr Siminerio organized efforts toward a Diabetes Action Plan and served on the Chronic Care Commission for Pennsylvania. She has received numerous awards, including the American Diabetes Association’s (ADA) Harold Rifkin Award for Distinguished International Service in the Cause of Diabetes and the Outstanding Educator Award. Dr Siminerio has served as ADA President of Health Care and Education and as Senior Vice President of the International Diabetes Federation. In these positions, she has organized and led national and international efforts aimed at developing programs, curricula, and standards for diabetes education directed toward health professionals, patients, and the community. W elcome to the latest edition of US Endocrinology. The selection of articles contained within cover a broad spectrum of topics within our specialist field, highlighting its diverse nature. The issues raised are ones we face in our clinics or in our research laboratories on a daily basis, and the articles provide insight and discussion that will be both educational and of value to our clinical and scientific practice. Diabetes immunology and complications are discussed, as are two very different pituitary disorders, and an in-depth review of treatment options for polycystic ovary syndrome is provided within the female endocrinology section. This edition also puts a spotlight on technology and patient-centered strategies for both children and adults with diabetes. Many advances have been made in diabetes, including the introduction of highly successful therapies, tools, and technology. Yet, despite all of this progress, there remains controversy about management practices and patients are still unable to meet target goals. A prime example of practice controversy is the self-monitoring of blood glucose (SMBG). Despite improvements in SMBG technology—with more sophisticated, user-friendly devices and advanced communication components—dispute continues regarding the benefits of SMBG for people with type 2 diabetes. However, it appears that there is a general consensus that much of the problem lies with the fact that patients are not educated about the relationship between their blood glucose results and their therapies (food, activity, and medications). If patients do not understand how to use blood glucose results, it is unlikely that they will feel motivated to continue testing and/or be willing to advance their treatment therapies, and subsequent behavioral and clinical outcomes will remain poor. The complexity of diabetes management requires that health providers be able to support their patients with the appropriate amount of time, the education, and the long-term support that are necessary for effective self-management and adherence to treatment. An average appointment, lasting only 17 minutes, does not provide sufficient time to successfully problem-solve, manage, educate, and motivate patients in order to achieve desired outcomes, given the complexity of chronic disease management. Patients report frustration with testing when their healthcare provider has little time to review months of logged results. The time has come for a change in the way we support our diabetes patients in their self-management efforts. This issue of US Endocrinology provides perspectives on key issues related to technological approaches that support diabetes care, including empowerment, behavior change, and communication. US Endocrinology would like to take this opportunity to thank all contributors to this edition, and would like to extend special thanks to the expert authors who have given their time and effort to provide an insightful and informative selection of articles for our perusal. n 8 © TOUCH BRIEFINGS 2012