The prevalence of diabetes during pregnancy is rapidly increasing. In the USA alone, an estimated 1–2% of pregnant women have type 1 diabetes (T1D) or type 2 diabetes (T2D), and an additional 6–9% develop gestational diabetes.1 From 2000 to 2010, the prevalence of gestational diabetes increased by 56%, and the prevalence of existing diabetes among pregnant […]

Hepatic steatosis is the liver manifestation of metabolic syndrome and a common cause of chronic liver disease. Nonalcoholic fatty liver disease (NAFLD) diagnosis relies on the presence of hepatic steatosis, defined as >5% fat accumulation in the liver, as observed through imaging or histology. This diagnosis is made when there are no other concurrent secondary […]

Hypercalcaemia is a common clinical condition in hospitalized patients. Malignancies and primary hyperparathyroidism (PHPT) are the two most common causes of hypercalcaemia in hospitalized patients.1–3 Apparently, there is a changing profile of hypercalcaemia in India, especially in hospital settings, because of increasing reports of vitamin D toxicity and the early detection of PHPT, necessitating clinicians to […]

Dipeptidyl peptidase-4 (DPP-4) is a ubiquitous, multifunctional, 766-amino acid, type 2 transmembrane glycoprotein, which participates in the regulation of metabolic functions, immune and inflammatory responses, cancer growth and cell adhesion.1 It has two forms: the first is a membrane-bound form, which is extensively expressed in the body, including the cells of the immune system, haematopoietic cells, […]

Polycystic ovary syndrome (PCOS) is a multifactorial, multifaceted syndrome that affects women across all ages from adolescence to post-menopause. It is reported to be the most common endocrinopathy in women of the reproductive age group.1 The nature of this syndrome is such that it requires support and intervention from multiple medical and allied specialties. The treatment […]

Hyperthyroidism is prevalent in 0.1–2.5% of the population, and Graves’ disease is diagnosed in 80% of patients with hyperthyroidism.1,2 This condition arises from the uncontrolled, excessive activation of the thyroid-stimulating hormone (TSH) receptor by autoreactive TSH-receptor antibodies.2 Elevated thyroid hormones in hyperthyroidism result in a hyperdynamic circulatory state, leading to an increase in cardiac contractility, resting heart […]

Thyroid nodules are common worldwide, and their prevalence is increasing. Most nodules are asymptomatic and detected incidentally on cross-sectional imaging or physical examination. In rare cases (10–15%), nodules are malignant and require diagnostic evaluation. Even malignant nodules frequently show non-aggressive behaviour.1 The increase in the incidence of thyroid cancer is unfairly distributed globally, and the […]

Metformin Metformin has been recommended as the first-line glucose-lowering agent for the management of type 2 diabetes (T2D) for several decades due to its efficacy and safety profile.1–3 In fact, metformin has been widely used as an insulin-sensitizing agent for not only T2D but also pre-diabetes and polycystic ovary syndrome. The common side effects of metformin are […]

Tirzepatide is a first-in-class novel dual glucose-dependent insulinotropic peptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist (twincretin), formulated as a synthetic peptide containing 39 amino acids based on the native GIP.1 Tirzepatide has a GIP receptor-binding affinity comparable with native GIP and five times lower GLP-1 receptor affinity than native GLP-1.1 Several systematic reviews and meta-analyses (SRMs) have been […]