EUROPEAN ENDOCRINE DISEASE – VOLUME 1 – SUMMER 2006

Diabetes is a silent killer that today kills one person every 10 seconds. It is a global drama with devastating human, social and economic impacts. New data recently released by the International Diabetes Federation (IDF) indicate that more than 230 million people worldwide are living with diabetes, and that this number is sadly expected to […]

European Parliament Announces a Written Declaration on Diabetes The resounding support from the European Parliament to act against the growing diabetes epidemic culminated in the adoption of a Written Declaration on Diabetes. The declaration received a clear majority with 423 MEPs signing their support in April of this year. This rarely-seen level of support emphasises […]

Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial Dormandy J A, et al.; PROactive investigators. Lancet (2005);366(9493): pp. 1,279–1,289

Each year the International Diabetes Federation (IDF) emphasises a theme of worldwide importance to people living with diabetes and to health professionals working with people who have diabetes. In 2005 that theme was the diabetic foot. This year it is diabetes in disadvantaged and vulnerable groups. These campaigns aim to increase awareness of diabetes in […]

Incretins are hormones from the gut that augment the postprandial nutrient-induced insulin secretion. The incretin effect is normally quantified by comparing the insulin responses to oral and intravenous glucose administration, where the infusion is adjusted so that the plasma glucose concentrations are similar to those observed after the oral administration. The insulin response to oral […]

In the last two decades, the worldwide explosion in the prevalence of type 2 diabetes mellitus has become a major societal challenge of the 21st century.1 Diabetes still remains the first cause of blindness below the age of 65 in industrialised countries, the first cause of end-stage renal disease and non-traumatic amputation, and a major […]

There is increasing evidence that the postprandial state is an important contributing factor to the development of atherosclerosis. In diabetes, the postprandial phase is characterised by a rapid and large increase in blood glucose levels, and the possibility that the postprandial ‘hyperglycaemic spikes’ may be relevant to the pathophysiology of late diabetic complications has received […]

Diabetes is at epidemic levels, with the costs of treatment placing a significant economic burden on healthcare systems worldwide. Most people with type 2 diabetes are failing to achieve optimal blood glucose control, leading to disease progression and the onset of debilitating and expensive complications, including heart disease, amputations, blindness and kidney failure. To achieve […]

Since the discovery of insulin in 1922, there have been attempts to develop alternative methods of administration to injection, as it was soon realised that this was a major issue for both patients and physicians.1,2 To avoid multiple injections, oral antidiabetic agents and slow-acting insulins were developed.

Immediately these data raise questions: • How much loss of islet cell function can be tolerated without elevation of blood glucose levels? • What was happening in the islets during and beyond the phase leading up to diabetes? • Are these processes modifiable?

This brief article on the role of glucagon in type 2 diabetes mellitus is intended to review the facts, to integrate these facts into what has been called the ‘glucagon logic’,1 to analyse the mechanisms that might explain the hyperglucagonaemia of type 2 diabetes and to discuss whether inhibiting glucagon release or antagonising the effects […]

In the development of type 2 diabetes, environmental influences (most importantly diet and sedentary lifestyle) and genetic factors lead to the development of insulin resistance (i.e.

Diabetes mellitus is becoming one of the most common diseases in the world. The number of people with diabetes is estimated to double in the next 20 years, reaching 350 million affected people by 2025 (see Figure 1). This will be accompanied by an increased number of diabetic patients with long-term complications, causing a phenomenal […]

Pathogenesis of Foot Ulceration

Prolactin (PRL) is a 199-amino-acid polypeptide with molecular weight of 23 kilo Daltons (kDa) secreted by lactotroph cells of the anterior pituitary that plays a pivotal role in a variety of reproductive functions.

Acromegaly is a rare disease due to growth hormone (GH) hypersecretion by a pituitary adenoma. The rheumatologic, cardiovascular, respiratory and metabolic consequences determine the prognosis, and their severity increases with the length and degree of GH hypersecretion. The prognosis of acromegaly also depends on the culprit pituitary tumor, which may cause a tumoral syndrome, with […]

Growth hormone (GH) is a polypeptide hormone consisting of 191 amino acids, synthesised, stored and secreted by somatotroph cells in the lateral wings of the anterior pituitary, in a gender- and age-dependent manner. GH acts to mediate widespread effects, controlling growth and metabolic functions, playing a role in maintaining the integrity of many tissues. GH […]

Traditionally, short stature is defined as a height that lies more than two standard deviations (SD) below the mean for age compared with gender-specific standards based on an appropriate healthy population. In multi-ethnic societies, it is important to compare children with controls from an appropriate ethnically matched normal population. Additionally, the genetic background of an […]

The incidence of cardiovascular and cerebrovascular diseases in women is low before the menopause but after the age of 50 years they become the leading cause of mortality and morbidity for women living in most developed countries. This increased incidence is only partially explained by ageing, since the state of oestrogen deficiency developing after the […]

Within just one century the average lifespan of women in Western countries has significantly increased and nowadays about a third of a woman’s life is lived after the menopause. This implies that the menopause is a rather new entity for humans and that the consequences of long-term life in the absence of ovarian hormones have […]

In men, fertility persists until very old age; simulteously, an age-associated decrease in testosterone levels exhibiting a marked inter-individual variation is observed.1 Subnormal testosterone levels are not a general, but frequent feature of ageing men. This age-related deterioration of androgen production can be seen as a combined dysfunctionality of both the central and peripheral parts […]

Erectile dysfunction (ED) is a highly prevalent disease that is expected to affect 322 million men by 2025. Risk factors include ageing, cardiovascular disease (CVD), diabetes, hyperlipidaemia, smoking, absence of physical exercise and obesity. ED is associated with depression and has a negative impact on patients’ and partners’ quality of life. Potentially reversible causes include […]

Erectile dysfunction (ED) has clearly emerged as one of the significant medical problems of the 21st century. Attention from the media and the public as a result of a better understanding of the physiology of erections and the pathophysiology of ED, as well as new treatment options, has made ED almost a household term. This […]

“Couples are wholes and not wholes, what agrees disagrees, the concordant is discordant. From all things one and from one all things.” Heraclitus of Ephesus (540–480BC) These words illustrate the complexity and necessity to consider a couple as a whole; nevertheless respecting each individual. There has been limited research on sexual dysfunction in the couple, […]

Sexual thoughts and fantasies are a joy of life. Sexual desire is fun and a vital part of good health. It is a much appreciated basis for relationships between women and their partners. Sexual apathy is anguishing and distressing; it is a common complaint heard by gynaecologists. In older women, androgen production and sexual desire […]

Sexual thoughts and fantasies are a joy of life. Sexual desire is fun and a vital part of good health. It is a much appreciated basis for relationships between women and their partners. Sexual apathy is anguishing and distressing; it is a common complaint heard by gynaecologists. In older women, androgen production and sexual desire […]

Acromegaly is a rare disease due to growth hormone (GH) hypersecretion by a pituitary adenoma. The rheumatologic, cardiovascular, respiratory and metabolic consequences determine the prognosis, and their severity increases with the length and degree of GH hypersecretion. The prognosis of acromegaly also depends on the culprit pituitary tumor, which may cause a tumoral syndrome, with […]

“Couples are wholes and not wholes, what agrees disagrees, the concordant is discordant. From all things one and from one all things.” Heraclitus of Ephesus (540–480BC) These words illustrate the complexity and necessity to consider a couple as a whole; nevertheless respecting each individual. There has been limited research on sexual dysfunction in the couple, […]

Traditionally, short stature is defined as a height that lies more than two standard deviations (SD) below the mean for age compared with gender-specific standards based on an appropriate healthy population. In multi-ethnic societies, it is important to compare children with controls from an appropriate ethnically matched normal population. Additionally, the genetic background of an […]

Growth hormone (GH) is a polypeptide hormone consisting of 191 amino acids, synthesised, stored and secreted by somatotroph cells in the lateral wings of the anterior pituitary, in a gender- and age-dependent manner. GH acts to mediate widespread effects, controlling growth and metabolic functions, playing a role in maintaining the integrity of many tissues. GH […]

Diabetes mellitus is becoming one of the most common diseases in the world. The number of people with diabetes is estimated to double in the next 20 years, reaching 350 million affected people by 2025 (see Figure 1). This will be accompanied by an increased number of diabetic patients with long-term complications, causing a phenomenal […]

Incretins are hormones from the gut that augment the postprandial nutrient-induced insulin secretion. The incretin effect is normally quantified by comparing the insulin responses to oral and intravenous glucose administration, where the infusion is adjusted so that the plasma glucose concentrations are similar to those observed after the oral administration. The insulin response to oral […]

Erectile dysfunction (ED) has clearly emerged as one of the significant medical problems of the 21st century. Attention from the media and the public as a result of a better understanding of the physiology of erections and the pathophysiology of ED, as well as new treatment options, has made ED almost a household term. This […]

The incidence of cardiovascular and cerebrovascular diseases in women is low before the menopause but after the age of 50 years they become the leading cause of mortality and morbidity for women living in most developed countries. This increased incidence is only partially explained by ageing, since the state of oestrogen deficiency developing after the […]

Studies of the natural history of type 2 diabetes have transformed views on the nature of the condition in the last two decades. The Belfast Study is one of the earliest and most complete studies to observe the change in blood glucose control during six years of best possible management by dietary means.1 After the […]