EUROPEAN ENDOCRINOLOGY – VOLUME 4 ISSUE 1 – SUMMER 2008

The world is facing a pandemic of type 2 diabetes – described colourfully as a ‘tsunami’ by Professor Zimmet of Australia. The number of sufferers is estimated to increase from 246 million to 380 million by 2030 – an unaffordable burden for most national health budgets. Diabetes is associated with an increased risk of macrovascular […]

Celebrated every year on November 14, World Diabetes Day is now an official UN World Health Day as a result of the successful Unite for Diabetes campaign. This year sees the second of a two-year World Diabetes Day campaign. The theme for the 2008 campaign is ‘Diabetes in Children and Adolescents.’ In this article, we […]

Recent developments indicate that the efforts of diabetes teams who are implementing approaches focused on age-appropriate education of patients, families and other care-givers in intensified insulin treatment in paediatric diabetes care have been successful. Also, the increased availability of continuous glucose sensors is likely to have a significant impact on paediatric diabetes therapy and education […]

The prevalence of obesity and type 2 diabetes has increased rapidly over the last 20 years. This has occurred not only in affluent societies, but also in developing countries, e.g. China and India. The dramatic increase in the prevalence of type 2 diabetes is considered one of the largest health problems worldwide, and it also […]

The prevalence of insulin-resistant conditions—such as obesity, the metabolic syndrome, and type 2 diabetes—is on the increase, affecting all age groups and both sexes.1 A sedentary lifestyle lies at the core of these disorders; therefore, increased physical activity is considered an integral part of lifestyle modification for the prevention and treatment of insulin resistance.2,3 There […]

Epidemiology Recent statistics from the World Health Organization (WHO) indicate that in 2005 approximately 1.6 billion adults (aged 15 years and over) were overweight worldwide, while at least 400 million adults were obese. Furthermore, the WHO predicts that by 2015 approximately 2.3 billion adults will be overweight and more than 700 million will be obese.1 […]

Prognostic Importance of Obesity The worldwide prevalence of diabetes has increased over the past 40 years.

The prevalence of diabetes in Europe has been dramatically increasing since the early 1990s. It is estimated that in 2007, 53 million people have diabetes in Europe. Quantitively, Russia and Germany have the highest number of people with diabetes, with a combined figure of about 17 million.

The World Health Organization (WHO) has predicted that 366 million people will have diabetes by 2030, which is an increase of over 100% from the figure for 2000.1 Five to 10% of these individuals will have insulin-dependent type 1 diabetes, which is treated by subcutaneous injections or infusions of recombinant insulin to replace insulin lost […]

1–3 GLP-1 and GIP also stimulate (3-cell proliferation, promote resistance to apoptosis and ncrease (3-cell survival, thus increasing (3-cell mass and function in the long term.1 Furthermore, GLP-1 inhibits glucagon secretion and reduces food intake through the inhibition of gastric emptying and through a direct hypothalamic effect.1 All of these actions of GIP and GLP-1 […]

Type 2 diabetes is characterised by high blood sugar caused by the inability of the pancreas to produce sufficient insulin, in combination with a loss of the normal reciprocal relationship between glucose and glucagon concentrations in the blood and impaired tissue sensitivity to insulin. In the longer term, high blood glucose concentrations can result in […]

Symptoms of painful diabetic neuropathy (PDN) occur in 30–40% of patients with diabetic neuropathy.1 It is most commonly associated with distal symmetrical neuropathy affecting the lower limbs (especially toes and feet), and patients present with burning, stabbing and tingling sensations.

The past 50 years have seen extraordinary developments, from the somatomedin hypothesis1 to a broad understanding of the insulin-like growth factor (IGF) system with its varied components and diverse actions.2 At the centre of the system is IGF-1, the insulin-like peptide with major effects on metabolism and cellular function.

Pituitary adenomas are common benign monoclonal neoplasms— accounting for 15% of intracranial neoplasms—that may be clinically silent or secrete anterior pituitary hormones such as prolactin, growth hormone (GH), adrenocorticotrophic hormone (ACTH), or, rarely, thyroid-stimulating hormone (TSH) or gonadotrophins.

Pituitary adenomas are benign tumours that may induce clinical signs either by secreting hormones (growth hormone [GH], adrenocorticotropin hormone [ACTH] or prolactin [PRL]) or by local mass effect, particularly chiasmatic compression. Thus, the therapeutic algorithm is different whether the aim of the treatment is to control signs of hormone hypersecretion (for instance in a secreting […]

Autoimmune hyperthyroidism due to Graves’ disease is the most common form of thyroid hyperfunction in iodine-sufficient areas. Ultimately, it is caused by autoantibodies that interact with the thyroidstimulating hormone (TSH) receptors on thyroid follicular cells – i.e. the TSH-receptor antibody (TRAb) – and thereby cause uncontrolled stimulation of thyroid function and growth.1 Currently, pathogenic treatments […]

Thyroid cancer accounts for approximately only 1% of all reported malignancies, but is the most common endocrine malignancy.1 It is of either follicular cell origin with well-differentiated papillary thyroid cancer and follicular thyroid cancer, poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC), or of parafollicular C-cell origin with medullary thyroid cancer (MTC).2 ATC, […]

In young hyperthyroid patients, Graves’ disease is the most likely explanation for the patient’s symptoms; however, there are other reasons that have to be considered. A hyperthyroid metabolic state can also be caused by thyroid cell inflammation and destruction. As thyroid cells die, their stored supplies of thyroid hormone are released into the blood circulation. […]

Testosterone therapy is of growing interest because of its increasingly recognized role in sexual and mental health, bone and muscle trophism, and vitality.1–4 An expanding body of evidence supports the influence of testosterone on sexuality, with the focus on desire and central (mental) arousal. This is more evident in women who have undergone oophorectomy and, […]

Advances in the diagnosis and treatment of childhood, adolescent and adult cancer have greatly enhanced the life expectancy of premenopausal women with the disease. As a result, there is a growing population of adolescent and adult long-term survivors of childhood malignancies.1 For the majority of women, ovarian damage caused by radiotherapy and/or chemotherapy will result […]