EUROPEAN ENDOCRINOLOGY – VOLUME 6 ISSUE 1 – SUMMER 2010

Welcome to this edition of European Endocrinology, which once again seeks to examine and discuss some of the most pertinent issues and developments relating to our area of medicine. This edition includes excellent and insightful coverage of the ghrelin system and cardiovasculature, non-alcoholic fatty liver disease (NAFLD) in children, acromegaly, total thyroidectomy in thyroid cancer […]

The Natural History of Human Obesity The accumulation of body fat in obese people indicates the failure of the body’s systems to ensure proper energy homeostasis by adjusting for environmental influences, behaviour, psychological factors, genetic make-up and neurohormonal status.1 While a body mass index (BMI) >30kg/m2 is convenient to define obesity, this index does not […]

The International Diabetes Federation (IDF) launched the fourth edition of the IDF Diabetes Atlas at its 20th World Diabetes Congress in Montreal, Canada in October 2009.1 Based on conservative modeling assumptions, this edition estimates that the global prevalence of diabetes in 2010 has risen to 285 million people, representing 6.6% of the world’s adult population. […]

There is general recognition among physicians and other health professionals that regular participation in moderate- to vigorousintensity physical activity (i.e. brisk walking, jogging, lap-swimming) is one of the cornerstones of chronic disease prevention and management.

Over the last few decades the prevalence of diabetes has reached epidemic proportions in western societies and is even higher in developing countries,1–4 mainly due to population growth, ageing and obesity.1,5 The World Health Organization (WHO) has estimated that the global prevalence of diabetes will increase from 2.8% in 2000 to 4.4% by 2030.6 The […]

Hypoglycaemia is a common problem for many patients with diabetes and the risks and consequences need to be considered when prescribing therapy. Mild episodes can cause unpleasant symptoms and disrupt daily activities, while severe hypoglycaemia can result in disorientation and unusual behaviour, and may be life-threatening.

In 1993, the Diabetes Control and Complication Trial (DCCT) clearly showed that intensified diabetes treatment improves clinical outcome and reduces long-term complications in patients with type 1 diabetes. We also learned from the DCCT that metabolic control needs to be optimised from the diagnosis of diabetes to delay or at least slow the progression of […]

Advantages of a Flexible Lifestyle in Type 1 Diabetes Nutritional management is recognised as one of the cornerstones of diabetes care.1 Medical nutrition therapy in diabetes aims to provide sufficient and appropriate energy intake, encourage healthy lifelong eating habits and achieve and maintain the best possible glycaemic control and ideal bodyweight.2 A correct nutritional regimen […]

Increasing evidence supports the pivotal role of health education in preventing and treating diabetes more effectively.1,2 The World Health Organization (WHO) Regional Office for Europe officially acknowledged in its 1980 and 1992 reports that education should allow patients to acquire and maintain the ability and skills necessary to live a fulfilling life with their disease, […]

The worldwide prevalence of type 2 diabetes is rising dramatically, leading to an increase in the complications of this disease. The total number of people with diabetes may reach 440 million worldwide by 2030.1 Due to this development and the fact that most patients do not reach their therapeutic goals, novel, effective and safe treatment […]

Evidence from several large randomised clinical trials has linked glycated haemoglobin (HbA1c) to vascular diabetes complications.1,2 Consequently, current diabetes management relies mainly on HbA1c to assess quality of treatment and to adjust therapy. Optimal glycaemic control aims to restore levels of HbA1c to as normal as possible to reduce or avoid diabetic complications. However, traditional […]

Charcot neuroarthropathy in the feet of patients with diabetes is not a common problem and is often under-diagnosed in clinical practice. Once it occurs, it can progress rapidly and result in severe foot deformity, increasing the risk of ulceration and amputation. Charcot foot is said to occur in approximately 0.2% of patients with diabetes.1 Recognition […]

Since non-alcoholic fatty liver disease (NAFLD) was first described in children in the early 1980s by Moran and colleagues,1 a number of case series have been reported. Awareness of the disease has been growing among healthcare providers in the last few years, and nowadays NAFLD represents the most common cause of chronic liver disease in […]

Growth hormone secretagogues (GHS) were originally devised as small synthetic compounds, either peptides or non-peptides, with the ability to stimulate GH secretion from the pituitary.1 It has been demonstrated that GHS signalling is mainly through the GH secretagogue receptor (GHS-R), which is a G-protein-coupled receptor with seven transmembrane domains.2 Studies using in situ hybridisation have […]

Acromegaly is a severe endocrine disease resulting from growth hormone (GH) and insulin-like growth factor (IGF)-I excess, usually due to a somatotroph pituitary adenoma. Prolonged exposure to hormonal excess induces a progressive somatic disfigurement and many systemic complications (see Table 1) that develop insidiously and slowly, generally delaying the diagnosis by more than 10 years.1

Thyroid cancer is estimated to be the seventh most common cause of any new malignancy in women in the US. In 2007, 25,480 cases and 3.8% of new cases were diagnosed in women, while thyroid cancer represented just over 1% of new cases in men (8,070 cases), incidence rank 14th.1–4 The annual incidence of thyroid […]

Thyroid Hormones and the Heart The heart represents an important target for thyroid hormones (TH).1 Both transcriptional and non-transcriptional effects of TH may act to modulate the function of the myocardium.