Current Opinion in Endocrinology & Diabetes and Obesity最新文献

Current challenges in Cushing's syndrome testing: blood, saliva, urine, or hair? 目前库欣综合征检测的挑战：血液、唾液、尿液还是头发？

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI: 10.1097/MED.0000000000000923

Amandine Ferriere, Antoine Tabarin

{"title":"Current challenges in Cushing's syndrome testing: blood, saliva, urine, or hair?","authors":"Amandine Ferriere, Antoine Tabarin","doi":"10.1097/MED.0000000000000923","DOIUrl":"10.1097/MED.0000000000000923","url":null,"abstract":"Purpose of review: Endogenous Cushing's syndrome is one of the most difficult diagnoses in endocrinology. It is mainly based on biochemical tests that assess qualitative and quantitative alterations in cortisol production. Whether performed on blood, saliva, urine, or hair, the biochemical tests currently available have limited diagnostic specificity and sensitivity. Their performance varies depending on the individual characteristics of the patient, the stage of the disease, and the laboratory techniques used to determine cortisol levels. Knowledge of these factors will help physicians choose the most appropriate diagnostic test for each individual.Recent findings: Relevant studies and meta-analyses have clarified the actual performance of various biochemical tests in a real-world setting. In addition, the diagnostic arsenal for Cushing's syndrome has been expanded with new tools, such as hair cortisol and cortisone assays, new methods for measuring cortisol in urine or saliva, and new approaches such as steroid metabolomics or multiomics techniques.Summary: This review is a critical reappraisal of the merits and drawbacks of the various \"old\" and new biochemical tools. Its purpose is to provide the physician with practical advice on the use of biochemical tests at various stages of Cushing's syndrome in order to improve diagnostic accuracy.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"233-239"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The overlooked role of high-density lipoprotein in adrenal stress adaptation: the HDL/SCARB1 axis as a regulator of stress-induced steroidogenesis. 高密度脂蛋白在肾上腺应激适应中被忽视的作用：HDL/SCARB1轴作为应激诱导的甾体生成的调节因子。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI: 10.1097/MED.0000000000000924

Olivia White, Maki Tsujita, Rafael Zubiran

{"title":"The overlooked role of high-density lipoprotein in adrenal stress adaptation: the HDL/SCARB1 axis as a regulator of stress-induced steroidogenesis.","authors":"Olivia White, Maki Tsujita, Rafael Zubiran","doi":"10.1097/MED.0000000000000924","DOIUrl":"10.1097/MED.0000000000000924","url":null,"abstract":"Purpose of review: This review examines the critical role of the high-density lipoprotein (HDL)/scavenger receptor class B type 1 (SCARB1) pathway in adrenal glucocorticoid production during stress, emphasizing recent mechanistic evidence and its clinical implications.Recent findings: SCARB1 mediates the selective uptake of HDL-derived cholesteryl esters by adrenocortical cells, providing the cholesterol substrate needed for rapid glucocorticoid synthesis under stress. Experimental models show that loss of SCARB1 function abolishes stress-induced glucocorticoid production even when low-density lipoprotein (LDL) is abundant, confirming that LDL cannot substitute for HDL/SCARB1-mediated cholesterol delivery. ACTH rapidly upregulates SCARB1 expression and function, driving microvillar channel formation and enhancing cholesterol flux to mitochondria. Disruption of this pathway impairs the physiologic stress response and increases vulnerability to inflammatory complications. Human genetic data and clinical observations reinforce these findings and highlight the impact of hypoalphalipoproteinemia and SCARB1 defects on adrenal reserve.Summary: The HDL/SCARB1 axis is essential for acute glucocorticoid synthesis and integrates lipid metabolism with endocrine and immune resilience. This shifts the focus from HDL-C from a passive biomarker to HDL to an active endocrine cofactor. Preserving HDL functionality and SCARB1 integrity should guide the design of HDL-targeted interventions, especially in patients at risk for sepsis, systemic inflammation, or adrenal insufficiency.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"188-193"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiometabolic risk and therapeutic outcomes in mild autonomous cortisol secretion. 轻度自主皮质醇分泌的心脏代谢风险和治疗结果。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-07-30 DOI: 10.1097/MED.0000000000000922

Shobana Athimulam

{"title":"Cardiometabolic risk and therapeutic outcomes in mild autonomous cortisol secretion.","authors":"Shobana Athimulam","doi":"10.1097/MED.0000000000000922","DOIUrl":"10.1097/MED.0000000000000922","url":null,"abstract":"Purpose of review: Adrenal tumors are increasingly detected due to widespread use of cross-sectional imaging, with mild autonomous cortisol secretion (MACS) present in up to 50% of cases. This review summarizes the current evidence linking MACS to cardiometabolic comorbidities and outcomes, and evaluates the impact of adrenalectomy and emerging medical therapies.Recent findings: MACS is consistently associated with higher prevalence of hypertension, impaired glucose metabolism, dyslipidemia, obesity, and cardiovascular events compared to nonfunctioning adrenal tumors (NFATs). Several observational studies and randomized controlled trials have shown that adrenalectomy can improve blood pressure and glycemic control, although evidence regarding lipid metabolism and obesity is mixed. Despite growing evidence, gaps remain in predicting which patients will benefit most from surgical or medical therapy.Summary: MACS is clinically relevant entity with substantial cardiometabolic burden. While adrenalectomy may confer benefits in selected patients, individualized risk stratification remains a key challenge. Future research should focus on identifying predictive biomarkers, clarifying therapeutic thresholds and conducting large-scale prospective trials to inform clinical decision-making.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"194-200"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of adrenal incidentalomas: who, why and how? 肾上腺偶发瘤的管理：谁，为什么和如何？

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-05-14 DOI: 10.1097/MED.0000000000000917

Marta Araujo-Castro, María Bernarda Iriarte-Durán, Paola Parra-Ramírez, Sara Donato

{"title":"Management of adrenal incidentalomas: who, why and how?","authors":"Marta Araujo-Castro, María Bernarda Iriarte-Durán, Paola Parra-Ramírez, Sara Donato","doi":"10.1097/MED.0000000000000917","DOIUrl":"10.1097/MED.0000000000000917","url":null,"abstract":"Purpose of review: To summarize the epidemiology and clinical implications of adrenal incidentalomas, as well as the recommended hormonal and radiological evaluation, treatment and follow-up that should be carried out in patients with adrenal incidentalomas.Recent findings: The prevalence of adrenal incidentalomas has increased in the last decades due to advanced and more sensitive imaging modalities, their increased utilization, and the aging population. The evaluation of patients with adrenal incidentalomas should be focused on addressing two questions: Is the tumor functional, and is the tumor malignant? In relation to functionality, although most adrenal incidentalomas are clinically nonfunctioning, a significant proportion of patients have mild autonomous cortisol secretion and a lower proportion over functional adrenal syndromes. The differentiation between malignant and benign lesions is usually based on the radiological appearance of the lesion in CT and/or MRI. Adrenalectomy is considered the first-line treatment for malignant and functioning tumors. Radiological follow-up is not necessary for lesions classified as benign, but for indeterminate lesions, CT/MRI should be repeated in 6-12 months.Summary: Adrenal incidentalomas are a common clinical problem, and their assessment should be focused on ruling out hormonal hypersecretion and malignancy. In general, adrenalectomy is considered the treatment of choice for malignant and functioning adrenal tumors.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"210-221"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosis and management of thyroid nodule. 甲状腺结节的诊断与治疗。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-09-04 DOI: 10.1097/MED.0000000000000926

Suganya Sekar, Deepak Thomas Abraham

{"title":"Diagnosis and management of thyroid nodule.","authors":"Suganya Sekar, Deepak Thomas Abraham","doi":"10.1097/MED.0000000000000926","DOIUrl":"https://doi.org/10.1097/MED.0000000000000926","url":null,"abstract":"Purpose of review: To review the current medical evidence in the diagnosis and management of thyroid nodules.Recent findings: The widespread use of imaging modalities in recent years has led to frequent discovery of incidental thyroid nodules. These nodules are mostly benign (over 90%), hence precise insight in evaluating nodules of concern and following up other nodules is important to avoid unnecessary surgeries and its complications.Summary: Certain nodules, which are symptomatic or suspicious on clinical evaluation, need further evaluation with ultrasonography and cytopathology before embarking on definitive treatment. Indeterminate nodules can further be analysed by newer advances like molecular tests, liquid biopsy to guide further management. Active surveillance is an option for select malignant nodules that fit the defined criteria. Small benign nodules which are symptomatic or of cosmetic concern can also be treated with minimally invasive options of ethanol injection or thermal ablative techniques. Hemithyroidectomy is diagnostic for follicular neoplasm or definitive treatment for solitary, symptomatic or hypersecreting benign nodules or even for small solitary thyroid carcinoma. Total thyroidectomy is option of choice for symptomatic or hypersecreting or malignant multiple nodules.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"32 5","pages":"167-174"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Subclinical hyperthyroidism. 亚临床甲状腺机能亢进。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-08-20 DOI: 10.1097/MED.0000000000000928

Alasdair Cooper, Prakash Abraham

{"title":"Subclinical hyperthyroidism.","authors":"Alasdair Cooper, Prakash Abraham","doi":"10.1097/MED.0000000000000928","DOIUrl":"10.1097/MED.0000000000000928","url":null,"abstract":"Purpose of review: Subclinical hyperthyroidism is a clinical condition where thyroid-stimulating hormone (TSH) is below the normal range along with normal levels of circulating thyroid hormones. It is associated with cardiovascular complications such as atrial fibrillation, but the effects on other organ systems is less certain. There are areas of uncertainty in the management of this condition, which this review seeks to address by reviewing relevant literature from the last 18 months.Recent findings: Data on prevalence from recent meta-analyses are in line with previous studies. Individual TSH reference ranges are influenced by genetic factors, which suggests that current reference ranges may be leading to misdiagnosis. Further research has increased the strength of evidence for the association with atrial fibrillation. A meta-analysis has shown increased risk of osteoporosis and fractures. Data support an association between subclinical hyperthyroidism and dementia. A randomised controlled trial has recently been conducted to investigate the effect of treatment on atrial fibrillation incidence, in which post hoc-analysis showed normalisation of TSH decreased risk of atrial fibrillation.Summary: Degree of TSH suppression is an important element of clinical assessment. Subclinical hyperthyroidism is associated with atrial fibrillation, osteoporosis and dementia. Further research in this field is warranted.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"175-179"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The approaches and challenges in the management of differentiated thyroid carcinoma. 分化型甲状腺癌治疗的途径与挑战。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-08-20 DOI: 10.1097/MED.0000000000000927

Nicholas D A Blefari, James C Lee

{"title":"The approaches and challenges in the management of differentiated thyroid carcinoma.","authors":"Nicholas D A Blefari, James C Lee","doi":"10.1097/MED.0000000000000927","DOIUrl":"10.1097/MED.0000000000000927","url":null,"abstract":"Purpose of review: Whilst the prognosis of thyroid carcinoma remains excellent, patients with advanced thyroid carcinoma have a considerable burden of disease. Clinicians continue to face and manage challenging scenarios in the setting of thyroid cancer, particularly in those with recurrent disease, metastatic disease or special scenarios such as thyroid cancer in pregnancy. The purpose of this article is to provide an overview of thyroid cancer management and an update in emerging areas of management, particularly in the setting of locally advanced disease.Recent findings: Systemic treatment of thyroid malignancy, particularly in the setting of locally advanced thyroid cancer, is rapidly evolving. Advances in targeted therapy have allowed for previously unresectable thyroid malignancies to undergo surgery, with significant increases to disease-free survival. Genomic profiling of tumours allows for specific mutations to be targeted with promising results for this cohort of patients.Summary: This overview of the current management of thyroid carcinoma pays close attention to differentiated thyroid malignancy, with summaries of assessment, work-up and surgical management. Focus is made to the scenarios that continue to challenge clinicians, with up-to-date summaries of recent advances in this field.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"180-187"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emerging treatment options for adrenocortical carcinoma. 肾上腺皮质癌的新治疗方案。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-07-16 DOI: 10.1097/MED.0000000000000921

Olga Papalou, Stylianos Tsagarakis, Dimitra Argyro Vassiliadi

{"title":"Emerging treatment options for adrenocortical carcinoma.","authors":"Olga Papalou, Stylianos Tsagarakis, Dimitra Argyro Vassiliadi","doi":"10.1097/MED.0000000000000921","DOIUrl":"10.1097/MED.0000000000000921","url":null,"abstract":"Purpose of review: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options and poor prognosis. This review highlights recent advances in risk stratification, systemic therapies, surgical approaches and personalized treatment strategies to improve outcomes in ACC.Recent findings: Significant progress has been made in molecular characterization of ACC, enabling more precise risk stratification and prognostication. Novel biomarkers and integrated scoring systems now complement traditional staging methods. Therapeutic advances include refinements in surgical approaches for both localized and metastatic disease, while systemic treatment options are expanding beyond traditional mitotane-based regimens. Immunotherapy and targeted agents show emerging promise, particularly in molecularly selected patients. The role of adjuvant therapy continues to evolve, with recent evidence supporting more selective application based on individual risk assessment. Multimodal strategies combining locoregional and systemic therapies are demonstrating improved outcomes in advanced disease.Summary: The ACC treatment landscape is undergoing significant transformation, moving toward personalized approaches guided by molecular profiling and risk-adapted strategies. While challenges remain in overcoming treatment resistance and validating new biomarkers, the integration of advanced diagnostics with innovative therapies offers hope for improved patient outcomes. Future progress will depend on collaborative research efforts and the development of robust clinical trials.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"201-209"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in the medical management of hypercortisolism: current strategies, monitoring, and emerging therapies. 高皮质醇症的医学管理进展：当前的策略、监测和新兴疗法。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-10-01 Epub Date: 2025-07-17 DOI: 10.1097/MED.0000000000000920

Jorge Esteban Mosquera, Leili Rahimi, Oksana Hamidi

{"title":"Advances in the medical management of hypercortisolism: current strategies, monitoring, and emerging therapies.","authors":"Jorge Esteban Mosquera, Leili Rahimi, Oksana Hamidi","doi":"10.1097/MED.0000000000000920","DOIUrl":"10.1097/MED.0000000000000920","url":null,"abstract":"Purpose of review: This review outlines the indications for medical management of hypercortisolism and summarizes available and emerging pharmacologic agents.Recent findings: Endogenous Cushing syndrome is a complex endocrine disorder resulting from chronic cortisol excess. The underlying etiology of Cushing syndrome is due to either adrenocorticotropic hormone (ACTH)-dependent causes, such as pituitary tumors (Cushing disease) or ectopic ACTH syndrome from nonpituitary neuroendocrine tumors, or ACTH-independent causes, such as autonomous cortisol production by adrenal adenomas, hyperplasia, or carcinomas. Cushing syndrome is associated with increased cardiometabolic morbidity and mortality, infections, thromboembolic events, cognitive and psychiatric disorders, and reduced quality of life. Successful treatment significantly reduces mortality and improves associated clinical and metabolic consequences of chronic hypercortisolism. Management of Cushing syndrome varies depending on the underlying etiology. While surgical resection of the causal lesion remains the first-line treatment for all etiologies of Cushing syndrome, second-line treatments, such as medical management, radiation therapy, and bilateral adrenalectomy, may be needed when surgery is not feasible or has failed.Summary: We discuss the efficacy of medical therapies for hypercortisolism, combination therapy strategies, special considerations in unique populations, and monitoring protocols. Finally, we explore emerging treatments and potential future directions in the management of this complex condition.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"222-232"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Personalizing therapy in early gestational diabetes. 妊娠早期糖尿病的个体化治疗。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-09-19 DOI: 10.1097/MED.0000000000000931

Simran Thakkar, Ponnusamy Saravanan, Lakshmi Nagendra, Saptarshi Bhattacharya

{"title":"Personalizing therapy in early gestational diabetes.","authors":"Simran Thakkar, Ponnusamy Saravanan, Lakshmi Nagendra, Saptarshi Bhattacharya","doi":"10.1097/MED.0000000000000931","DOIUrl":"https://doi.org/10.1097/MED.0000000000000931","url":null,"abstract":"Purpose of review: Early gestational diabetes mellitus (eGDM) is being increasingly detected on the background of rising obesity rates and widespread early pregnancy screening. However, diagnostic criteria and management strategies remain uncertain. This review summarizes current evidence on diagnostic thresholds, maternal and fetal outcomes, and the impact of early treatment, with an emphasis on balancing benefits and risks.Recent findings: While observational studies link eGDM to adverse maternal and fetal outcomes, evidence from intervention studies remains limited. The Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) is the only large multicenter randomized controlled trial (RCT) published till date. The early intervention arm in the study received education on dietary counseling and capillary blood glucose monitoring, with pharmacotherapy using insulin or metformin introduced when indicated. The trial reported that treatment before 14 weeks reduced neonatal respiratory distress in higher glycemic bands but increased the risk of small-for-gestational-age state at lower glycemic bands. Notably, one-third of the untreated control group reverted to normoglycemia at 24-28 weeks. Given the uncertainties in diagnostic thresholds used in TOBOGM, a composite risk score-based approach integrating clinical and biochemical parameters may provide an alternative for identifying pregnancies in need of intervention.Summary: Current diagnostic criteria may not identify eGDM pregnancies that would benefit from intervention. Redefining diagnostic thresholds and integrating them with clinical risk factors could categorize pregnancies in need of intervention. Appropriately designed RCTs are required to generate evidence for accurate identification and optimal treatment of eGDM.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0