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Training Programs for Thyroid Biopsy and Ablation: A Systematic Review. 甲状腺活检和消融培训计划:系统回顾。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-19 DOI: 10.1016/j.eprac.2025.09.010
Sharon Bridgemohan, Andrea Ortiz, Gilberto Perez Rodriguez Garcia, Sannidhi Kolukula, Gonzalo J Acosta, Christopher Samouce, Samsun Lampotang, Juan P Brito, Naykky Singh Ospina
{"title":"Training Programs for Thyroid Biopsy and Ablation: A Systematic Review.","authors":"Sharon Bridgemohan, Andrea Ortiz, Gilberto Perez Rodriguez Garcia, Sannidhi Kolukula, Gonzalo J Acosta, Christopher Samouce, Samsun Lampotang, Juan P Brito, Naykky Singh Ospina","doi":"10.1016/j.eprac.2025.09.010","DOIUrl":"10.1016/j.eprac.2025.09.010","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the structure, components, and outcomes of educational programs designed to train clinicians in thyroid fine needle aspiration (FNA) and ablative procedures.</p><p><strong>Methods: </strong>A systematic review of 5 databases was conducted for studies published from 2000 through April 2025 evaluating training interventions for thyroid FNA or ablative techniques. Two independent reviewers screened, extracted data, and assessed risk of bias for all eligible studies.</p><p><strong>Results: </strong>Ten studies met inclusion criteria: nine addressed FNA training, and one addressed radiofrequency ablation (RFA). All studies were rated at moderate to high risk of bias. Common instructional components included didactic sessions (n = 5), hands-on simulation (n = 9), supervised clinical experience (n = 4), and multimodal approaches (n = 7). Simulation models varied in complexity, including food-based models, cadavers, and 3D-printed phantoms. Reported educational outcomes included improved learner confidence and perceived realism (reaction outcomes); enhanced accuracy, procedural speed, and knowledge (learning outcomes); and improvements in biopsy adequacy, malignant diagnostic yield, and procedural wait times (clinical outcomes). The single RFA study demonstrated a median nodule volume reduction of 82% at 12 months following simulation-based and supervised training.</p><p><strong>Conclusion: </strong>Structured, multimodal training programs in thyroid FNA and RFA improve both learner performance and clinical outcomes. These findings support the integration of simulation-based learning and supervised procedural experience into thyroid intervention training.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111482","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
American Association of Clinical Endocrinology Consensus Statement: Algorithm for the Evaluation and Treatment of Adults with Obesity/Adiposity-Based Chronic Disease - 2025 Update. 美国临床内分泌学会共识声明:评估和治疗成人肥胖/肥胖慢性疾病的算法- 2025年更新。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-18 DOI: 10.1016/j.eprac.2025.07.017
Karl Nadolsky, W Timothy Garvey, Monica Agarwal, Alex Bonnecaze, Bartolome Burguera, Michelle DeGeeter Chaplin, Marcio L Griebeler, Samantha R Harris, Jeffrey N Schellinger, Juliana Simonetti, Reshmi Srinath, Volkan Yumuk
{"title":"American Association of Clinical Endocrinology Consensus Statement: Algorithm for the Evaluation and Treatment of Adults with Obesity/Adiposity-Based Chronic Disease - 2025 Update.","authors":"Karl Nadolsky, W Timothy Garvey, Monica Agarwal, Alex Bonnecaze, Bartolome Burguera, Michelle DeGeeter Chaplin, Marcio L Griebeler, Samantha R Harris, Jeffrey N Schellinger, Juliana Simonetti, Reshmi Srinath, Volkan Yumuk","doi":"10.1016/j.eprac.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.017","url":null,"abstract":"<p><strong>Objective: </strong>This 2025 consensus statement provides evidence-based visual guidance in graphic algorithms and a summary of evidence to assist health care professionals and adults with obesity and adiposity-based chronic disease (ABCD) in shared decision making to improve care and achieve health goals.</p><p><strong>Methods: </strong>AACE selected a task force of medical experts to update the 2016 AACE algorithm for the medical care of patients with obesity and align this algorithm update with related AACE clinical guidance. Details on surgical and procedural therapies for obesity treatment as well as the care of pediatric-aged patients are beyond the scope of this algorithm.</p><p><strong>Results: </strong>The algorithm includes 11 sections: (1) principles of person-centered and complication-centric management of obesity/ABCD, (2) care model for people with obesity/ABCD: screening and diagnosis, (3) diagnosis: anthropometric component, (4) diagnosis: clinical component, (5) individualized treatment plan, therapeutic goals, and follow-up, (6) response to therapy and weight-loss targets for people with ABCD, (7) behavioral/lifestyle therapy for people with obesity/ABCD, (8) hierarchies of preferred medications for complication-centric care of people with ABCD, (9) lower-cost pharmacologic step therapy for ABCD, (10) medications for obesity: individualization of therapy, and (11) medications for obesity approved by the U.S. Food and Drug Administration.</p><p><strong>Conclusions: </strong>This 2025 algorithm for the medical care of adults with obesity underscores that ABCD is a complex, chronic disease that necessitates long-term treatment and care. Emphasis is placed on optimizing health rather than just weight reduction and achieving clinical goals other than a singular focus on body mass index (ie, complication-centric care). Choice of interventions and intensity of treatment should be individualized, taking disease severity or stage into account. Equality of care and reducing weight bias and stigma through a biopsychosocial chronic care model are critical and included throughout this clinical guidance statement.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069302","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
Expanding the Clinical Profile of Mild Autonomous Cortisol Secretion: New Diagnostic Markers and Emerging Complications. 扩展轻度自主皮质醇分泌的临床特征:新的诊断标记和新出现的并发症。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-17 DOI: 10.1016/j.eprac.2025.09.009
Antonio Prinzi, Ausilia Maria Lombardo, Salvatore Finocchiaro, Antonio Galvano, Veronica Vella, Francesco Frasca, Pasqualino Malandrino
{"title":"Expanding the Clinical Profile of Mild Autonomous Cortisol Secretion: New Diagnostic Markers and Emerging Complications.","authors":"Antonio Prinzi, Ausilia Maria Lombardo, Salvatore Finocchiaro, Antonio Galvano, Veronica Vella, Francesco Frasca, Pasqualino Malandrino","doi":"10.1016/j.eprac.2025.09.009","DOIUrl":"10.1016/j.eprac.2025.09.009","url":null,"abstract":"<p><strong>Objective: </strong>Mild autonomous cortisol secretion (MACS) is a frequent finding in adrenal incidentalomas (AI), yet its diagnosis remains challenging. We aimed to compare clinical and biochemical profiles between MACS and non-functioning AIs and to identify reliable biomarkers, alternative to the 1 mg dexamethasone suppression test (DST), that can support the diagnosis of MACS.</p><p><strong>Methods: </strong>We retrospectively analyzed 171 patients with AIs (70 MACS, 101 non-functioning AI) evaluated between 2005 and 2025. MACS was defined by DST cortisol >1.8 μg/dL without overt Cushing's syndrome.</p><p><strong>Results: </strong>Patients with MACS showed a higher prevalence of dyslipidemia (68.1% vs 52.0%; P = .037) and anxiety-depressive disorders (25.0% vs 11.0%; P = .018). Biochemically, they showed lower adrenocorticotropic hormone (11.1 pg/mL vs 16.8 pg/mL; P = .014), dehydroepiandrosterone-sulfate (0.3 μg/mL vs 0.9 μg/mL; P < .001), and testosterone levels in male (3.56 ng/ml vs 5.41 ng/ml, P = .04), with higher post-DST cortisol (2.8 μg/dL vs 1.2 μg/dL; P < .001), 24-hour urinary-free cortisol (67.2 μg/24h vs 44.8 μg/24h; P < .001), and late-night serum cortisol (8.2 μg/dL vs 3.6 μg/dL, P < .001). Adrenocorticotropic hormone <15 pg/mL (P = .029) and dehydroepiandrosterone-sulfate <0.5 μg/mL (P = .009) independently predicted MACS (area under the curve: 0.78) and were combined into a 2-point diagnostic score with 89.5% sensitivity and 97.5% negative predictive value. Late-night cortisol ≥5.1 μg/dL showed good accuracy (area under the curve: 0.83) for identifying patients with MACS and correlated with the number of MACS-related comorbidities (P = .0178).</p><p><strong>Conclusions: </strong>MACS is associated with neuropsychiatric and gonadal dysfunction. A simple and easily applicable biochemical score, together with late-night cortisol, may support diagnosis, particularly when the DST is inconclusive or in hospitalized patients.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091387","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
Differences in α-Blockade Practices Between Endocrine and Surgical Specialties for Pheochromocytoma and Paraganglioma Resection: A Single-Center Retrospective Study. 嗜铬细胞瘤和副神经节瘤切除术中α-阻断治疗在内分泌和外科专科的差异:一项单中心回顾性研究
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-12 DOI: 10.1016/j.eprac.2025.09.006
Jorge E Mosquera, Shubham Agarwal, Megan Maxwell, Trent Bryson, Mishal Johny, Aiden Berry, Sasan Mirfakhraee, Sarah C Oltmann, Alan P Dackiw, Ankeeta Mehta, Ana Islam, Solomon Woldu, Fiemu Nwariaku, Oksana Hamidi
{"title":"Differences in α-Blockade Practices Between Endocrine and Surgical Specialties for Pheochromocytoma and Paraganglioma Resection: A Single-Center Retrospective Study.","authors":"Jorge E Mosquera, Shubham Agarwal, Megan Maxwell, Trent Bryson, Mishal Johny, Aiden Berry, Sasan Mirfakhraee, Sarah C Oltmann, Alan P Dackiw, Ankeeta Mehta, Ana Islam, Solomon Woldu, Fiemu Nwariaku, Oksana Hamidi","doi":"10.1016/j.eprac.2025.09.006","DOIUrl":"10.1016/j.eprac.2025.09.006","url":null,"abstract":"<p><strong>Objective: </strong>Surgery remains the only definitive cure for pheochromocytoma and paraganglioma. The impact of variable α-blockade practices preoperatively has not been explored. This study compared preoperative α-blockade strategies between endocrine and surgical specialties and assessed their differences in perioperative outcomes.</p><p><strong>Methods: </strong>This retrospective longitudinal cohort study included patients with pheochromocytoma and paraganglioma who underwent laparoscopic or robot-assisted surgical resection between 2006 and 2023 at a single academic center.</p><p><strong>Results: </strong>The cohort comprised 78 patients (endocrine group [n = 28] and surgical group [n = 50]). There were no significant differences in baseline hormonal profiles or tumor size between the groups. Both groups more commonly used selective α-blockers over nonselective agents. Patients in the endocrine group underwent a shorter course of α-blockade (median [IQR]: 17 days [14-39] vs 27 days [17-55]), received higher doses of selective (mean ± SD: 10 mg ± 8.6 vs 6.9 mg ± 4.3) and nonselective α-blockers (60 mg ± 32 vs 35 mg ± 14.5), and had a higher frequency of daily α-blocker administration compared to the surgical group. Despite these variations in practice, perioperative hemodynamic outcomes remained comparable between groups. Across the overall cohort, larger tumor size and higher metanephrine concentrations were associated with both systolic and diastolic hypotension (P < .05 for both). Elevated metanephrine levels and older age correlated with prolonged duration of systolic blood pressure >160 mmHg (P < .05).</p><p><strong>Conclusion: </strong>Despite differences in α-blockade strategies between the groups, perioperative hemodynamic outcomes were comparable, supporting flexibility in management. Tumor burden and patient age were associated with perioperative hemodynamic variability.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063651","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
Use of the 36-Point Thyroid Symptom Questionnaire to Potentially Guide Optimal Thyroid Hormone Replacement Therapy. 使用36点甲状腺症状问卷可能指导最佳甲状腺激素替代治疗。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-12 DOI: 10.1016/j.eprac.2025.09.007
Thanh D Hoang, Arjun A Patel, Andrew J Spiro, Nora L Watson, Mohamed K M Shakir
{"title":"Use of the 36-Point Thyroid Symptom Questionnaire to Potentially Guide Optimal Thyroid Hormone Replacement Therapy.","authors":"Thanh D Hoang, Arjun A Patel, Andrew J Spiro, Nora L Watson, Mohamed K M Shakir","doi":"10.1016/j.eprac.2025.09.007","DOIUrl":"10.1016/j.eprac.2025.09.007","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between a transition from levothyroxine (LT4) to combination therapy and change in the Thyroid Symptom Questionnaire (TSQ-36).</p><p><strong>Methods: </strong>We performed a post hoc subgroup analysis of 2 previous randomized, double-blind, crossover studies (total n = 143) to evaluate patient symptoms on treatment with LT4, desiccated thyroid extract (DTE), and levothyroxine + liothyronine (LT4+LT3). The TSQ-36 was completed at the end of each treatment period in the context of normal thyroid stimulating hormone levels. Patients were stratified based on their TSQ-36 score on LT4: Low Symptoms (TSQ-36: 0-12), Moderate Symptoms (TSQ-36: 13-24), and High Symptoms (TSQ-36: 25-36). Mean TSQ-36 scores were compared on LT4, LT4+LT3, and DTE. Treatment-blinded preference of therapy was also stratified by TSQ-36 score on LT4.</p><p><strong>Results: </strong>In cohort 1, the Moderate-High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P = .01). In cohort 2, the High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P < .01) and on LT4+LT3 vs LT4 (P < .001). The Moderate Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P = .02). The Low Symptoms group had significantly lower TSQ-36 scores on LT4 vs DTE (P = .03) and LT4+LT3 (P = .02). Patients who preferred combination therapy had significantly higher TSQ-36 scores than patients who preferred LT4. Persistent symptoms may be due to a relative deficiency in triiodothyronine, which could be remedied by combination therapy.</p><p><strong>Conclusion: </strong>The TSQ-36 can potentially be used to quantify patient symptoms and guide thyroid hormone therapy. Patients on LT4, with moderate-to-severe symptoms despite normalization of thyroid stimulating hormone, could consider a trial of combination therapy. Patients with low symptoms on LT4 should generally avoid combination therapy.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063621","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
Osilodrostat Treatment for Cushing Syndrome: 5 Years on Since Regulatory Approval. 奥西洛司他治疗库欣综合征:自监管部门批准以来的五年。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-12 DOI: 10.1016/j.eprac.2025.09.005
Kevin C J Yuen
{"title":"Osilodrostat Treatment for Cushing Syndrome: 5 Years on Since Regulatory Approval.","authors":"Kevin C J Yuen","doi":"10.1016/j.eprac.2025.09.005","DOIUrl":"10.1016/j.eprac.2025.09.005","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063576","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
American Association of Clinical Endocrinology Consensus Statement: Algorithm for Management of Adults with Dyslipidemia – 2025 Update 美国临床内分泌学会共识声明:成人血脂异常管理算法- 2025年更新。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-12 DOI: 10.1016/j.eprac.2025.07.014
Shailendra B. Patel BM, ChB, DPhil , L. Maria Belalcazar MD , Samina Afreen MD , Ramiro Balderas MD , Robert A. Hegele MD, FRCPC , Fredrik Karpe MD, PhD , Carlos I. Ponte-Negretti MD , Aman Rajpal MBBS, MD
{"title":"American Association of Clinical Endocrinology Consensus Statement: Algorithm for Management of Adults with Dyslipidemia – 2025 Update","authors":"Shailendra B. Patel BM, ChB, DPhil ,&nbsp;L. Maria Belalcazar MD ,&nbsp;Samina Afreen MD ,&nbsp;Ramiro Balderas MD ,&nbsp;Robert A. Hegele MD, FRCPC ,&nbsp;Fredrik Karpe MD, PhD ,&nbsp;Carlos I. Ponte-Negretti MD ,&nbsp;Aman Rajpal MBBS, MD","doi":"10.1016/j.eprac.2025.07.014","DOIUrl":"10.1016/j.eprac.2025.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>To provide visual guidance in concise algorithms and tables to assist with clinical decision making in the management of adults with dyslipidemia to reduce risk of ASCVD and triglyceride-induced pancreatitis.</div></div><div><h3>Methods</h3><div>An international multidisciplinary task force of clinical experts was convened to update the 2020 AACE algorithm for dyslipidemia. Literature searches informed the creation of visual guidance graphics and supporting narratives that reflect consensus of the task force.</div></div><div><h3>Results</h3><div>The 2025 algorithm for the management of adults with dyslipidemia includes the following sections: (1) guiding principles for patient-centered management of dyslipidemia; (2) risk assessment and testing for dyslipidemia; (3) identifying genetic dyslipidemias; (4) specific lifestyle recommendations for adults with dyslipidemia; (5) targeting LDL-cholesterol with pharmacologic therapy for ASCVD prevention in adults; (6) approach to statin-associated muscle symptoms in adults; (7) management of adults with hypertriglyceridemia; (8) management of special populations with dyslipidemia (older adults, adults receiving transgender care or HIV control, adults with autoimmune disorders, survivors of childhood cancers, adults with organ transplantation); (9) management of hypercholesterolemia in pregnant and lactating individuals; (10) management of hypertriglyceridemia in pregnant and lactating individuals; and (11) FDA-approved medications for dyslipidemia.</div></div><div><h3>Conclusions</h3><div>This 2025 dyslipidemia algorithm update aligns with the 2025 <em>AACE Clinical Practice Guideline for Pharmacologic Management of Adults with Dyslipidemia</em> and other recent AACE guidance. The algorithm is also in agreement with guidance provided by the other international bodies represented within this task force. This update emphasizes ASCVD risk assessment, addresses pancreatitis risk, and highlights individualized pharmacotherapy. The algorithm includes considerations on health equity, cost effectiveness, and the benefits and harms of different management options.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 10","pages":"Pages 1207-1238"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039354","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
Inpatient Diet Orders and Continuous Glucose Monitoring in Noncritically Ill, Hospitalized Adult Patients. 非危重症、住院成人患者的住院饮食命令和持续血糖监测。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-11 DOI: 10.1016/j.eprac.2025.09.002
Anushka Sharma, Evangelos Vassilakis, Kristen L Flint, Hui Zheng, Melissa S Putman, Hassan S Dashti
{"title":"Inpatient Diet Orders and Continuous Glucose Monitoring in Noncritically Ill, Hospitalized Adult Patients.","authors":"Anushka Sharma, Evangelos Vassilakis, Kristen L Flint, Hui Zheng, Melissa S Putman, Hassan S Dashti","doi":"10.1016/j.eprac.2025.09.002","DOIUrl":"10.1016/j.eprac.2025.09.002","url":null,"abstract":"<p><strong>Objectives: </strong>Inpatient diet orders are commonly prescribed in clinical practice and may influence the glycemic management in hospitalized patients, yet empirical data remain limited. This study aimed to evaluate the relationship between diet orders and continuous glucose monitoring (CGM) derived glycemic measures in noncritically ill hospitalized adults.</p><p><strong>Methods: </strong>This secondary analysis used data from a prospective, observational study. Inpatient diet orders were extracted from clinical documentation and standardized into 11 general diet order categories. The primary outcome was percent time in range (70-180 mg/dL). Secondary outcomes included time above range, time below range, and glycemic variability. Associations were examined using multivariate linear mixed-effects models, accounting for demographics, insulin therapy, and other relevant medications.</p><p><strong>Results: </strong>The analytical sample included 283 hospitalized adults (mean age 60.7 years, body mass index 38.5 kg/m<sup>2</sup>, 36.4% female), primarily admitted to medical units, with most having type 2 diabetes (77.4%). CGM-derived glycemic measures and insulin therapy use varied significantly across inpatient diet orders. Compared to a regular diet, a regular diet with restrictions was associated with lower time in range and higher time above range, whereas diabetic and liquid diets were associated with higher time below range. Measures of glucose variability did not differ across diet orders.</p><p><strong>Conclusions: </strong>Inpatient diet orders are modestly associated with 24-hour CGM-derived glycemic measures adjusted by insulin therapy and other related medications. Future research is needed to standardize diet order classifications and assess their impact on inpatient glycemic management.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Choice of Hormone Assay to Monitor Feminizing Gender-Affirming Hormone Therapy. 选择激素检测监测女性化性别肯定激素治疗。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-11 DOI: 10.1016/j.eprac.2025.08.010
Daniel J Slack, Nithya Krishnamurthy, Meghan Garrity, Derek Chen, Moira Kyweluk, Eli Trakhtenberg, Jerrica Kirkley, Joshua D Safer
{"title":"Choice of Hormone Assay to Monitor Feminizing Gender-Affirming Hormone Therapy.","authors":"Daniel J Slack, Nithya Krishnamurthy, Meghan Garrity, Derek Chen, Moira Kyweluk, Eli Trakhtenberg, Jerrica Kirkley, Joshua D Safer","doi":"10.1016/j.eprac.2025.08.010","DOIUrl":"10.1016/j.eprac.2025.08.010","url":null,"abstract":"<p><strong>Objective: </strong>Studies have shown variability in the correlation among testosterone (T) concentrations, estradiol (E2) concentrations, and other clinical parameters to monitor response to feminizing gender-affirming hormone therapy (GAHT). We aimed to determine the degree to which data support the use of serum T, serum E2, luteinizing hormone (LH), or follicle stimulating hormone to monitor feminizing GAHT with the goal of decreasing the effect of endogenous androgens.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of T and E2 concentrations in 9916 transfeminine individuals prescribed estradiol to examine the association between individuals' most recent serum T, E2, LH, and follicle stimulating hormone concentrations in the context of feminizing GAHT treatment.</p><p><strong>Results: </strong>Changes in T concentrations were inversely correlated with changes in E2 concentrations (P < .001). However, orchiectomy, age, and the use of spironolactone were associated with changes in T, but not E2 concentrations (P < .001). Changes in T concentrations were also correlated with changes in LH (P < .05). Such correlations were not demonstrated with E2 concentrations.</p><p><strong>Conclusions: </strong>To monitor feminizing GAHT, it may be reasonable to favor target T concentrations over E2 concentrations in patients with testes and to consider LH concentrations in patients without testes who are not taking gonadotropin-releasing hormone agonists.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058348","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
Young Adult Diabetes Technology Use in Pediatric as Compared to Adult Practices. 青少年糖尿病技术在儿科和成人实践中的应用。
IF 4.6 3区 医学
Endocrine Practice Pub Date : 2025-09-11 DOI: 10.1016/j.eprac.2025.09.001
Sean DeLacey, Saketh Rompicherla, Jody Grundman, Naomi R Fogel, Sarah Corathers, Shivani Agarwal, Roberto Izquierdo, Lauren Golden, Jill Weissberg-Benchell, Osagie Ebekozien
{"title":"Young Adult Diabetes Technology Use in Pediatric as Compared to Adult Practices.","authors":"Sean DeLacey, Saketh Rompicherla, Jody Grundman, Naomi R Fogel, Sarah Corathers, Shivani Agarwal, Roberto Izquierdo, Lauren Golden, Jill Weissberg-Benchell, Osagie Ebekozien","doi":"10.1016/j.eprac.2025.09.001","DOIUrl":"10.1016/j.eprac.2025.09.001","url":null,"abstract":"<p><strong>Objective: </strong>People with type 1 diabetes (T1D) are more likely to have high hemoglobin A1C (HbA1C) levels in emerging adulthood. The transition to adult practices is often difficult, and the ideal age for transfer is unclear. We aimed to characterize differences in disease outcomes and care between pediatric and adult institutions for young adults (YAs) with T1D.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients aged 18 to 23 years, using data from the T1D Exchange (January 1, 2022 to December 31, 2023) and categorized patients according to location of care (n = 8538 from pediatric institutions, n = 839 from adult institutions). We compared group characteristics in an unadjusted manner and then used logistic regression to compare rates of optimal (HbA1C <7.0%) and poor (HbA1C >9%) diabetes control, acute complications, and technology use between groups.</p><p><strong>Results: </strong>Those at adult institutions were older at time of analysis (mean: 21.4 vs 20 years) and more likely to have undocumented insurance (21% vs 2%). Technology use was high in both populations. However, adjusting for covariates, those in adult institutions were more likely to have poor control (odds ratio [OR] 1.23, P = .03) and less likely to use a continuous glucose monitor (OR 0.64, P < .001) or an insulin pump (OR 0.62, P < .001).</p><p><strong>Conclusion: </strong>YAs receiving care in adult versus pediatric centers appear more likely to have poor diabetes control and less likely to use diabetes technology. The findings are limited by unequal regional representation and smaller adult center population. Research is needed to identify barriers to technology use for YAs particularly in adult practices.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058486","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}
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