Endocrine Practice最新文献_第2页

Comparison between alendronate and denosumab in preventing bone loss and lowering fracture risk related to adjuvant endocrine therapy (AET) for breast cancer: real-world data from a Third Level Centre experience. 阿仑膦酸钠和地诺单抗在预防乳腺癌辅助内分泌治疗（AET）相关骨质流失和降低骨折风险方面的比较：来自第三级中心经验的真实数据

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-11 DOI: 10.1016/j.eprac.2025.07.004

Claudio Gianfelice, Francesca Firmani, Gianmaria Salvio, Alessandro Ciarloni, Rossella Ferroni, Francesca Silvetti, Lara Giovannini, Mirco Pistelli, Veronica Agostinelli, Rossana Berardi, Giancarlo Balercia, Gilberta Giacchetti

{"title":"Comparison between alendronate and denosumab in preventing bone loss and lowering fracture risk related to adjuvant endocrine therapy (AET) for breast cancer: real-world data from a Third Level Centre experience.","authors":"Claudio Gianfelice, Francesca Firmani, Gianmaria Salvio, Alessandro Ciarloni, Rossella Ferroni, Francesca Silvetti, Lara Giovannini, Mirco Pistelli, Veronica Agostinelli, Rossana Berardi, Giancarlo Balercia, Gilberta Giacchetti","doi":"10.1016/j.eprac.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.004","url":null,"abstract":"Objectives: Adjuvant endocrine therapy (AET) for breast cancer treatment is associated with bone loss and increased fracture risk. This study evaluated variations in bone mineral density (BMD), trabecular bone score (TBS), biochemical parameters, and incidence of major fracture in a population of postmenopausal women on AET comparing denosumab 60 mg s.c/six months and alendronate 70 mg p.o/week.Methods: After propensity-score matching, a population of postmenopausal women on AET was retrospectively evaluated comparing effects on BMD, TBS, bone turnover markers, and major fracture incidence (assessed by quantitative vertebral morphometry) after nearly 3-year follow up of denosumab 60 mg s.c. every 6 months and alendronate 70 mg p.o. every week (n=286, ratio 1:1) RESULTS: Denosumab group showed greater increase in total hip BMD (+0.034 g/cm2 vs +0.002 g/cm2; p<0.01), femoral neck BMD (+0.014 vs 0.000 g /cm2; p<0.01), lumbar spine BMD (+0.053 vs +0.005 g/cm2; p<0.01) and TBS (+0.017 vs -0.027; p<0.01) in comparison to alendronate. Treatment with denosumab was associated with 66% risk reduction of major fractures in comparison to alendronate (OR 0.34; p<0.01). There was no significant difference between groups in reducing fracture risk considering only patients with normal BMD at baseline.Conclusions: Treatment with denosumab during AET improves BMD and TBS more than alendronate and is associated with greater reduction of major fractures in postmenopausal patients affected by osteopenia or osteoporosis.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625545","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

A Real-World Study of Oral Anti-Hyperglycemic Agents as Compared to Basal Insulin in Hospitalized Patients with Type 2 Diabetes. 2型糖尿病住院患者口服降糖药与基础胰岛素的对比研究

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-08 DOI: 10.1016/j.eprac.2025.06.014

Maya Fayfman, Irit Hochberg, Michelle Magee, Ammar Rashied, Nataliya Chaudhry, Ram Jagannathan, Francisco J Pasquel, Guillermo E Umpierrez

{"title":"A Real-World Study of Oral Anti-Hyperglycemic Agents as Compared to Basal Insulin in Hospitalized Patients with Type 2 Diabetes.","authors":"Maya Fayfman, Irit Hochberg, Michelle Magee, Ammar Rashied, Nataliya Chaudhry, Ram Jagannathan, Francisco J Pasquel, Guillermo E Umpierrez","doi":"10.1016/j.eprac.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.014","url":null,"abstract":"Introduction: Oral antihyperglycemic drugs (OADs) are commonly used in the hospital despite limited safety and efficacy data.Research design and methods: We pooled data from three healthcare systems in the US and Israel from 2010-2019 (n=79,047) of hospitalized patients with type 2 diabetes. Treatment with OADs was compared to insulin-based therapy (\"Basal\") and combined OAD and basal insulin (\"OAD+Basal\"). The primary outcome was inpatient target glycemia defined as a mean blood glucose (BG) of 80-180 mg/dL and no hypoglycemia (<70 mg/dl). We conducted inverse probability weighting adjusting for age, sex, admission BG, creatinine, specialty type (medicine vs surgery), and Charlson comorbidity scores.Results: People treated with basal insulin had higher admission BG and comorbidities than those in the other two groups. Compared to Basal, people treated with OAD were more likely to have target glycemia [odds ratio (OR): 2.07; 95% CI (confidence interval): 1.85, 2.31] and lower odds of hypoglycemia (OR: 0.54; 95% CI: 0.46, 0.62), while OAD+Basal showed no difference in glycemia (OR: 0.99; 95% CI: 0.95, 1.04). Metformin monotherapy was not associated with higher risk of lactic acidosis. Patients treated with sulfonylureas, had higher rates of hypoglycemia. Mortality was lower among those treated with OADs (OR 0.16; 95%; 95% CI 0.11, 0.24) and OAD+Basal (OR 0.34; 95% CI: 0.23, 0.49) as compared to Basal.Conclusion: The use of OADs in the hospital appeared to be safe and effective for management of hyperglycemia among patients with T2D and a lower burden of comorbidities.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607773","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

Injectable estradiol monotherapy effectively suppresses testosterone in gender-affirming hormone therapy. 注射雌二醇单药治疗在性别确认激素治疗中有效抑制睾酮。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-08 DOI: 10.1016/j.eprac.2025.07.002

Aaron L Misakian, Danit Ariel, Erika A Sullivan, Gagandeep Singh, Danielle Loeb, Tyler Strickland, Sean J Iwamoto, Micol S Rothman, Bren Botzheim, Jane W Liang, Carly Kelley, Ole-Petter R Hamnvik

{"title":"Injectable estradiol monotherapy effectively suppresses testosterone in gender-affirming hormone therapy.","authors":"Aaron L Misakian, Danit Ariel, Erika A Sullivan, Gagandeep Singh, Danielle Loeb, Tyler Strickland, Sean J Iwamoto, Micol S Rothman, Bren Botzheim, Jane W Liang, Carly Kelley, Ole-Petter R Hamnvik","doi":"10.1016/j.eprac.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.002","url":null,"abstract":"Objectives: 1. Evaluate association between injectable estradiol and serum TT concentrations. 2. Determine additional associations between covariates (age, intramuscular vs subcutaneous administration, ester [cypionate vs valerate], injection timing relative to lab draw, antiandrogen use, progestogen use) and TT concentration.Methods: Cross-sectional retrospective multisite study including adult TGD patients without history of gonadectomy or concurrent GnRH agonist use prescribed weekly injectable estradiol at a stable dose for >75 days between 2019-2023 with confirmed timing of estradiol and TT concentrations relative to last injection. Those who reached guideline-recommended TT suppression (<50 ng/dL) were compared to those who did not. A weighted linear mixed model evaluated relationship between TT concentration and covariates.Results: Of the 357 patients included, median estradiol dose was 4 mg (interquartile range [IQR] 3-6), estradiol concentration 232 pg/mL (IQR 134-371), and TT concentration 17 ng/dL (IQR 10-33). There was no significant difference in TT concentration or proportion reaching TT suppression between patients using estradiol monotherapy vs estradiol with an antiandrogen(s) and/or a progestogen. In the weighted linear mixed model, higher estradiol concentration, fewer days since injection, and progestogen use was associated with lower TT concentration.Conclusions: Injectable estradiol, even as monotherapy, was effective at TT suppression in 82.6% of patients and comparable to combination therapy with an antiandrogen(s) or progestogen. Progestogen use was independently associated with lower TT concentration while spironolactone had no significant effect.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607774","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

Neck Ultrasound in Older Adults With Thyroid Nodules: Considering Risk of Death From Other Causes. 老年人甲状腺结节的颈部超声检查：考虑其他原因导致的死亡风险。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-07 DOI: 10.1016/j.eprac.2025.06.007

Nina Francis-Levin, Edward Shao, Jacob Ortlieb, Brittany Gay, Mousumi Banerjee, Maria Papaleontiou, Megan R Haymart

{"title":"Neck Ultrasound in Older Adults With Thyroid Nodules: Considering Risk of Death From Other Causes.","authors":"Nina Francis-Levin, Edward Shao, Jacob Ortlieb, Brittany Gay, Mousumi Banerjee, Maria Papaleontiou, Megan R Haymart","doi":"10.1016/j.eprac.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.007","url":null,"abstract":"Objective: Thyroid nodules are common in older adults with the majority being benign. Optimal use of neck ultrasound for nodule surveillance in older adults, particularly in the setting of comorbidities and competing causes of death, remains unknown. We aimed to evaluate the use of neck ultrasound for thyroid nodule surveillance in older adults and to assess subsequent cause of death.Methods: We used a dataset that combines the Centers for Medicare & Medicaid Services data with the health data of University of Michigan Medicine patients between 2016 and 2021. We identified patients aged ≥ 65 with thyroid nodule(s) (median follow-up 2 years, range 0-6 years). Demographic characteristics, number of comorbidities (range 0-6), frequency of neck ultrasound, and cause of death were analyzed.Results: Of the 18 001 patients diagnosed with thyroid nodules, median age was 75 years (range 65-105), and 71.2% were female. Only 29 (0.2%) died of thyroid cancer and 2387 (13.3%) died of other causes. Patients who died of other causes had more comorbidities (mean comorbidities 1.73, range 0-5 vs mean comorbidities in entire cohort 1.2, range 0-6). During the study period, those who died of other causes received a mean of 1.31 neck ultrasounds (range 0-12) whereas the rest of the cohort received a mean of 2.41 neck ultrasounds (range 0-26), P < .001.Conclusions: Older adults with thyroid nodules are more likely to die of causes other than thyroid cancer. Neck ultrasound for surveillance should be tailored to the patient, with consideration for comorbidities and life expectancy.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636562","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

Hypocalcemia Post Total Thyroidectomy: A Ten-Year, Single Institution Experience with a PTH-Guided Calcium and Calcitriol Supplementation Protocol. 全甲状腺切除术后的低钙血症：pth引导的钙和骨化三醇补充方案的10年单一机构经验。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-07 DOI: 10.1016/j.eprac.2025.07.003

Ana-Maria Chindris, Rockey Dahiya, Michael G Heckman, Hanna Sledge, Kaniksha Desai, Victor J Bernet, Sarika N Rao, Adrian G Dumitrascu, Selmin Karatayli Ozgursoy, Jeffrey Janus, John D Casler, Ejigayehu Abate

{"title":"Hypocalcemia Post Total Thyroidectomy: A Ten-Year, Single Institution Experience with a PTH-Guided Calcium and Calcitriol Supplementation Protocol.","authors":"Ana-Maria Chindris, Rockey Dahiya, Michael G Heckman, Hanna Sledge, Kaniksha Desai, Victor J Bernet, Sarika N Rao, Adrian G Dumitrascu, Selmin Karatayli Ozgursoy, Jeffrey Janus, John D Casler, Ejigayehu Abate","doi":"10.1016/j.eprac.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.003","url":null,"abstract":"Objective: To report ten-year experience with a parathyroid hormone (PTH)-guided Calcium (Ca) and calcitriol supplementation protocol in reducing the incidence of hypocalcemia after total thyroidectomy (TT).Methods: Single-institution, retrospective chart review of patients who underwent TT. One hundred forty-eight patients had an operation prior to the protocol introduction and 735 had surgery after the protocol was started. Total serum Ca < 8 mg/dL was defined as hypocalcemia. The 4h-PTH stratified patients into low (>30 pg/mL), intermediate (15-30 pg/mL), and high (<15 pg/mL) hypocalcemia risk groups, to guide Ca and calcitriol management. Demographic information, pre- and post-operative characteristics, and outcomes were recorded. Fisher's exact test and Wilcoxon rank sum test were used to compare the characteristics between the 2 groups. Multivariable logistic regression was used to account for confounding variables. Area under the ROC curve was used to determine optimal 4h-PTH value as predictor of hypocalcemia.Results: The post-protocol group had significantly lower hypocalcemia incidence (9.9% vs. 20.9%, p<0.001) and related readmissions (0.9% vs. 4.7%, p=0.004) than the pre-protocol group. Lymph node dissection and parathyroids embedded in thyroid tissue were significant risk factors for hypocalcemia. Hypocalcemia occurred in 24.3% of patients with PTH <15pg/mL vs. 2.3% with PTH >30pg/mL. Lymph node dissection and parathyroids embedded in thyroid tissue were significant risk factors. .Conclusion: A PTH-guided Ca and calcitriol supplementation protocol significantly reduces post-TT hypocalcemia and related readmissions and may represent a useful approach in managing suitable candidates for outpatient TT.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599745","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

Progestogen Experience Among Transgender Women and Gender Diverse Adults Assigned Male at Birth in the United States. 美国变性妇女和出生时被指定为男性的不同性别成人的孕激素使用经验。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-07 DOI: 10.1016/j.eprac.2025.06.028

Julia J Chang, Nguyen Khai Tran, Annesa Flentje, Micah E Lubensky, Juno Obedin-Maliver, Mitchell R Lunn, Danit Ariel

{"title":"Progestogen Experience Among Transgender Women and Gender Diverse Adults Assigned Male at Birth in the United States.","authors":"Julia J Chang, Nguyen Khai Tran, Annesa Flentje, Micah E Lubensky, Juno Obedin-Maliver, Mitchell R Lunn, Danit Ariel","doi":"10.1016/j.eprac.2025.06.028","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.028","url":null,"abstract":"Objectives: Progestogens are often sought as part of estrogen-based gender-affirming hormone therapy (E-GAHT) in transgender and gender diverse (TGD) adults assigned male sex at birth (AMAB). Few studies describe their use or impact. The purpose of this study is to describe and evaluate the patient experience with progestogens for E-GAHT.Methods: Through a cross-sectional, mixed-methods concurrent embedded design study, an online cohort of TGD AMAB adults with feminine/transfeminine or non-binary gender identity in the United States was surveyed about progestogen use patterns, initiation reasons, perceived impact of progestogens, side effects, and care satisfaction.Results: 543 participants completed the study. Among 310 progestogen users, the most common progestogens were oral micronized progesterone (58.4%), rectal micronized progesterone (10.6%), and oral medroxyprogesterone acetate (7.7%). Breast development (85.2%) was the most cited reason for progestogen initiation. Most progestogen users perceived improvement in breast development (79.6%) and sense of femininity (81.3%). Fewer participants reported changes in libido, sleep, and memory. Common side effects were breast pain (28.7%) and mood fluctuation (21.9%). Cases of lower extremity venous thrombosis (n=6), pulmonary embolism (n=4), and stroke (n=4) were reported. Most users expressed satisfaction with progestogens (71.9%) but also reported barriers and lack of clarity surrounding effectiveness or whether to initiate.Conclusions: In the largest survey describing progestogen experience in E-GAHT to date, over half of TGD AMAB adults used progestogens. While most report satisfaction with use, further objective evidence on the benefits of progestogens is needed to clarify its clinical impact as part of E-GAHT.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599746","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

Characteristics of Dyslipidemia in Adults With Resistance to Thyroid Hormone β. 对甲状腺激素β有抵抗的成人血脂异常的特点：RTHβ的血脂异常。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-05 DOI: 10.1016/j.eprac.2025.07.001

Timothy M E Davis, Wendy A Davis, Carla Moran, Greta Lyons, Ellis Bryden, Krishna Chatterjee

{"title":"Characteristics of Dyslipidemia in Adults With Resistance to Thyroid Hormone β.","authors":"Timothy M E Davis, Wendy A Davis, Carla Moran, Greta Lyons, Ellis Bryden, Krishna Chatterjee","doi":"10.1016/j.eprac.2025.07.001","DOIUrl":"10.1016/j.eprac.2025.07.001","url":null,"abstract":"Objective: To assess determinants of dyslipidemia (specifically raised serum low-density lipoprotein cholesterol and triglycerides, and reduced high-density lipoprotein cholesterol) in individuals with Resistance to Thyroid Hormone β (RTHβ).Methods: Multivariable linear regression analyses of cross-sectional fasting serum lipid profiles from 105 genetically-confirmed individuals with RTHβ (mean age 40.0 years, 40% males) were conducted, including candidate variables with plausible independent associations with the individual components of dyslipidemia such as indices of thyroid function, plasma non-esterified fatty acid concentrations, and insulin resistance assessed using the Homoeostasis Model Assessment equation.Results: Age was positively related to both serum total and low-density lipoprotein-cholesterol concentrations (P < .001), while there were similar directional associations between body mass index and total:high-density lipoprotein-cholesterol ratio, and Homoeostasis Model Assessment-insulin resistance and serum triglycerides (P ≤ .007). Plasma non-esterified fatty acid concentrations were not associated with serum triglycerides. The only thyroid function measure revealed by the individual models was an inverse association between reverse triiodothyronine and serum triglycerides (P = .009).Conclusions: The dyslipidemia associated with RTHβ shares recognized contributory factors found in studies of the general population but appears independent of thyroid status. The reason for the significant inverse association between circulating reverse triiodothyronine and serum triglyceride concentrations is unclear and merits further investigation.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583432","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

Non-insulin therapies in management of type 1 diabetes. 1型糖尿病的非胰岛素治疗

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-04 DOI: 10.1016/j.eprac.2025.06.027

Zeb I Saeed, Jayachidambaram Ambalavanan, Melanie Natasha Rayan, Palak Patadia, Viral N Shah

{"title":"Non-insulin therapies in management of type 1 diabetes.","authors":"Zeb I Saeed, Jayachidambaram Ambalavanan, Melanie Natasha Rayan, Palak Patadia, Viral N Shah","doi":"10.1016/j.eprac.2025.06.027","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.027","url":null,"abstract":"With increasing prevalence of double diabetes (features of type 2 diabetes in people with type 1 diabetes (T1D)), there is a growing interest in using non-insulin therapies to improve glycemic outcomes, promote weight loss, and reduce cardiovascular risk in T1D. In this narrative review, we summarize current literature and provide practical guidance for clinicians when considering these therapies. Using a PubMed literature search, we identified 51 randomized clinical trials investigating sodium glucose co-transporter inhibitors (SGLTi :9), glucagon like peptide 1 receptor agonist (GLP1RA: 13), metformin (13), dipeptidyl peptidase-4 inhibitor (DPP-4i: 9), pramlintide (4), bromocriptine (1) and combination therapies (2) in T1D. Outcomes of interest included change in HbA1c, weight, total daily dose (TDD) of insulin, surrogate cardiovascular outcomes and safety parameters. Data shows that GLP-1RAs and SGLTi have demonstrated the greatest efficacy in reducing HbA1c up to 0.7% and 0.5% respectively compared to placebo. GLP-1RAs reduced TDD of insulin by up to 18.5% and weight up to 9.3% (8.3kg). SGLTi reduced insulin TDD by up to 15.3% and weight 5.3% (4.3kg). Neither class increased the risk of severe hypoglycemia but SGLTi had a two-to-fivefold higher risk of diabetic ketoacidosis (DKA). Other agents (metformin, DPP-4i and bromocriptine) failed to demonstrate a sustained glycemic efficacy in T1D. In summary, GLP-1RA has a great potential as adjunct therapy in T1D. SGLTi could be another beneficial therapy in T1D, however, more research is needed to improve DKA risk with this therapy. Efficacy trials of weekly GLP-1RA and its potential cardio-renal benefits in T1D are much needed.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575086","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

Adverse Drug Reaction-Related Hospital Admissions in Older Adults with Diabetes: Incidence and Implicated Drug Classes. 老年糖尿病患者药物不良反应相关住院：发生率和相关药物类别

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-03 DOI: 10.1016/j.eprac.2025.06.026

Azizah Vonna, Mohammed S Salahudeen, Gregory M Peterson

{"title":"Adverse Drug Reaction-Related Hospital Admissions in Older Adults with Diabetes: Incidence and Implicated Drug Classes.","authors":"Azizah Vonna, Mohammed S Salahudeen, Gregory M Peterson","doi":"10.1016/j.eprac.2025.06.026","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.026","url":null,"abstract":"Objectives: Adverse drug reaction (ADR)-related hospital admissions are common among older adults. However, those with diabetes have received little research attention with respect to ADRs in recent years, despite the rising prevalence of diabetes and its associated multimorbidity. This study aimed to examine temporal trends in ADR-related hospital admissions among older adults with diabetes, compared to those without diabetes.Methods: The National Minimum Dataset from the three major public hospitals in Tasmania, Australia, was used to identify all individuals aged ≥65 years hospitalised between 2017 and 2023. International Classification of Diseases Tenth Revision, Australian Modification (ICD-10-AM) codes were used to identify patients with diabetes and ADR-related hospital admissions. Rates of ADR-related hospital admissions were expressed as estimated incidence rate (IR) in the population corresponding to the hospitals' catchment area.Results: Between 2018 and 2022, the estimated sex-adjusted IR of ADR-related hospital admissions remained stable in the diabetes group (39.9 to 40.3 per 1,000 person-years; p=0.85) and decreased in the non-diabetes group (17.8 to 14.8 per 1,000 person-years; p <0.001). The IR ratio of an ADR-related admission in those with diabetes, compared to those without diabetes, increased over the same period (p<0.05), from 2.24 (95% CI: 2.03-2.47) to 2.72 (95% CI: 2.48-2.98). Corticosteroids, anticoagulants and antihypertensives were major contributors to ADR-related admissions in older adults with diabetes.Conclusions: ADR-related hospital admissions were consistently more common in older adults with diabetes, compared to those without diabetes. These findings underscore the need for targeted medication safety strategies in this high-risk population.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567327","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 experience of discrimination impacts technology readiness and psychosocial states of minoritized families living with type 1 diabetes: Findings from the BEAD-T1D Pilot study. 歧视经历影响1型糖尿病少数民族家庭的技术准备和心理社会状态：来自BEAD-T1D试点研究的结果

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-07-03 DOI: 10.1016/j.eprac.2025.06.023

Ananta Addala, Ricardo Medina Peñaranda, Lauren E Figg, Sarah Hanes, Daniel Garfias Silva, Hector I Ortega, Diana Peña, Gary M Shaw, Lisa J Chamberlain, Diana Naranjo, Jennifer K Raymond, David M Maahs, Korey K Hood

{"title":"The experience of discrimination impacts technology readiness and psychosocial states of minoritized families living with type 1 diabetes: Findings from the BEAD-T1D Pilot study.","authors":"Ananta Addala, Ricardo Medina Peñaranda, Lauren E Figg, Sarah Hanes, Daniel Garfias Silva, Hector I Ortega, Diana Peña, Gary M Shaw, Lisa J Chamberlain, Diana Naranjo, Jennifer K Raymond, David M Maahs, Korey K Hood","doi":"10.1016/j.eprac.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.023","url":null,"abstract":"Objectives: This study aims to understand the association of perceived discrimination with diabetes technology utilization and psychosocial states in minoritized families with public insurance and pediatric type 1 diabetes.Methods: The Building the Evidence to Address Disparities in Type 1 Diabetes Pilot (BEAD-Pilot) study engaged parents/guardians of children aged<12 years with type 1 diabetes and public insurance. Parents/guardians were invited to participate in surveys, focus groups, and/or advisory groups. Surveys included validated measures assessing perceived discrimination, psychosocial factors, and diabetes technology acceptance. Data were analyzed via descriptive statistics, group comparisons, and regressions. Through semi-structured interviews we explored barriers to diabetes technology use and data were coded inductively by a five-member bilingual group.Results: Discrimination correlated with lower diabetes technology acceptance (r=-0.38, p=0.05). Higher perceived discrimination was significantly associated with increased depression (β=0.45, p<0.001) and decreased global health (β=-0.27, p=0.011). Qualitative data revealed that parents experienced discrimination based on race, ethnicity, and insurance status, often leading to mistrust and reluctance to engage in care.Conclusions: Perceived discrimination appears to be an underexplored but meaningful barrier to diabetes technology utilization. Addressing discrimination in healthcare and community settings, in addition to access, is essential for closing disparities in diabetes technology utilization.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567329","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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