Endocrinologia, Diabetes y Nutricion最新文献

{"title":"Hipercalcemia neonatal grave secundaria a inflamación de la grasa intraabdominal","authors":"Pedro Agudo-Montore, Elena Merchante, Marisa Rosso, Emilio García-García","doi":"10.1016/j.endinu.2026.501822","DOIUrl":"10.1016/j.endinu.2026.501822","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501822"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated vascular age using the Framingham model as a predictor of metabolic syndrome in a large cohort of Spanish workers","authors":"Natalia Montero Muñoz,&nbsp;Pedro Juan Tárraga López,&nbsp;Irene Coll Campayo,&nbsp;Ángel Arturo López-González,&nbsp;Carla Busquets-Cortés,&nbsp;José Ignacio Ramírez-Manent","doi":"10.1016/j.endinu.2026.501773","DOIUrl":"10.1016/j.endinu.2026.501773","url":null,"abstract":"<div><h3>Background</h3><div>Vascular age, estimated using the Framingham model, is an intuitive indicator of cardiovascular risk. Metabolic syndrome (MetS) includes several cardiometabolic abnormalities associated with increased morbidity and mortality. The relationship between vascular age and MetS has not been extensively assessed in large working populations.</div></div><div><h3>Objective</h3><div>To evaluate the predictive ability of vascular age for identifying MetS in a large cohort of Spanish workers.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study among 336,450 employees aged 18–69 years who underwent standardized occupational health examinations from 2018 to 2022. Vascular age and avoidable lost life years (ALLY) were calculated using the Framingham equation. MetS was defined according to NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria. Associations were examined using logistic regression models adjusted for sociodemographic and lifestyle variables. Discriminatory performance was assessed through ROC curve analyses.</div></div><div><h3>Results</h3><div>MetS prevalence increased progressively across higher vascular age categories in both sexes. Vascular age demonstrated strong diagnostic performance, with areas under the curve<!--> <!-->&gt;<!--> <!-->0.80 and reaching 0.86 in women according to NCEP ATP III and JIS definitions. Multivariable analyses confirmed independent associations between elevated vascular age and MetS.</div></div><div><h3>Conclusions</h3><div>Vascular age is a strong and consistent predictor of MetS and represents a practical tool for early cardiometabolic risk detection in occupational settings. Its integration into workplace health surveillance may enhance the identification of high-risk workers and support targeted preventive strategies.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501773"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resumen ejecutivo del Proceso Asistencial Integrado para la detección y el abordaje de la diabetes tipo 1 en estadios preclínicos: consenso SED-SEEN-SEEP","authors":"Ana Lucía Gómez Gila,&nbsp;Fernando Gómez-Peralta,&nbsp;Susana Pica Montesinos,&nbsp;Virginia Bellido,&nbsp;Roque Cardona-Hernandez,&nbsp;María Asunción Martínez-Brocca","doi":"10.1016/j.endinu.2026.501879","DOIUrl":"10.1016/j.endinu.2026.501879","url":null,"abstract":"<div><div>Type 1 diabetes (T1D) can be identified in preclinical stages through the detection of islet autoantibodies and staged before clinical onset. This evolving paradigm highlights the need for structured care models allowing coordinated identification, staging, and follow-up of individuals with positive islet autoimmunity. This document describes an Integrated Care Pathway (ICP) developed from the available scientific evidence and the national SED-SEEN-SEEP consensus on screening and monitoring of preclinical T1D. The model is organised into three core sub-processes (target population identification, autoantibody detection and confirmation, and clinical follow-up with staging) and one transversal support sub-process based on information systems and performance indicators. This ICP provides a structured, evaluable, and scalable framework for the homogeneous implementation of screening and follow-up of preclinical T1D.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501879"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and fetal outcomes associated with flash glucose monitoring metrics in women with type 1 diabetes: A cohort study","authors":"Gema López-Gallardo,&nbsp;Ana Piñar-Gutiérrez,&nbsp;Celia Hernández-Reina,&nbsp;Sandra Amuedo,&nbsp;Noelia Gros-Herguido,&nbsp;Pablo J. Remón-Ruiz,&nbsp;Virginia Bellido,&nbsp;Pilar Santa Cruz-Álvarez,&nbsp;Lucas Cerrillo,&nbsp;Alfonso Soto-Moreno","doi":"10.1016/j.endinu.2026.501804","DOIUrl":"10.1016/j.endinu.2026.501804","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between flash glucose monitoring (FGM) metrics and perinatal outcomes in pregnant women with type 1 diabetes (T1DM).</div></div><div><h3>Research design and methods</h3><div>This retrospective cohort study included pregnant women with T1DM who used FGM. The primary outcome was a composite endpoint including fetal or neonatal mortality, large-for-gestational-age (LGA) birth weight, neonatal intensive care unit (NICU) admission, or neonatal hypoglycemia. Glycated hemoglobin (HbA1c) levels were assessed together with time in range (TIR), time below range (TBR), and time above range (TAR) within pregnancy-specific glucose targets, as well as glucose variability.</div></div><div><h3>Results</h3><div>A total of 70 women were included, with a median age of 36 years (IQR, 31–38), body mass index (BMI) 27<!--> <!-->±<!--> <!-->5<!--> <!-->kg/m², diabetes duration 20<!--> <!-->±<!--> <!-->8 years, and pregestational HbA1c 7.3<!--> <!-->±<!--> <!-->1.4%. Among them, 21.7% were smokers, 4.5% had hypertension, 10.1% had dyslipidemia, and 41.2% had diabetic retinopathy. Women who experienced the composite endpoint exhibited significantly lower TIR and higher TAR across all trimesters, greater glycemic variability (CV) during the first (1T) and third trimesters (3T), and a higher glucose management indicator (GMI) in the third trimester. Logistic regression analysis showed that a TIR<!--> <!-->&lt;<!--> <!-->69.5% during the second trimester (2T) increased the risk of the composite endpoint by 10.56-fold (<em>P</em> <!-->=<!--> <!-->.015). Similarly, CV<!--> <!-->≥<!--> <!-->31.85% during the first trimester was associated with a 6.42-fold increased risk (<em>P</em> <!-->=<!--> <!-->.039). A model combining these 2 variables achieved a sensitivity of 94.3% and a specificity of 50%.</div></div><div><h3>Conclusions</h3><div>Glycemic control assessed through FGM metrics, particularly TIR during the second trimester and CV during the first trimester, is associated with adverse maternal–fetal outcomes in pregnant women with T1DM.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501804"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio MEDEA (modelos organizativos en la atención a la diabetes mellitus tipo 2 en Andalucía): la aportación del endocrinólogo","authors":"Pablo Jesús Remon-Ruiz,&nbsp;Román Villegas-Portero,&nbsp;Fernando Losada Viñau,&nbsp;Miguel Ángel Mangas Cruz,&nbsp;Alfonso Pumar Lopez,&nbsp;Josefa Mayoral Sánchez,&nbsp;María del Mar Muñoz García,&nbsp;Alfonso Soto Moreno","doi":"10.1016/j.endinu.2026.501819","DOIUrl":"10.1016/j.endinu.2026.501819","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;diabetes mellitus is currently a major healthcare priority due to its high prevalence, complexity, and associated morbidity and mortality. The organization of care for type 2 diabetes mellitus (T2DM) is essential to deliver high-quality care aimed at optimizing clinical outcomes. However, the effectiveness of different healthcare delivery models remains under evaluation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;The MEDEA project was a multicenter, quasi-experimental study that assessed three different models of care for T2DM. The comparison groups consisted of an intensive intervention group, a moderate intervention group, and the remainder of the healthcare system as a control group. The groups differed according to the degree of hospital-based specialist involvement in primary care.&lt;/div&gt;&lt;div&gt;Based on electronic health record data, at-risk patients were identified according to predefined criteria: poor metabolic control (HbA1c &gt;8%), inadequate lipid control (LDL &gt;100&lt;!--&gt; &lt;!--&gt;mg/dL), and risk of hypoglycemia in older adults (patients older than 75 years with HbA1c &lt;7% receiving potentially hypoglycemia-inducing treatments). Outcomes were measured as the percentage of patients achieving targets across these three domains.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;No significant differences were observed in mean HbA1c at baseline and at the end of the study among the three intervention groups. However, the proportion of patients achieving HbA1c &lt;8% increased significantly in the intensive intervention group (17.9%) compared with the moderate intervention and control groups. A total of 3,513 patients were included in the intensive intervention group. In the centers belonging to this group (CS1 and CS2), the target HbA1c &lt;8% was achieved in 56.9% and 68.02% of patients, respectively. Regarding deprescribing, pharmacological withdrawal was achieved in 41.9% and 26.9% of eligible patients in CS1 and CS2, respectively. There was a significant increase in the number of patients treated with more than one oral antidiabetic drug (p&lt;0.001), with increased use of DPP-4 inhibitors (p=0.000) and SGLT2 inhibitors (p=0.002). A reduction in basal–bolus insulin therapy was observed (p=0.01), alongside an increase in the proportion of patients treated with basal insulin analogues (p=0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Intensive intervention leads to improved health outcomes in patients with diabetes and is clearly superior to on-demand intervention, which does not demonstrate improvements compared with routine clinical practice. Centralized data more closely reflect the reality of individual centers and enable the identification of at-risk patient groups; however, health records lack specificity and require individualized validation, data cleaning, and clinical contextualization to ensure that analyses accurately represent real-world practice.&lt;/div&gt;&lt;div&gt;Mean HbA1c may not be an optimal parameter f","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501819"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavior change techniques to improve treatment adherence in type 2 diabetes: A systematic review","authors":"Ana Rosa Villalpando-Gutiérrez,&nbsp;Héctor Velázquez-Jurado,&nbsp;Carolina Palacios-Burguete,&nbsp;Karla Paola Colin-Mendiola,&nbsp;Julián Grostieta Dominguez,&nbsp;Ana Cristina García-Ulloa,&nbsp;Liliana Pérez-Peralta","doi":"10.1016/j.endinu.2026.501774","DOIUrl":"10.1016/j.endinu.2026.501774","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognitive-behavioral interventions have shown positive results in type 2 diabetes mellitus (T2DM) self-management; however, the lack of detailed descriptions of these interventions makes their replication difficult. This study aims to identify behavioral change techniques (BCT) for improving adherence to medication, diet, and exercise in adults with T2DM.</div></div><div><h3>Method</h3><div>We conducted a systematic search in June 2024 across PubMed, Cochrane, Web of Science, PsycINFO, and CINAHL to identify studies published since 2013 that examined BCTs aimed at improving treatment adherence in adults with T2DM.</div></div><div><h3>Results</h3><div>A total of 6 articles – including randomized controlled trials, a scoping review, and systematic reviews – were included, addressing adherence to medication, diet, and exercise. BCTs associated with improved adherence and reported across multiple studies included action planning (1.4), social support (unspecified) (3.1), social support (practical) (3.2), instruction on how to perform a behavior (4.1), information about health consequences (5.1), prompts and cues (7.1), and credible source (9.1).</div></div><div><h3>Conclusions</h3><div>The findings highlight the importance of clearly structured intervention descriptions and the use of robust theoretical frameworks. Future interventions should incorporate components targeting patient education, skill development, and support networks to enhance adherence to dietary recommendations, physical activity, and pharmacological treatment.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501774"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor neuroendocrino de vesícula: una localización inusual","authors":"María José Vallejo Herrera,&nbsp;Verónica Vallejo Herrera,&nbsp;Félix Serrano Puche","doi":"10.1016/j.endinu.2026.501797","DOIUrl":"10.1016/j.endinu.2026.501797","url":null,"abstract":"<div><div>Neuroendocrine tumors of the gallbladder are included among neuroendocrine tumors of uncommon location. Because they are non-functioning tumors, they usually do not produce symptoms and are often discovered at advanced stages. Their main differential diagnosis, due to gallbladder wall thickening, is acute cholecystitis. If imaging findings do not improve despite appropriate treatment, this entity should be considered in the differential diagnosis to achieve early treatment. Histopathological examination is the key to diagnosis. Small-cell neuroendocrine tumors with a high Ki-67 index have a poor prognosis and high short-term morbidity and mortality.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 7","pages":"Article 501797"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticotropin-secreting pheochromocytoma: A case report","authors":"Pedro Iglesias ,&nbsp;Juan González González ,&nbsp;Emiliano González-Vioque ,&nbsp;Cesáreo Corbacho","doi":"10.1016/j.endinu.2025.501728","DOIUrl":"10.1016/j.endinu.2025.501728","url":null,"abstract":"<div><div>Corticotropin (ACTH)-secreting pheochromocytomas are rare neuroendocrine tumors that combine catecholamine and cortisol excess, posing major diagnostic and therapeutic challenges. We report the case of a 38-year-old man with hypertension, episodic adrenergic symptoms, and biochemical evidence of elevated metanephrines and ACTH-dependent hypercortisolism. Imaging revealed a right adrenal mass compatible with pheochromocytoma, but metaiodobenzylguanidine (MIBG) scintigraphy was negative. After preoperative preparation with alpha- and beta-blockade and intraoperative steroid coverage, the patient underwent laparoscopic adrenalectomy. Histopathology confirmed pheochromocytoma with focal ACTH expression and malignant potential (PASS 5). Postoperatively, he required transient glucocorticoid replacement and achieved normotension without antihypertensives. This case illustrates the complexity of diagnosing and managing ACTH-secreting pheochromocytomas, highlights the need for careful preoperative stabilization, and underscores the importance of multidisciplinary follow-up to detect recurrence and manage adrenal insufficiency.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 6","pages":"Article 501728"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragilidad y sobretratamiento en personas mayores con diabetes tipo 2 en red de salud argentina","authors":"Ignacio Martingano ,&nbsp;María Pilar Lopez Gutierrez ,&nbsp;Azul Milena Maccio ,&nbsp;Mariana Andrea Burgos ,&nbsp;Gastón Perman ,&nbsp;María Paula Russo ,&nbsp;María Florencia Grande Ratti","doi":"10.1016/j.endinu.2025.501745","DOIUrl":"10.1016/j.endinu.2025.501745","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the clinical and sociodemographic characteristics of people aged 65 years or older with type 2 diabetes mellitus, estimate the prevalence of frailty, and explore its association with metabolic control and pharmacological regimens used.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study with consecutive sampling of patients, active members of an integrated health service network in Argentina as of March 1^st, 2022. Frailty was assessed using the Electronic Screening Index of Frailty, considering frail those with ≥ 9 coded clinical conditions. Glycemic control was defined according to individualized HbA1c goals (&lt;7% non-frail, &lt;<!--> <!-->8% frail), and overtreatment as the use of drugs with a high risk of hypoglycemia (insulin, sulfonylureas, and/or glinides) in patients at goal.</div></div><div><h3>Results</h3><div>A total of 5,937 individuals (mean age, 78 years; 20% older than 85 years) were included. Hypertension and dyslipidemia were the most prevalent comorbidities, and 68% had polypharmacy. Frailty was 8.92% (95%CI, 8.21–9.68), doubling in individuals older than 85 years. Frail patients had more chronic complications and achieved glycemic goals more frequently (57% vs 42%), but at the expense of greater use of risky drugs (37% vs 20%) and overtreatment (23.7% vs 5.9%; aOR, 5.00; 95%CI, 3.88–6.45).</div></div><div><h3>Conclusions</h3><div>Frailty was associated with a higher risk of overtreatment. It is essential to implement individualized management strategies, deprescribing, and adjusting goals according to functional status. Based on this real-world evidence, we seek to contribute elements for a critical review of current policies and strategies in Latin America.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 6","pages":"Article 501745"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common errors in the initial management of hyponatremia","authors":"Jorge Gabriel Ruiz-Sánchez ,&nbsp;Yvonne Fernández-Cagigao ,&nbsp;Paola Parra-Ramírez ,&nbsp;Patricia Martín Rojas-Marcos ,&nbsp;Cristina Álvarez-Escolá","doi":"10.1016/j.endinu.2026.501768","DOIUrl":"10.1016/j.endinu.2026.501768","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 6","pages":"Article 501768"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}