Journal of the ASEAN Federation of Endocrine Societies最新文献

{"title":"Direct Medical Cost Analysis of Hyperglycemic Emergencies Among Patients with Diabetes Mellitus in a Tertiary Government Hospital in the Philippines.","authors":"Juan Paolo Abasolo, Aldrich Ivan Lois Burog, Margarette Rose Pajanel, Emilio Villanueva, Celito Tamban","doi":"10.15605/jafes.041.01.5233","DOIUrl":"10.15605/jafes.041.01.5233","url":null,"abstract":"<p><strong>Background: </strong>There is limited published local data on the direct medical costs of hyperglycemic emergencies. This study aimed to analyze direct medical costs incurred during hospitalization for hyperglycemic emergencies from a healthcare payer perspective.</p><p><strong>Methodology: </strong>This is a retrospective cohort study done in a tertiary government hospital in the Philippines. The primary outcome measure was the median cost and distribution of direct medical costs (in Philippine Pesos) incurred during hospitalization.</p><p><strong>Results: </strong>Among 319 patients with cost data, the median direct medical cost was PhP 79,331.50 (USD 1,375.02; USD 1: PhP 57.69), representing approximately 22.5% of the average annual family income and 7.2 times the average annual healthcare expenditure per capita. HHS incurred the highest costs (PhP 143,902.77; USD 2,494.21) with diagnostic fees as the largest expense (PhP 41,507.00; USD 719.42). The total costs exceeded the coverage provided by PhilHealth, the national health insurance in the Philippines.Socioeconomic disparities were evident, with lower-income patients incurring higher expenses due to delayed presentation and more severe illness.</p><p><strong>Conclusion: </strong>This study highlights the substantial economic burden of hyperglycemic emergencies in a public tertiary hospital. As one of the first of its kind locally, the study informs policy efforts to reduce financial risk for vulnerable populations and optimize resource allocation for diabetes-related emergencies.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"18-31"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline-Directed Medical Therapies for Diabetic Kidney Disease Among Thai People With Type 2 Diabetes: A Real-World Data Based on Theptarin Diabetes Staging.","authors":"Peachaphol Chongvoranond, Waralee Chatchomchaun, Ekgaluck Wanothayaroj, Siriwan Butadej, Soontaree Nakasatien, Thep Himathongkam, Yotsapon Thewjitcharoen","doi":"10.15605/jafes.041.01.6239","DOIUrl":"10.15605/jafes.041.01.6239","url":null,"abstract":"<p><strong>Background: </strong>The \"pillar approach\" was recently proposed to holistically address diabetic kidney disease (DKD). Theptarin Diabetes Staging (TDS) is a staging system for type 2 diabetes (T2D) designed to prevent or delay the progression to advanced stages.</p><p><strong>Objective: </strong>To evaluate the rate of guideline-directed medical therapies (GDMT) among individuals with DKD from 2021 to 2025 according to the TDS system.</p><p><strong>Methodology: </strong>A retrospective review of medical records of T2D patients with TDS stage 4Ka (moderately increased persistent albuminuria), Stage 4Kb (severely increased persistent albuminuria), and stage 5Ka (eGFR <45 mL/min/1.73 m²) was conducted. The rates of RASi, SGLT2i, GLP-1 RA, and finerenone use, along with achievement of metabolic targets, were evaluated prospectively from 2021 to 2025.</p><p><strong>Results: </strong>A total of 206 medical records were reviewed (mean age 64.1 ± 10.3 years, A1C 7.3 ± 1.2%, mean eGFR 71.6 ± 24.5 mL/min/1.73 m²). In 2021, the use of RASi was 78.2%, 51.5% for SGLT2i and 13.6% for GLP-1 RA among all patients. Four years later, rates of GDMT improved as follows: RASi 79.7%, SGLT2i 59.3%, GLP-1 RA 19.8% and finerenone 2.8%. However, only 1.1% of all patients in 2025 received all 4 GDMT items. More stable or improved TDS were observed in patients who received GDMT ≥3 classes across all 4 medication classes, compared with those who received GDMT <3 classes (96.2% vs. 78.8%, <i>P</i>-value = 0.036).</p><p><strong>Conclusion: </strong>The real-world implementation of GDMT among DKD patients remains inadequate, and more efforts are required to improve GDMT adoption. Regular reviews and feedback are warranted to improve attainment of treatment targets and better clinical outcomes.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"49-58"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with Legacy: Outcomes and Future Implications for Offspring of Patients with MEN1.","authors":"Dimuthu Tharanga Muthukuda, Kushalee Poornima Jayawickreme, Gayathri Wijeweera, Ashley Grossman","doi":"10.15605/jafes.041.01.5125","DOIUrl":"10.15605/jafes.041.01.5125","url":null,"abstract":"<p><strong>Background: </strong>Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition with an autosomal dominant inheritance, with a predisposition to both endocrine and non-endocrine tumours. MEN1-related tumours can appear as early as the age of five, with disease penetrance increasing with age. Offspring of a MEN1 parent shows a 50% probability of inheriting the MEN1-related gene mutation. A MEN1 diagnosis in a parent can lead to significant anxiety for both the diagnosed parent and their undiagnosed at-risk children. There is limited consensus specific for managing offspring of individuals diagnosed with MEN1.</p><p><strong>Objectives: </strong>This review aims to evaluate the existing literature on the outcomes of MEN1 syndrome in the offspring of affected patients, to identify gaps in current protocols and to suggest possible improvements.</p><p><strong>Methodology: </strong>A literature review was conducted to examine the outcomes and characteristics of the offspring of individuals diagnosed with MEN1.</p><p><strong>Results: </strong>Predictive testing and screening for organ involvement in MEN1 aid early diagnosis and timely interventions. DNA testing is recommended for children within the first decade of life, and screening for organ involvement should ideally begin at age 5 years for all MEN1 mutation carriers. Manifestations of MEN1 in younger children are different from those of affected adults.</p><p><strong>Conclusions: </strong>Standardised, internationally-accepted guidelines that provide specific recommendations for screening, diagnosis and treatment of offspring of adults diagnosed with MEN1 is a timely need. Furthermore, the absence of national and international data pooling across regions remains a serious limitation, impeding the ability to draw conclusions from larger, more representative patient populations.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"154-161"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Factors Associated with Diabetes Related Emotional Distress (DRED) Among Filipino Adult Patients with Type 2 Diabetes Mellitus Using A Validated Filipino Version of the Diabetes Distress Scale (DDS).","authors":"Carissa Rae Mirano, Oliver Allan Dampil, Hanna Clementine Tan","doi":"10.15605/jafes.041.01.6243","DOIUrl":"10.15605/jafes.041.01.6243","url":null,"abstract":"<p><strong>Background: </strong>Diabetes related emotional distress (DRED) is important in diabetes management. There are limited studies involving diabetes distress and its association with glycemic control and other clinicodemographic factors among Filipinos.</p><p><strong>Objective: </strong>This study aimed to translate the Diabetes Distress Scale (DDS) into Filipino and validate this version among Filipino adult patients with type 2 DM and assess the prevalence of DRED and its association with glycemic control and other factors.</p><p><strong>Methodology: </strong>A Filipino DDS was constructed through forward and backward translation of the English version and was validated. A subsequent cross-sectional study was conducted among 186 individuals with type 2 diabetes in a single-center tertiary hospital. The prevalence of DRED and its association with HbA1c level and other related factors were assessed.</p><p><strong>Results: </strong>The overall prevalence of DRED for this study was 34.41% with a mean overall score for the DDS of 2.02. Age (AOR 0.95, 95% CI 0.93-0.98; <i>p</i> = 0.002), higher medication burden, (AOR 1.33, 95% CI 1.01-1.77; <i>p</i> = 0.043) and peripheral artery disease (AOR 6.03, 95% CI 1.79-23.29; <i>p</i> = 0.005) were predictors of DRED.</p><p><strong>Conclusion: </strong>This Filipino version of the DDS showed that it is a valid instrument in the assessment of diabetes related distress among Filipino patients with type 2 diabetes. Diabetes distress scores were not associated with glycemic control. A younger age of diagnosis of diabetes, a history of PAD, and higher medication burden were found to be associated with development of DRED.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"88-100"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Endocrine Window Widens: A New Chapter for JAFES.","authors":"Cecilia A Jimeno","doi":"10.15605/jafes.041.01.6480","DOIUrl":"https://doi.org/10.15605/jafes.041.01.6480","url":null,"abstract":"","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"6-7"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Study of Clinical Characteristics, Natural History and Predictive Factors for Mild Autonomous Cortisol Secretion (MACS) in Patients with Adrenal Incidentalomas in Malaysia.","authors":"Vanusha Devaraja, Subashini Rajoo, Vijiya Mala Valayatham, Foo Siew Hui","doi":"10.15605/jafes.041.01.5143","DOIUrl":"10.15605/jafes.041.01.5143","url":null,"abstract":"<p><strong>Introduction: </strong>Adrenal incidentalomas (AIs) are frequently discovered during imaging performed for unrelated conditions. While most are benign and non-functional, a subset demonstrates hormonal activity or malignant potential. This study aimed to describe the clinical and radiological characteristics, natural history and predictors of mild autonomous cortisol secretion (MACS) in a Malaysian cohort.</p><p><strong>Methodology: </strong>This retrospective multicentre study reviewed medical records of 251 patients with AIs from three tertiary hospitals in Malaysia. Data on demographics, imaging findings, hormonal evaluations, histopathological diagnoses and longitudinal follow-up, including serial imaging and hormonal assessments, were collected and analysed.</p><p><strong>Results: </strong>The median age of the cohort was 58 years (IQR 19), with a slight female predominance (53%). The population was predominantly Malay (n = 126, 50.2%), followed by Chinese (36.3%) and Indian (12.7%). The median follow-up duration was 39 months.Most AIs were non-malignant (92%) and non-functioning (72%). Bilateral lesions were present in 9.6% of patients. Among non-malignant AIs, 27% were functioning, with higher rates of hypertension and osteoporosis, larger tumour size and greater tumour density. Adrenalectomy was more commonly performed in the functioning group, mainly for MACS and pheochromocytoma. In contrast, 94% of benign non-functioning AIs were managed conservatively, with no cases of malignant transformation and only one case developing hormonal activity over a median follow-up of 30 months. Among the 20 malignant AIs, 12 were primary adrenal carcinomas. Malignant AIs were associated with larger size, overt Cushing's syndrome, higher Hounsfield units, lower contrast washout and increased mortality.MACS was identified in 12.7% of the cohort. It was associated with bilateral lesions, larger tumour size, and higher prevalence of diabetes, dyslipidaemia, obesity and osteoporosis. On multivariate analysis, only bilaterality and osteoporosis remained significant predictors of MACS.</p><p><strong>Conclusion: </strong>This study reinforces that most benign non-functioning AIs carry minimal risk of progression, supporting less intensive follow-up in stable cases. Bilaterality and osteoporosis were identified as independent predictors of MACS, emphasizing the importance of targeted hormonal and bone health monitoring in these patients.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"138-147"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Paediatric Adrenocortical Carcinoma with Aggressive Clinical Course.","authors":"Kah Yin Lim, Pian Pian Tee","doi":"10.15605/jafes.041.01.5167","DOIUrl":"10.15605/jafes.041.01.5167","url":null,"abstract":"<p><p>Adrenocortical carcinomas are among the rarest and most aggressive paediatric endocrine neoplasms. We report a case of a functional adrenocortical carcinoma in a 6-year and 7-month-old female who initially presented with hypertensive encephalopathy, later progressing to overt Cushing syndrome with refractory hypertension. Given the presence of distant metastases, the patient was commenced on neoadjuvant chemotherapy and mitotane. Genetic testing for <i>TP53</i> to evaluate Li-Fraumeni syndrome was declined. Despite initial response to the treatment, the disease remained refractory, and the patient succumbed after seven months of therapy.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"204-208"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraductal Papillary Mucinous Neoplasm of the Pancreas Presenting as Worsening Hyperglycemia in a 72-Year-Old Patient with Type 2 Diabetes.","authors":"Yotsapon Thewjitcharoen, Nopparath Tongpoo, Veekij Veerasomboonsin, Soontaree Nakasatien, Thep Himathongkam","doi":"10.15605/jafes.041.01.5251","DOIUrl":"10.15605/jafes.041.01.5251","url":null,"abstract":"","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"211-212"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on the article, '<i>Perioperative Complications Associated with Routine Preoperative Glucocorticoid Use Among Patients Undergoing Pituitary Surgery with Normal Preoperative HPA Axis: A Retrospective Cohort Study</i>' by Magnaye and Paz-Pacheco, published in JAFES Vol. 40. No. 1.","authors":"Eisha Fatimah, Sarosh Usman, Muhammad Aqib Farooq Khan","doi":"10.15605/jafes.041.01.6257","DOIUrl":"10.15605/jafes.041.01.6257","url":null,"abstract":"","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"41 1","pages":"209-210"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Visualization Analysis of Hotspots and Frontiers in Obesity-Related Executive Functions Research: A Bibliometric Study.","authors":"Lili Su, Jing He, Yan Xiao, Xiaorong He, Ruimei Song, Xiaorong Wu, Yunxin Si Tu, Shen Qu","doi":"10.15605/jafes.040.02.07","DOIUrl":"10.15605/jafes.040.02.07","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to provide a visual analysis of the research hotspots and frontiers in the field of obesity-related executive functions using bibliometric methods.</p><p><strong>Methodology: </strong>Our analysis is based on 5814 English-language documents retrieved from the Web of Science Core Collection database. CiteSpace 6.2.R4 software was utilized to conduct bibliometric analysis. The study examines the trends, key players, and thematic evolution in obesity-related executive function research over the past decade.</p><p><strong>Results: </strong>The number of publications in this domain has exhibited a steady linear growth trend, with American institutions and scholars leading in research contributions. The current research focus encompasses co-occurrence and cluster analysis of keywords and references, as well as the brain and associated cognitive functions. Our bibliometric analysis reveals a shift in focus towards the brain, cognition, executive functions, the prefrontal cortex and other related topics in obese individuals, in addition to established areas such as metabolic syndromes, insulin resistance, diabetes, gut microbiota, and dietary intake.</p><p><strong>Conclusion: </strong>This study highlights new entry points for aspiring researchers in the field of obesity and executive functions. Future research directions may include a deeper exploration of the relationship between obesity and specific components of executive functions, such as working memory, inhibitory control, cognitive flexibility, and planning.</p>","PeriodicalId":41792,"journal":{"name":"Journal of the ASEAN Federation of Endocrine Societies","volume":"40 2","pages":"100-113"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}