Linda M Siminerio, Youjia Wang, Denise Charron-Prochownik
{"title":"Diabetes Care and Education: A Look Backward and Forward.","authors":"Linda M Siminerio, Youjia Wang, Denise Charron-Prochownik","doi":"10.17925/EE.2025.21.1.5","DOIUrl":"10.17925/EE.2025.21.1.5","url":null,"abstract":"<p><p>The importance of self-management and education is now generally known and accepted in the diabetes community. Despite this, the number of people with diabetes who receive diabetes education and psychosocial services continues to be disappointing. While clinical advances are being adopted, referrals to diabetes education remain low, and resources for behavioural support are scarce. This calls for a need to inform and remind care providers and healthcare decision-makers of the efforts of all those who built the foundation for comprehensive diabetes care, which continues to inform practice and serve as a backdrop for research to address today's challenges.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251247","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}
Abm Kamrul-Hasan, Sunetra Mondal, Fatema Tuz Zahura Aalpona, Lakshmi Nagendra, Deep Dutta
{"title":"Role of Sodium-Glucose Cotransporter-2 Inhibitors in Managing Polycystic Ovary Syndrome: A Systematic Review.","authors":"Abm Kamrul-Hasan, Sunetra Mondal, Fatema Tuz Zahura Aalpona, Lakshmi Nagendra, Deep Dutta","doi":"10.17925/EE.2025.21.1.2","DOIUrl":"10.17925/EE.2025.21.1.2","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) can improve metabolic parameters and significantly reduce weight and fat mass. Evidence regarding the use of SGLT2i in polycystic ovary syndrome (PCOS) is limited. The current systematic review compared the efficacy of SGLT2i with placebo or other active comparators in PCOS.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) involving patients with PCOS who are overweight and obese and receiving SGLT2i as intervention and placebo or any non-hormonal comparator as controls were identified through electronic databases. The outcomes of interest included changes in metabolic, hormonal, anthropometric and body composition parameters.</p><p><strong>Results: </strong>Five RCTs involving 269 participants were included. Canagliflozin, empagliflozin, dapagliflozin and licogliflozin were studied either as monotherapy or in combination with metformin or exenatide. SGLT2i reduced insulin resistance, as evidenced by decreased homeostatic model assessment for insulin resistance and insulin and fasting plasma glucose levels. Reductions in body weight, body mass index, waist circumference and total body fat were observed with most of the SGLT2i. A reduction in dehydroepiandrosterone sulphate (DHEAS) levels was also observed in two RCTs, whereas a decrease in total testosterone level or free-androgen index was not associated with most SGLT2i. Improvements in menstrual irregularity and hirsutism scores were observed. Triglycerides were reduced, while low-density lipoprotein level was slightly increased with SGLT2i in most RCTs. Improvements in body composition and metabolic parameters were most prominent with a combination of SGLT2i with a glucagon-l ike peptide receptor-1 agonist (GLP1RA), while the combination of SGLT2i with metformin showed better effects on hormonal parameters. Adverse effects with SGLT2i were mostly mild and included genital infections.</p><p><strong>Conclusion: </strong>SGLT2i, when used as monotherapy or combined with metformin or GLP1RA, are a promising therapy for improving metabolic and hormonal parameters in PCOS.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251251","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}
David M Williams, Jagadish Nagaraj, Jeffrey W Stephens, Thinzar Min
{"title":"The Use of Non-i nvasive Biomarkers to Screen for Advanced Fibrosis Associated with Metabolic Dysfunction-associated Steatotic Liver Disease in People with Type 2 Diabetes: A Narrative Review.","authors":"David M Williams, Jagadish Nagaraj, Jeffrey W Stephens, Thinzar Min","doi":"10.17925/EE.2025.21.1.4","DOIUrl":"10.17925/EE.2025.21.1.4","url":null,"abstract":"<p><p>There is growing interest in metabolic dysfunction-associated steatotic liver disease (MASLD), given its increasing prevalence and our developing understanding of the disease. People living with type 2 diabetes or obesity have a greater risk of developing significant hepatic steatosis and a greater risk of more rapid progression to steatohepatitis, advanced hepatic fibrosis and hepatocellular carcinoma. As such, various international bodies now advocate for routine screening for MASLD-related hepatic fibrosis in people with such risk factors. This would permit earlier targeted lifestyle interventions and the use of pharmacotherapies, which may reverse earlier stages of MASLD-associated fibrosis. This may improve both liver-related and cardiovascular outcomes in these higher-risk groups. Nonetheless, the identification of MASLD-related hepatic fibrosis is frequently limited to liver enzyme tests, given the lack of a systematic approach to investigation and screening. In this article, we discuss the potential to screen for advanced fibrosis in people with MASLD using various blood-based biomarkers, such as the Fibrosis-4 score, non-alcoholic fatty liver disease fibrosis score and enhanced liver fibrosis test, amongst other available patented and non-patented tests. We discuss the relative benefits and limitations of each and the potential for future research in this evolving area of clinical interest.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251261","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}
Georgios Logothetis, Konstantinos Avramidis, Evanthia Konstantaki, Vasiliki Matziou, John Doupis
{"title":"The Role of Remote Glucose Management Using Real-time Continuous Glucose Monitoring Systems in ICU-hospitalized Patients with COVID-19.","authors":"Georgios Logothetis, Konstantinos Avramidis, Evanthia Konstantaki, Vasiliki Matziou, John Doupis","doi":"10.17925/EE.2025.21.1.7","DOIUrl":"10.17925/EE.2025.21.1.7","url":null,"abstract":"<p><p>The recent coronavirus disease 2019 (COVID-19) pandemic has induced many challenges in the clinical environment worldwide. In a bid to reduce the exposure of healthcare providers to severe acute respiratory syndrome coronavirus 2 and the utilization of personal protective equipment (PPE), while maintaining optimal patient care, in April 2020, the US Food and Drug Administration issued a new policy, allowing the use of continuous glucose monitoring (CGM) systems in the intensive care unit (ICU) setting. This article aimed to explore the role of real-time continuous glucose monitoring systems in patients in the ICU with COVID-19. The hybrid protocols integrating real-time CGM and point of care seem to be a feasible and safe alternative for the glycaemic management of critically ill patients with COVID-1 9, including the reduction of healthcare providers' exposure and the preservation of PPE, whilst achieving and maintaining optimal glycaemic control.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251260","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}
Than Than Aye, Mya Thanda Sein, Phyo Thiha, Tin Myo Han, Htar Ni Aye, Yin Thu Theint, Mie Mie Pyone, Kyaw Swar Thet, Thet Htun Zaw, Aye Moh Moh Han
{"title":"Changes in Urinary Aquaporin 2 and Serum Sodium After Catheterization in Elderly Patients with Syndrome of Inappropriate Antidiuretic Hormone and Urinary Retention: A Preliminary Hospital-based Study in Yangon, Myanmar.","authors":"Than Than Aye, Mya Thanda Sein, Phyo Thiha, Tin Myo Han, Htar Ni Aye, Yin Thu Theint, Mie Mie Pyone, Kyaw Swar Thet, Thet Htun Zaw, Aye Moh Moh Han","doi":"10.17925/EE.2025.21.1.6","DOIUrl":"10.17925/EE.2025.21.1.6","url":null,"abstract":"<p><strong>Background: </strong>The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common electrolyte disorder among elderly patients. Chronic urinary retention has also been implicated in the development of SIADH. The mechanism by which urinary retention leads to SIADH remains unclear. Increased responsiveness of the collecting ducts to arginine vasopressin has been observed in elderly patients with urinary retention. This study aims to evaluate whether SIADH in elderly patients with urinary retention is associated with increased urinary aquaporin 2 (U-AQP2) levels and whether the insertion of an indwelling catheter with fluid restriction, without the administration of 3% saline, can lower the U-AQP2 level, leading to the resolution of SIADH.</p><p><strong>Method: </strong>This hospital-based clinical intervention study was conducted from January 2022 to January 2023. Eighteen elderly patients who met the selection criteria for euvolaemic SIADH (identified by Bartter and Schwartz criteria) associated with urinary retention, after excluding other causes, were selected. Serum sodium (Nas), serum osmolality (Osms), U-AQP2 levels, urinary osmolality (Osmu) and 24-hour urine volume on days 1 and 4 post-catheterization were assessed and compared. Clinical responses, including neurological signs and symptoms (Glasgow Coma Scale [GCS]), were also recorded.</p><p><strong>Results: </strong>All 18 cases had comorbidities and were in a range of severe hyponatraemia, defined as Nas<125 mmol/L. Nas levels significantly increased (p<0.05) on days 2 and 4 after the drainage of residual urine, with mean (± standard deviation) changes of 8.39 (± 5.7) and 15.67 (± 5.6) mmol/L, respectively, from a baseline of 110.7 mmol/L. Osms significantly increased (p<0.05) from 240.01 (± 15.68) mOsm/kg on day 1 to 272.74 (± 13.41) mOsm/kg on day 4 post-catheterization. The mean urinary aquaporin:creatinine ratio significantly decreased (p<0.05) from 3,348.01 (± 2,127.82) fmol/mg Cr on day 1 to 1,135.27 (± 1,194.42) fmol/mg Cr on day 4. The mean Osmu significantly decreased (p=0.00) from 450.67 (± 187.3) mOsm/kg on day 1 to 229.33 (± 123.56) mOsm/kg on day 4. The mean urine volume significantly increased (p<0.05) from 1,610.00 (± 530.15) mL on day 1 to 2,725.56 (± 898.29) mL on day 4. All patients showed neurological improvement, with the mean GCS increasing from 11 to 14, without complications of osmotic demyelination syndrome.</p><p><strong>Conclusion: </strong>U-AQP2 levels are elevated in elderly patients with SIADH with urinary retention. After catheterization, these levels decrease, leading to the spontaneous resolution of hyponatraemia without complications.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251246","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}
Deep Dutta, Lakshmi Nagendra, Abm Kamrul-Hasan, Kunal Mahajan
{"title":"Efficacy and Safety of Early Initiation of Sodium-Glucose Co-transporter-2 Inhibitors Following Acute Myocardial Infarction: A Systematic Review and Meta-analysis.","authors":"Deep Dutta, Lakshmi Nagendra, Abm Kamrul-Hasan, Kunal Mahajan","doi":"10.17925/EE.2025.21.1.1","DOIUrl":"10.17925/EE.2025.21.1.1","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are the preferred agents for managing type 2 diabetes in patients with established atherosclerotic cardiovascular disease and for reducing hospitalization for heart failure (HHF) in patients with heart failure with reduced and preserved ejection fraction. We undertook this meta-analysis, as, to date, no meta-analysis has holistically analysed the potential benefits and safety of SGLT2i in patients with acute myocardial infarction (MI).</p><p><strong>Methods: </strong>Electronic databases were searched for randomized controlled trials (RCTs) involving patients with MI who received SGLT2i in the intervention arm (initiated within 2 weeks of the index event) and placebo/active comparator in the control arm. The primary outcome was to evaluate the impact on cardiovascular death, all-cause death and HHF. The secondary outcomes were to evaluate the impact on echocardiographic parameters, N-terminal pro-b-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein, MI, stroke, all-cause hospitalization and safety issues.</p><p><strong>Results: </strong>From initially screened 8,922 articles, data from 6 RCTs were analysed (7,409 patients). Early initiation of SGLT2i following MI was associated with significantly lower future HHF (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.62-0.90; p=0.002; <i>I</i> <sup>2</sup>=0%) and significantly higher left-ventricular ejection fraction (mean difference [MD]: 1.65%; 95% CI: 0.34-2.96; p=0.01; <i>I</i> <sup>2</sup>=0%) compared with placebo. Compared with placebo, SGLT2i following MI had no beneficial impact on cardiovascular deaths (OR: 1.04; 95% CI: 0.83-1.30; p=0.76; <i>I</i> <sup>2</sup>=0%), all-cause mortality (OR: 1.00; 95% CI: 0.82-1.21; p=0.98; <i>I</i> <sup>2</sup>=0%), stroke (OR: 0.58; 95% CI: 0.26-1.27; p=0.17), all-cause hospitalization (OR: 1.13; 95% CI: 0.97-1.32; p=0.11; <i>I</i> <sup>2</sup>=0%) and percentage change in NT-proBNP (MD: 1.18%; 95% CI: -9.78 to 12.14; p=0.83; <i>I</i> <sup>2</sup>=52%). SGLT2i were well tolerated without increased ketoacidosis, acute renal failure or hepatic injury.</p><p><strong>Conclusion: </strong>Early initiation of SGLT2i in acute MI is safe, well tolerated and associated with a reduction in HHF.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"14-23"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251248","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}
Saptarshi Bhattacharya, Sanjay Kalra, Lakshmi Nagendra, Deep Dutta
{"title":"Forty-four Years of the UK Prospective Diabetes Study: Legacy Effect and Beyond.","authors":"Saptarshi Bhattacharya, Sanjay Kalra, Lakshmi Nagendra, Deep Dutta","doi":"10.17925/EE.2025.21.1.8","DOIUrl":"10.17925/EE.2025.21.1.8","url":null,"abstract":"<p><p>The results of the third phase of the UK Prospective Diabetes Study, recently published in <i>The Lancet</i>, reinforce the crucial role of early intensive glycaemic control in protection against micro- and macrovascular complications of diabetes. The benefits persist into the third decade after the completion of the trial, long after the difference in glycated haemoglobin between the intensive and standard arms has disappeared. This 'legacy effect' emphasizes the need for early diagnosis and aggressive management of diabetes from the time of its identification. It also validates the long-term safety and efficacy of conventional agents such as metformin and sulfonylureas. Understanding the mechanisms behind the 'legacy effect' could help target pathways that lead to the development of complications.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251249","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}
Shubhashis Saha, Shaleen Dass, Kripa Elizabeth Cherian, Stephen A Jiwanmall, Dheeraj Kattula, Sandhiya Reddy, Rajeeb Jaleel, Thomas V Paul, Nitin Kapoor
{"title":"Performance of Simple Outpatient-based Biomarker Panels for Screening of Steatotic Liver Disease in Women with Morbid Obesity from Southern India.","authors":"Shubhashis Saha, Shaleen Dass, Kripa Elizabeth Cherian, Stephen A Jiwanmall, Dheeraj Kattula, Sandhiya Reddy, Rajeeb Jaleel, Thomas V Paul, Nitin Kapoor","doi":"10.17925/EE.2025.21.1.3","DOIUrl":"10.17925/EE.2025.21.1.3","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) and related health issues are increasing in Indian women with morbid obesity, but the standard diagnostic tool - abdominal ultrasound sonography (USG) - is costly and less accessible. This study aims to identify an affordable and effective biomarker panel to improve early detection and screening of NAFLD in resource-l imited settings.</p><p><strong>Methods: </strong>This cross-sectional study included 106 consecutive patients aged between 18 and 70 years with morbid obesity defined by body mass index (BMI) ≥32.5 kg/m<sup>2</sup> who underwent an abdominal USG for a non-hepatic indication. The serum biomarker indices used were hepatic steatosis index, lipid accumulation product (LAP), Framingham steatosis index, triglyceride-glucose (TyG) index, TyG weight-to-height ratio composite index, TyG-BMI and TyG waist circumference composite index.</p><p><strong>Results: </strong>The mean age was 40.2 ± 10.9 years, and the mean BMI was 41.5 ± 5.8 kg/m<sup>2</sup>. NAFLD was diagnosed in 71.7% of the participants. The TyG index showed the highest diagnostic accuracy with an area under the receiver operating characteristic curve (AUROC) of 0.835 (confidence interval [CI]: 0.713-0.957, p<0.001), with a sensitivity of 95.1% and a specificity of 70.8% at a cut-off of 9.0994. LAP showed an AUROC of 0.711 (CI: 0.584-0.838, p-value: 0.002). Using a cut-off score of 76.2, the sensitivity and specificity were 71.2 and 70.8%, respectively.</p><p><strong>Conclusion: </strong>Simple screening tools can be used to detect fatty liver disease in clinical practice. In our cohort, TyG index was found to be the best tool for identifying NAFLD, with LAP showing potential as a secondary option.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251250","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":"Clinical and Biochemical Profiles of Hospitalized Patients with Hypercalcaemia from a Tertiary Care Centre in North India.","authors":"Aman Kumar, Deepak Khandelwal, Lovely Gupta, Upasana Agrawal, Suresh Mittal, Vivek Aggarwal, Nishikant Avinash Damle, Monika Garg, Deep Dutta, Sanjay Kalra","doi":"10.17925/EE.2024.20.2.15","DOIUrl":"10.17925/EE.2024.20.2.15","url":null,"abstract":"<p><p><b>Background and aims:</b> The profile of hypercalcaemia in hospitalized patients in India seems to be changing. However, studies evaluating the profile of hypercalcaemia in hospitalized settings in India are extremely limited. This prospective study aims to evaluate the clinical and biochemical profile of hospitalized patients with hypercalcaemia from a tertiary care centre in north India. <b>Materials and methods:</b> Clinical and biochemical profiles of subjects with hypercalcaemia detected during hospitalization/hospitalized with hypercalcaemia were assessed. A total of 91 subjects with sustained hypercalcaemia, who were eligible, underwent further investigation as per the institutional protocol and the data collected were analyzed. <b>Results:</b> The mean age of participants was 57.88 ± 14.23 years, with 62.64% of participants being females. The most common symptoms were nausea and anorexia, which were observed in all patients. The most common clinical sign was dehydration, which was observed in 32.97% of subjects. Primary hyperparathyroidism was the most common cause (41.76%), followed by suspected or confirmed malignancy/solid tumours in 15.38% of subjects. Other causes were advanced chronic liver disease (10.99%), multiple myeloma (9.89%), vitamin D toxicity (8.79%), granulomatous disorders (2.20%) and drug-i nduced disorders (1.10%). Forty-one subjects (45.05%) developed acute kidney injury and 14 subjects (15.38%) developed acute pancreatitis as a complication. Six subjects (6.59%) died during the course of hospitalization because of either primary disease or other secondary complications. <b>Conclusions:</b> Clinicians should be aware of changing patterns of hypercalcaemia in a hospital setting. Hypercalcaemia in hospitalized patients is associated with significant complications and mortality. Further large-scale prospective studies are needed to understand the changing pattern of hypercalcaemia in hospitalized patients from India.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634525","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":"Metformin Use and Vitamin B12 Deficiency in People with Type 2 Diabetes. What Are the Risk Factors? A Mini-systematic Review.","authors":"Michael Atkinson, Prashamsa Gharti, Thinzar Min","doi":"10.17925/EE.2024.20.2.7","DOIUrl":"10.17925/EE.2024.20.2.7","url":null,"abstract":"<p><p><b>Background and Aim:</b> Metformin is recommended as the first-line agent for the management of type 2 diabetes following lifestyle and dietary changes. The long-term use of metformin has been associated with vitamin B12 deficiency. The aim of this review is to investigate the effect of metformin on vitamin B12 levels and identify any risk factors. <b>Method:</b> A literature search was conducted using MEDLINE, PubMed and ProQuest Central. Selected articles were peer-reviewed articles, written in English and published from 2015 and onwards. Excluded articles were case reports, reviews or meta-analyses, as well as those with no access to full text. <b>Results:</b> In total, 21 articles were included. There was a significant association between metformin use and vitamin B12 levels in 17 studies, while 4 studies found no such association. The risk factors examined were metformin dose, treatment duration, patient age and patient ethnicity. <b>Conclusion:</b> In summary, metformin use was associated with lower vitamin B12 concentrations, and higher doses and longer durations of treatment increase the risk of vitamin B12 deficiency. Routine vitamin B12 screening is recommended, prioritizing higher-risk patients. Further research is needed to identify when to initiate monitoring.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"42-53"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634535","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}