Pub Date : 2025-04-01DOI: 10.1016/j.ando.2024.10.002
Philippe Oriot , Noemie Klipper dit kurz , Michel P. Hermans
{"title":"Can standard CGM data be used to identify an HNF1B MODY-5 glucotype? Insights from a clinical case","authors":"Philippe Oriot , Noemie Klipper dit kurz , Michel P. Hermans","doi":"10.1016/j.ando.2024.10.002","DOIUrl":"10.1016/j.ando.2024.10.002","url":null,"abstract":"","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101673"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585045","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}
Pub Date : 2025-04-01DOI: 10.1016/j.ando.2024.09.004
Maria Adriana Rangel , Rita Calejo , Vilma Lopes , Rosa Arménia Campos , Ana Luísa Leite
Objective and methods
This study aimed to assess the body composition of pediatric patients with type-1 diabetes (T1D) in a Portuguese pediatric endocrinology/diabetic clinic, using the InBody 570 bioimpedance system. Preschool children (< 6 years) and those recently diagnosed (< 6 months) were excluded.
Results
The study included 78 patients (53% female). Median age at assessment was 14 years, with 81% pubertal children. Eighty-seven percent were using continuous subcutaneous insulin infusion (CSII), 25% with an automated closed-loop model. Median HbA1c was 7.3%. Most had an adequate body mass index (BMI) standard deviation score (62%) and 48% engaged in regular physical exercise (PE) outside of school. Median percentage body fat (PBF) was 21.5% and was abnormal in 48%, with median visceral adiposity of 4. Despite adequate BMI, 11% had excessive PBF. PBF was significantly associated with visceral fat (r = 0.79; P < 0.001), female gender (P < 0.001) and PE performed out of school (P = 0.005). PE was associated with lower PBF (P = 0.005), lower visceral fat (P = 0.002), and higher muscle-to-fat ratio (P = 0.006).
Conclusion
Engaging in physical exercise out of school correlated significantly with improved body composition, characterized by reduced PBF and diminished visceral adiposity. Considering the known benefits of physical exercise for metabolic and glycemic control, this study highlights the importance of promoting regular physical exercise in T1D patients.
{"title":"Body composition in a pediatric population with type-1 diabetes – The importance of planned physical exercise","authors":"Maria Adriana Rangel , Rita Calejo , Vilma Lopes , Rosa Arménia Campos , Ana Luísa Leite","doi":"10.1016/j.ando.2024.09.004","DOIUrl":"10.1016/j.ando.2024.09.004","url":null,"abstract":"<div><h3>Objective and methods</h3><div>This study aimed to assess the body composition of pediatric patients with type-1 diabetes (T1D) in a Portuguese pediatric endocrinology/diabetic clinic, using the InBody 570 bioimpedance system. Preschool children (<<!--> <!-->6 years) and those recently diagnosed (<<!--> <!-->6 months) were excluded.</div></div><div><h3>Results</h3><div>The study included 78 patients (53% female). Median age at assessment was 14 years, with 81% pubertal children. Eighty-seven percent were using continuous subcutaneous insulin infusion (CSII), 25% with an automated closed-loop model. Median HbA1c was 7.3%. Most had an adequate body mass index (BMI) standard deviation score (62%) and 48% engaged in regular physical exercise (PE) outside of school. Median percentage body fat (PBF) was 21.5% and was abnormal in 48%, with median visceral adiposity of 4. Despite adequate BMI, 11% had excessive PBF. PBF was significantly associated with visceral fat (r<!--> <!-->=<!--> <!-->0.79; <em>P</em> <!--><<!--> <!-->0.001), female gender (<em>P</em> <!--><<!--> <!-->0.001) and PE performed out of school (<em>P</em> <!-->=<!--> <!-->0.005). PE was associated with lower PBF (<em>P</em> <!-->=<!--> <!-->0.005), lower visceral fat (<em>P</em> <!-->=<!--> <!-->0.002), and higher muscle-to-fat ratio (<em>P</em> <!-->=<!--> <!-->0.006).</div></div><div><h3>Conclusion</h3><div>Engaging in physical exercise out of school correlated significantly with improved body composition, characterized by reduced PBF and diminished visceral adiposity. Considering the known benefits of physical exercise for metabolic and glycemic control, this study highlights the importance of promoting regular physical exercise in T1D patients.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101670"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303183","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}
Lipodystrophy and extreme insulin resistance syndrome are rare diseases with severe metabolic complications. Reported epidemiological data are conflicting.
Objective
We aimed to evaluate nationwide and regional prevalences of lipodystrophy and insulin resistance syndrome in France, and to study diagnostic and care-pathways.
Methods
We studied data from the French National Rare Disease Registry (BNDMR), which includes all patients attending rare disease reference centers in France. We analyzed demographic data and age at first signs and at diagnosis in patients with an ORPHA code of lipodystrophy or severe insulin resistance syndrome.
Results
The number of patients registered with lipodystrophy/insulin resistance syndrome doubled from 2017 to 2023, with the deployment of nationwide epidemiological tools in specialized rare diseases centers. Currently, 567 of the 652 patients (58% female) had a diagnosis of genetically determined disease with generalized (GL) or partial lipodystrophy (PL), giving an estimated national prevalence of 1.6 and 6.4 per million, respectively. Wide regional differences in estimated prevalence may be partly due to founder pathogenic variants, or local spread of clinical skills and knowledge. Median age at first signs and diagnosis were respectively 1 [IQR: 1–3] and 5 years [0–20] for GL, and 22 [14–35] and 40 years [25–52] for PL, with earlier first signs of PL in women than in men.
Conclusion
The estimated prevalence of genetic lipodystrophy/extreme insulin resistance syndrome has increases with the use of dedicated epidemiological tools, suggesting persistent underdiagnosis. Knowledge of these diseases needs to be improved to decrease diagnostic delay and reduce regional and gender-associated diagnostic disparities.
{"title":"Lipodystrophy and severe insulin resistance syndrome: Epidemiological data from a French national rare diseases registry","authors":"Marie-Christine Vantyghem , Estelle Nobécourt , Camille Vatier , Elise Bismuth , Clémence Deshuille , Nabila Elarouci , French Lipodystrophy Reference Network , Anne-Sophie Jannot , Brigitte Delemer , Corinne Vigouroux","doi":"10.1016/j.ando.2025.101730","DOIUrl":"10.1016/j.ando.2025.101730","url":null,"abstract":"<div><h3>Context</h3><div>Lipodystrophy and extreme insulin resistance syndrome are rare diseases with severe metabolic complications. Reported epidemiological data are conflicting.</div></div><div><h3>Objective</h3><div>We aimed to evaluate nationwide and regional prevalences of lipodystrophy and insulin resistance syndrome in France, and to study diagnostic and care-pathways.</div></div><div><h3>Methods</h3><div>We studied data from the French National Rare Disease Registry (BNDMR), which includes all patients attending rare disease reference centers in France. We analyzed demographic data and age at first signs and at diagnosis in patients with an ORPHA code of lipodystrophy or severe insulin resistance syndrome.</div></div><div><h3>Results</h3><div>The number of patients registered with lipodystrophy/insulin resistance syndrome doubled from 2017 to 2023, with the deployment of nationwide epidemiological tools in specialized rare diseases centers. Currently, 567 of the 652 patients (58% female) had a diagnosis of genetically determined disease with generalized (GL) or partial lipodystrophy (PL), giving an estimated national prevalence of 1.6 and 6.4 per million, respectively. Wide regional differences in estimated prevalence may be partly due to founder pathogenic variants, or local spread of clinical skills and knowledge. Median age at first signs and diagnosis were respectively 1 [IQR: 1–3] and 5 years [0–20] for GL, and 22 [14–35] and 40 years [25–52] for PL, with earlier first signs of PL in women than in men.</div></div><div><h3>Conclusion</h3><div>The estimated prevalence of genetic lipodystrophy/extreme insulin resistance syndrome has increases with the use of dedicated epidemiological tools, suggesting persistent underdiagnosis. Knowledge of these diseases needs to be improved to decrease diagnostic delay and reduce regional and gender-associated diagnostic disparities.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 4","pages":"Article 101730"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775128","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}
Pub Date : 2025-03-26DOI: 10.1016/j.ando.2025.101729
Mingqiao Zhang , Liang Liang , Hong Hu , Chengyang Tang , Qian Huang , Jian Long
Purpose
To assess correlations between orbital immune cell subsets and the clinical activity in thyroid eye disease (TED).
Methods
The orbital samples from 12 healthy controls and 29 TED patients (active group, n = 12; inactive group, n = 17) were analyzed. Total lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, CD3+ CD4+ CD8+ T cells (double-positive (DPT) T-cells), CD3+ CD4-CD8-T cells (double negative (DNT) T-cells), B cells, natural killer (NK) cells and NKT cells were counted on flow cytometry. Correlations between the number of orbital immune cells and clinical activity score (CAS) were analyzed.
Results
Age was greater in active than inactive TED patients, and in inactive TED patients than in controls (all P < 0.05). TED duration was shorter in active than inactive patients (all P < 0.05). FT3 and TSH levels were higher in controls than in active TED patients (P < 0.05). There was no significant difference in TRAb level between active and inactive patients. There were no significant differences in smoking status, gender or FT4 level between the 3 groups (all P > 0.05). The numbers of orbital total lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, DNT cells, NK cells, NKT cells and CD4+/CD8+ T cells in active TED patients were significantly higher than in inactive patients and controls (all P < 0.05). After adjusting for age and TED duration, the number of CD3+ T cells, CD4+ T cells, CD8+ T cells, NK cells and NKT cells were independent predictors of TED activity (P = 0.03, OR = 1.19; P = 0.04, OR = 1.69; P = 0.03, OR = 1.48; P = 0.04, OR = 2.08; P = 0.03, OR = 2.89, respectively).
Conclusions
Numerous immunoinflammatory cells were observed in the orbits of both active and inactive TED patients and in controls, but expression was highest in active TED patients. CD4+ T cell, CD8+ T cell, NK cell, and NKT cell counts were independent factors for the CAS in TED.
{"title":"Correlation between orbital immune cell subsets and clinical activity in thyroid eye disease","authors":"Mingqiao Zhang , Liang Liang , Hong Hu , Chengyang Tang , Qian Huang , Jian Long","doi":"10.1016/j.ando.2025.101729","DOIUrl":"10.1016/j.ando.2025.101729","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess correlations between orbital immune cell subsets and the clinical activity in thyroid eye disease (TED).</div></div><div><h3>Methods</h3><div>The orbital samples from 12 healthy controls and 29 TED patients (active group, <em>n</em> <!-->=<!--> <!-->12; inactive group, <em>n</em> <!-->=<!--> <!-->17) were analyzed. Total lymphocytes, CD3+<!--> <!-->T cells, CD4+<!--> <!-->T cells, CD8+ T cells, CD3+<!--> <!-->CD4+<!--> <!-->CD8+<!--> <!-->T cells (double-positive (DPT) T-cells), CD3+<!--> <!-->CD4-CD8-T cells (double negative (DNT) T-cells), B cells, natural killer (NK) cells and NKT cells were counted on flow cytometry. Correlations between the number of orbital immune cells and clinical activity score (CAS) were analyzed.</div></div><div><h3>Results</h3><div>Age was greater in active than inactive TED patients, and in inactive TED patients than in controls (all <em>P</em> <!--><<!--> <!-->0.05). TED duration was shorter in active than inactive patients (all <em>P</em> <!--><<!--> <!-->0.05). FT3 and TSH levels were higher in controls than in active TED patients (<em>P</em> <!--><<!--> <!-->0.05). There was no significant difference in TRAb level between active and inactive patients. There were no significant differences in smoking status, gender or FT4 level between the 3 groups (all <em>P</em> <!-->><!--> <!-->0.05). The numbers of orbital total lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, DNT cells, NK cells, NKT cells and CD4+/CD8+ T cells in active TED patients were significantly higher than in inactive patients and controls (all <em>P</em> <!--><<!--> <!-->0.05). After adjusting for age and TED duration, the number of CD3+ T cells, CD4+ T cells, CD8+ T cells, NK cells and NKT cells were independent predictors of TED activity (<em>P</em> <!-->=<!--> <!-->0.03, OR<!--> <!-->=<!--> <!-->1.19; <em>P</em> <!-->=<!--> <!-->0.04, OR<!--> <!-->=<!--> <!-->1.69; <em>P</em> <!-->=<!--> <!-->0.03, OR<!--> <!-->=<!--> <!-->1.48; <em>P</em> <!-->=<!--> <!-->0.04, OR<!--> <!-->=<!--> <!-->2.08; <em>P</em> <!-->=<!--> <!-->0.03, OR<!--> <!-->=<!--> <!-->2.89, respectively).</div></div><div><h3>Conclusions</h3><div>Numerous immunoinflammatory cells were observed in the orbits of both active and inactive TED patients and in controls, but expression was highest in active TED patients. CD4+ T cell, CD8+ T cell, NK cell, and NKT cell counts were independent factors for the CAS in TED.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 4","pages":"Article 101729"},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744626","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}
Pub Date : 2025-03-07DOI: 10.1016/j.ando.2025.101721
Louis Schubert , Martin Gaillard , Charlotte Melot , Thierry Delbot , Anne Ségolène Cottereau , Eugénie Koumakis , Fidéline Bonnet-Serrano , Lionel Groussin
Multiple endocrine neoplasia type 1 (MEN1) is a rare genetic disease with autosomal dominant transmission, which can cause various tumors, particularly endocrine, in a given patient. Primary hyperparathyroidism (PHPT) is the most common and earliest manifestation, leading to surgery before the age of 50 in most patients. Biological severity and renal and/or bone complications dictate the timing of parathyroid surgery. The objective is to correct hypercalcemia to prevent impact, while minimizing the risk of hypoparathyroidism. The most widely recommended procedure is subtotal parathyroidectomy (3 or 3.5 glands removed), with thymic horn resection via a cervical route. The development of imaging techniques, however, makes it possible to discuss partial surgery (resection of 1 or 2 glands) on a case-by-case basis depending on preoperative imaging and other elements such as patient age. Finally, hypercalcemia recurrence after initial surgery is a common feature of MEN1, and management of the remaining gland is challenging with various options: reoperation, calcimimetics and US-guided ablation or therapeutic abstention.
{"title":"Management of primary hyperparathyroidism in MEN1: From initial subtotal surgery to complex treatment of the remaining gland","authors":"Louis Schubert , Martin Gaillard , Charlotte Melot , Thierry Delbot , Anne Ségolène Cottereau , Eugénie Koumakis , Fidéline Bonnet-Serrano , Lionel Groussin","doi":"10.1016/j.ando.2025.101721","DOIUrl":"10.1016/j.ando.2025.101721","url":null,"abstract":"<div><div>Multiple endocrine neoplasia type 1 (MEN1) is a rare genetic disease with autosomal dominant transmission, which can cause various tumors, particularly endocrine, in a given patient. Primary hyperparathyroidism (PHPT) is the most common and earliest manifestation, leading to surgery before the age of 50 in most patients. Biological severity and renal and/or bone complications dictate the timing of parathyroid surgery. The objective is to correct hypercalcemia to prevent impact, while minimizing the risk of hypoparathyroidism. The most widely recommended procedure is subtotal parathyroidectomy (3 or 3.5 glands removed), with thymic horn resection via a cervical route. The development of imaging techniques, however, makes it possible to discuss partial surgery (resection of 1 or 2 glands) on a case-by-case basis depending on preoperative imaging and other elements such as patient age. Finally, hypercalcemia recurrence after initial surgery is a common feature of MEN1, and management of the remaining gland is challenging with various options: reoperation, calcimimetics and US-guided ablation or therapeutic abstention.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 4","pages":"Article 101721"},"PeriodicalIF":2.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588471","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}
Cranial radiotherapy for extrapituitary brain tumor is a rare cause of acquired pituitary deficiency. The main objective of the present study was to evaluate the incidence and time onset of pituitary deficit and to investigate predictive factors.
Material and methods
This retrospective cohort study included 246 patients referred to our endocrinology department between 2005 and 2021 for hormone testing after radiotherapy for extrapituitary brain tumor. Incidence of pituitary deficit was reported with 95% confidence intervals [95% CI]. Deficit-free survival was estimated on the Kaplan Meier method.
Results
Mean (SD) age at inclusion was 32.2 years (20.3). One hundred and forty-one patients were male (57.3%). One hundred and seventy-five (71.1%) were irradiated after and 71 (28.9%) at or before the age of 15. Mean (SD) follow-up was 10 years (7). At the end of the study, 118 patients (48.0%) had ≥ 1 hormonal deficit: GH deficit in 88 patients (36.5%), TSH deficit in 61 (24.8%), LH/FSH deficit in 47 (19.5%); ACTH deficit was identified in 12 patients (4.9%), and was never isolated. The overall incidence of pituitary deficits was 10.3 per 100 person-years (95% CI [30.8; 65.3]) and did not differ according to age at irradiation. Pituitary deficits occurred within a mean (SD) 2.6 years (2.5), 4.9 years (3.3), 4.0 years (2.4) and 4.8 years (3.1) for ACTH, TSH, GH and LH/FSH, respectively. The only factor associated with deficit-free survival was pituitary gland D50 (maximum dose received by at least 50% of gland volume): D50 37-44 Gy compared to 1-24 Gy; HR: 2.51; 95% CI [1.09; 5.80]; P = 0.031.
Conclusion
Half of the patients presented pituitary deficits 10 years after irradiation for extrapituitary brain tumor. However, ACTH deficit was rare, and never isolated, suggesting that it is not necessary to carry out a dynamic test for ACTH if no other deficits are diagnosed.
{"title":"Pituitary dysfunction after cranial radiotherapy for brain tumor","authors":"Julie Chapon , Julien Berthillier , Amna Klich , Ronan Tanguy , Nathalie Perreton , Pauline Drouin , Aude Brac-de-la-Perrière , Chantal Simonet , Helene Lasolle , Gerald Raverot , Fabien Subtil , Françoise Borson-Chazot","doi":"10.1016/j.ando.2025.101722","DOIUrl":"10.1016/j.ando.2025.101722","url":null,"abstract":"<div><h3>Background</h3><div>Cranial radiotherapy for extrapituitary brain tumor is a rare cause of acquired pituitary deficiency. The main objective of the present study was to evaluate the incidence and time onset of pituitary deficit and to investigate predictive factors.</div></div><div><h3>Material and methods</h3><div>This retrospective cohort study included 246 patients referred to our endocrinology department between 2005 and 2021 for hormone testing after radiotherapy for extrapituitary brain tumor. Incidence of pituitary deficit was reported with 95% confidence intervals [95% CI]. Deficit-free survival was estimated on the Kaplan Meier method.</div></div><div><h3>Results</h3><div>Mean (SD) age at inclusion was 32.2 years (20.3). One hundred and forty-one patients were male (57.3%). One hundred and seventy-five (71.1%) were irradiated after and 71 (28.9%) at or before the age of 15. Mean (SD) follow-up was 10 years (7). At the end of the study, 118 patients (48.0%) had <!--> <!-->≥<!--> <!-->1 hormonal deficit: GH deficit in 88 patients (36.5%), TSH deficit in 61 (24.8%), LH/FSH deficit in 47 (19.5%); ACTH deficit was identified in 12 patients (4.9%), and was never isolated. The overall incidence of pituitary deficits was 10.3 per 100 person-years (95% CI [30.8; 65.3]) and did not differ according to age at irradiation. Pituitary deficits occurred within a mean (SD) 2.6 years (2.5), 4.9 years (3.3), 4.0 years (2.4) and 4.8 years (3.1) for ACTH, TSH, GH and LH/FSH, respectively. The only factor associated with deficit-free survival was pituitary gland D50 (maximum dose received by at least 50% of gland volume): D50 37-44<!--> <!-->Gy compared to 1-24<!--> <!-->Gy; HR: 2.51; 95% CI [1.09; 5.80]; <em>P</em> <!-->=<!--> <!-->0.031.</div></div><div><h3>Conclusion</h3><div>Half of the patients presented pituitary deficits 10 years after irradiation for extrapituitary brain tumor. However, ACTH deficit was rare, and never isolated, suggesting that it is not necessary to carry out a dynamic test for ACTH if no other deficits are diagnosed.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 4","pages":"Article 101722"},"PeriodicalIF":2.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588419","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}
Pub Date : 2025-02-20DOI: 10.1016/j.ando.2025.101720
Madleen Lemaitre , Paul Quindroit , Camille Frévent , Pierre Balayé , Anne Vambergue , Jean-Baptiste Beuscart
Introduction
The objective of the present study was to evaluate the clinical, metabolic control and treatment profiles of patients with type 2 diabetes admitted to a university hospital.
Research design and methods
The study analyzed 5 years of data (2015–2020) in the University Hospital of Lille, France, focusing on stays lasting 48 hours or more for type 2 diabetes patients aged 55 or over. Stays in diabetology, outpatient and day hospital wards were excluded.
Results
Among 2,216,834 stays during the study period, 55,292 (30%) involved diabetic patients. 50,205 (90.2%) concerned wards other than the diabetology department, and 42,865 (85.4%) of these stays involved patients with type 2 diabetes. Median [interquartile range] age was 70 years [range, 64, 79], median glycated hemoglobin level 6.8% [range, 6.1, 7.8], and median hospital stay 8 days [range, 4.3, 15.1]. A total of 55.3% of the patients treated with insulin, 40.5% with oral antidiabetic drugs, 12.5% a combination of the two, and 16.5% with lifestyle and dietary measures alone. Only 13,640 (31.8%) stays had data for glycated hemoglobin, and a third of these revealed chronic metabolic imbalance. Data on glycated hemoglobin were available for only 43.5% by patients on insulin, 51.1% for patients taking 3 oral antidiabetic drugs, and 54.9% for patients taking 4 oral antidiabetic drugs.
Conclusion
It is necessary to optimize the management of people with diabetes admitted outside diabetes wards, ensuring at least HbA1c evaluation. Despite the use of various therapies, including hypoglycemic agents, few patients receive appropriate metabolic balance assessments with HbA1c as gold-standard. Optimizing collaboration between clinicians and use of clinical decision support system alerts can help in at-risk situations.
{"title":"Observational study of demographics and glycemia control in inpatients with type 2 diabetes: Challenges and clinical implications","authors":"Madleen Lemaitre , Paul Quindroit , Camille Frévent , Pierre Balayé , Anne Vambergue , Jean-Baptiste Beuscart","doi":"10.1016/j.ando.2025.101720","DOIUrl":"10.1016/j.ando.2025.101720","url":null,"abstract":"<div><h3>Introduction</h3><div>The objective of the present study was to evaluate the clinical, metabolic control and treatment profiles of patients with type 2 diabetes admitted to a university hospital.</div></div><div><h3>Research design and methods</h3><div>The study analyzed 5 years of data (2015–2020) in the University Hospital of Lille, France, focusing on stays lasting 48<!--> <!-->hours or more for type 2 diabetes patients aged 55 or over. Stays in diabetology, outpatient and day hospital wards were excluded.</div></div><div><h3>Results</h3><div>Among 2,216,834 stays during the study period, 55,292 (30%) involved diabetic patients. 50,205 (90.2%) concerned wards other than the diabetology department, and 42,865 (85.4%) of these stays involved patients with type 2 diabetes. Median [interquartile range] age was 70 years [range, 64, 79], median glycated hemoglobin level 6.8% [range, 6.1, 7.8], and median hospital stay 8 days [range, 4.3, 15.1]. A total of 55.3% of the patients treated with insulin, 40.5% with oral antidiabetic drugs, 12.5% a combination of the two, and 16.5% with lifestyle and dietary measures alone. Only 13,640 (31.8%) stays had data for glycated hemoglobin, and a third of these revealed chronic metabolic imbalance. Data on glycated hemoglobin were available for only 43.5% by patients on insulin, 51.1% for patients taking 3 oral antidiabetic drugs, and 54.9% for patients taking 4 oral antidiabetic drugs.</div></div><div><h3>Conclusion</h3><div>It is necessary to optimize the management of people with diabetes admitted outside diabetes wards, ensuring at least HbA1c evaluation. Despite the use of various therapies, including hypoglycemic agents, few patients receive appropriate metabolic balance assessments with HbA1c as gold-standard. Optimizing collaboration between clinicians and use of clinical decision support system alerts can help in at-risk situations.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 4","pages":"Article 101720"},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476947","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}
Pub Date : 2025-02-15DOI: 10.1016/j.ando.2025.101710
Justine Cristante , Frédéric Castinetti
The first-line treatment for acromegaly is transsphenoidal surgery. Somatostatin receptor ligands are usually prescribed if surgery fails, or, in some patients, as pre-surgical medical treatment. The efficacy and tolerance of first-generation somatostatin receptor ligands is well established, but they incur unmet medical needs due to their mode of administration and side effects. We report results for new compounds that may be used in the near future as alternatives to first-generation somatostatin receptor ligands, with data on efficacy and tolerance: oral octreotide, paltusotine and long-acting subcutaneous octreotide are reviewed in detail, together with potential new compounds under investigation. We also discuss their potential role in the therapeutic armamentarium for acromegaly.
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Pub Date : 2025-02-15DOI: 10.1016/j.ando.2025.101712
Bérénice Segrestin , Blandine Gatta Cherifi
Obesity has until now been defined in terms of body mass index, a parameter which lacks sensitivity. The definition rather needs to take account of the pathophysiology and impact of the mechanical, metabolic and psychological complications associated with excess adiposity, as proposed by the French Health Authority in 2022. Initial phenotyping of pathophysiological determinants and complications make it possible to precisely define treatment objectives and the means used to achieve them. For example, excess adiposity is associated with hypervolemia, which increases the risk of heart failure independently of classic cardiovascular risk factors, due in particular to myocardial remodeling and diastolic dysfunction. In this indication, SGLT2 (sodium/glucose cotransporter 2) inhibitors may be relevant. A global approach, involving assessment of eating behavior and sensations, energy expenditure and emotional eating, enables us to identify drug treatments suited to each profile. Obesity is a recurrent pathology requiring the development of new combined or sequential drug treatments. Currently under development, inhibitors of the myostatin/activin A pathway conserve lean body mass during weight loss, a crucial factor in limiting weight regain and maintaining functional capacity. Beyond medical or surgical approaches to obesity, lifelong lifestyle interventions are central to improving quality of life and limiting the risks associated with excess adiposity.
{"title":"Obesity and its treatment: Toward new approaches","authors":"Bérénice Segrestin , Blandine Gatta Cherifi","doi":"10.1016/j.ando.2025.101712","DOIUrl":"10.1016/j.ando.2025.101712","url":null,"abstract":"<div><div>Obesity has until now been defined in terms of body mass index, a parameter which lacks sensitivity. The definition rather needs to take account of the pathophysiology and impact of the mechanical, metabolic and psychological complications associated with excess adiposity, as proposed by the French Health Authority in 2022. Initial phenotyping of pathophysiological determinants and complications make it possible to precisely define treatment objectives and the means used to achieve them. For example, excess adiposity is associated with hypervolemia, which increases the risk of heart failure independently of classic cardiovascular risk factors, due in particular to myocardial remodeling and diastolic dysfunction. In this indication, SGLT2 (sodium/glucose cotransporter 2) inhibitors may be relevant. A global approach, involving assessment of eating behavior and sensations, energy expenditure and emotional eating, enables us to identify drug treatments suited to each profile. Obesity is a recurrent pathology requiring the development of new combined or sequential drug treatments. Currently under development, inhibitors of the myostatin/activin A pathway conserve lean body mass during weight loss, a crucial factor in limiting weight regain and maintaining functional capacity. Beyond medical or surgical approaches to obesity, lifelong lifestyle interventions are central to improving quality of life and limiting the risks associated with excess adiposity.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 2","pages":"Article 101712"},"PeriodicalIF":2.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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