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Update in Endocrinology
- Janet A. Schlechte, MD; and
- Robert Kreisberg, MD
- From the University of Iowa, Iowa City, Iowa; and Baptist Health System, Birmingham, Alabama. Requests for Reprints: Janet Schlechte, MD, Clinical Research Center, Room 157, MRF, University of Iowa, Iowa City, IA 52242. Current Author Addresses: Dr. Schlechte: Clinical Research Center, Room 157, MRF, University of Iowa, Iowa City, IA 52242.
Advances in endocrinology in 1996 occurred in many areas. First, another drug was added to the growing list of agents used to treat type 2 diabetes mellitus. Second, an additional agent was found to be effective in decreasing low-density lipoprotein (LDL) cholesterol and triglyceride levels and thus may provide more effective prevention of atherosclerotic vascular disease. Third, the bisphosphonates, especially the oral drug alendronate, were shown to benefit patients with a broad array of bone diseases. In addition, 1996 was a year of studies that contributed to the debate over the use of human growth hormone. Finally, estrogen therapies were shown not only to delay bone loss in postmenopausal women but also to actually increase bone mineral density.
Diabetes and Insulin Resistance
The criteria for the diagnosis of diabetes have been modified because evidence suggests that complications of hyperglycemia occur at plasma glucose levels below those previously used for diagnosis [1]. In the past, a fasting plasma glucose level of at least 140 mg/dL (7.71 mmol/L) was used as the general cutoff. This has been reduced to a level greater than 126 mg/dL (6.93 mmol/L). The diagnostic process is described in Table 1. Using this new guideline, the National Center for Health Statistics estimates that the prevalence of type 2 diabetes in the United States among adults 40 to 79 years of age is about 12.3%. Unfortunately, only about 50% of cases are diagnosed before end-organ damage occurs.
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Troglitazone Improved Diabetes Control
Kumar S, Boulton AJ, Beck-Nielsen H, et al. Troglitazone, an insulin action enhancer, improves metabolic control in NIDDM patients. Troglitazone Study Group. Diabetologia. 1996; 39:701-9.
Therapeutic options for patients with type 2 diabetes have exploded over the past 2 years. The most recently approved agent is troglitazone, an oral insulin-sensitizing agent. Troglitazone reduces insulin resistance and enhances insulin sensitivity by increasing insulin-dependent glucose disposal …
This 100-word excerpt has been provided in the absence of an abstract.
