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The management of adrenal tumours has evolved over the past few decades. Here, the surgical management of adrenocortical tumours is discussed, including controversies surrounding the different techniques.
Research published in Cell has shed light on the reorganization of circadian rhythm by nutrients. Mice fed a high-fat diet displayed extensive reprogramming of the hepatic clock with profound effects on key metabolic pathways. These changes involved repression of the Clock–Bmal1 network and PPARγ-regulated induction of a novel gene set.
A genetic analysis of patients with permanent neonatal diabetes mellitus has revealed functional conservation of transcription factors critical for β-cell development in both mouse and man. This finding supports the use of mice for modelling human disease but also highlights the need for additional human-specific studies of β-cell function.
Acromegaly usually occurs owing to a growth-hormone-secreting adenoma in the pituitary gland, which leads to metabolic and anatomical changes in the patient. This Expert Consensus Document outlines the current recommendations for the treatment of acromegaly as determined by the Acromegaly Consensus Group in March 2013.
A new trial has shown that targeting a blood glucose level of 4.0–7.0 mmol/l in critically ill children has some benefits, including a reduced incidence of kidney failure, shortened duration of hospital stay and lowered health-care costs. However, the chosen short-term primary end point was unaffected, which limits the applicability of the findings.
This Review highlights the importance of insulin in the treatment of type 2 diabetes mellitus (T2DM), with a focus on individualized treatment that achieves glycaemic targets. The authors also outline challenges regarding insulin treatment in different populations of patients with T2DM, and how to overcome barriers to insulin therapy.
Advances in the field of genetics have enabled the discovery of numerous loci associated with type 2 diabetes mellitus (T2DM). This Review examines current knowledge about T2DM genetic risk prediction, the effect of lifestyle intervention according to genetic risk and the role of genetic counselling to support behavioural modification.
Prediction of fracture risk is increasingly used to guide clinical use of antiosteoporosis drugs. Data from a large primary care prospective study in 10 countries has now been used to generate an empirical composite 5-year fracture risk model based on clinical data (excluding BMD). This model performed better than current widely used models.
