Articles in 2014

The long-term outcomes of the DIGAMI 1 study indicate that intensive glucose lowering could be beneficial after an acute myocardial infarction in patients with type 2 diabetes mellitus. However, questions have been raised about whether it is acute or long-term glycaemic control or insulin that is beneficial.

Patients with diabetes mellitus have an increased risk of developing heart failure. In a recent study, people hospitalised for first-time heart failure also had an increased risk of developing type 2 diabetes mellitus (T2DM) that was positively associated with loop-diuretic dosage. These findings highlight the need for extra awareness of T2DM in such patients.

The management of differentiated thyroid cancer (DTC) is undergoing a paradigm shift, with the recognition that personalized therapies might lead to improved outcomes with reduced severity and frequency of complications. In this Review, Markus Luster and colleagues discuss aspects of DTC management that are suitable for individualization, including the extent of surgery, the dosage of¹³¹I and the use of levothyroxine. Advances in imaging techniques and the potential benefit of multitargeted kinase inhibitors are also discussed in the context of DTC management.

In this Review, the authors explore the endocrine and neural basis of reward mechanisms triggered in response to food, and how they are influenced by obesity and overeating. They also discuss the relationship between excessive food intake and addiction-like eating behaviours.

Obesity is associated with an increased risk of certain cancers, such as breast and colon cancers and hepatocellular carcinoma. In this Review, the authors discuss the mechanisms that underlie the interplay between tumour cells and adipocyte-rich stromal tissues that drives the creation and maintenance of a unique microenvironment that favours tumour growth and metastasis.

Accumulating evidence suggests that common reproductive problems, such as male infertility and testicular cancer, originate during fetal development. In this Review, Anders Juul and colleagues discuss the current knowledge of a variety of male reproductive issues, focusing on the developmental origins of testicular pathologies in the context of male infertility.

Reducing or eliminating the clinical burden associated with the debilitating long-term complications of diabetes has long been a goal of management of this disease. A new study, published in the New England Journal of Medicine, suggests that we are closer to achieving this goal than previously thought.

A gain-of-function point mutation in the gene that encodes one of the catalytic subunits of protein kinase A (PRKACA) in cortisol-producing adrenocortical adenomas has been independently reported by three groups. This hotspot point mutation (c.617T>G PRKACA) drives increased cAMP signalling and expands the pathogenic role of protein kinase A in benign lesions of the adrenal cortex.