Patient is male, 48 years of age, type 2 diabetes with hyperglycemia for eight years, class III obesity,  and very symptomatic GERD. Patient planned to have laparoscopic sleeve gastrectomy. I asked him why he chose that particular surgery. He said, "Because it's less invasive." I asked if his surgeon told him the sleeve gastrectomy could increase his GERD, and is not as effective for the treatment of type 2 diabetes nor for weight loss as is a bypass. He said, "No, the surgeon just left it to my choice. I said I wanted the sleeve and he was good with that."

Joshua Safer, MD, FACP, is the Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery in New York. Previously, he was the inaugural Medical Director of the Center for Transgender Medicine and Surgery at Boston Medical Center. He is also Senior Faculty at the Icahn School of Medicine at Mount Sinai.

In this week's Homerun Slides, it's time for another round of Endocrinology Jeopardy, courtesy of Dr. Claude Lardinois! This week's clue: 56-year-old male with loss of libido, testosterone 40 mg/dL, and prolactin 65 mg/dL (Normal <20).

Chronic hyperglycemia as a cause of impaired insulin secretion In 1948, Lukens and Dohan administered large doses of glucose to normal cats and induced permanent hyperglycemia, hydropic degeneration of the islet of Langerhans, and ketonuria in 4 out of 35 cats studied. These investigators proposed that hyperglycemia could play a role in the pathogenesis of diabetes. In recent years, several approaches have been used to directly examine the harmful effects of chronic hyperglycemia on insulin secretion. These studies have established that chronic hyperglycemia impairs beta-cell responsiveness to glucose although the exact biochemical mechanism(s) mediating this effect remain to be clearly defined.

In this Exclusive Interview transcript, Joshua Safer talks with Diabetes in Control publisher Steve Freed during the AACE 2018 convention in Boston about transgender medicine and the role of endocrinology in treating transgender patients.

In this Exclusive Interview, Joshua Safer talks with Diabetes in Control publisher Steve Freed during the AACE 2018 convention in Boston about transgender medicine and the approach to transgender care.

In part 1 of this Exclusive Interview, Joshua Safer talks with Diabetes in Control Publisher Steve Freed about the need to understand the evidence for and approach to transgender medicine, and strategies for the use of hormones.

In part 2 of this Exclusive Interview, Joshua Safer talks with Diabetes in Control Publisher Steve Freed about working with transgender patients and the course of a conversation with a new patient.

In part 3 of this Exclusive Interview, Joshua Safer talks with Diabetes in Control Publisher Steve Freed about the number of specialists that can be found and more on the field overall as a specialty.

In part 4 of this Exclusive Interview, Joshua Safer talks with Diabetes in Control Publisher Steve Freed about the potential of hormones to cause diabetes.