December 11, 2018 : DCMS #427

DISASTERS AVERTED — Near Miss Case Studies

PCOS: Motivate Young Women to Make Changes

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Andrea Dunaif on PCOS and Diabetes

HOMERUN SLIDES — Great Clinical Presentation Highlights

Endocrinology Jeopardy: Pituitary for $500!

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #155: Monogenic Disorders of the Beta Cell Part 5

MOST POPULAR ARTICLES OF THE MONTH

#1 Possible Breakthrough In Treating Type 2 Diabetes and Prediabetes
#2 GLP-1/GIP Drug Shows Promise in Reducing A1c and Reducing Weight
#3 Preserving Beta-cell Function in Youth Newly Diagnosed with Type 2 or Prediabetes

We are all very familiar with the onset of type 1 diabetes in young children. In fact, we used to call type one diabetes “juvenile diabetes” until well in to the 1980’s. We no longer use that moniker, but we often think it is the oddity when someone over the age of 20 loses all insulin production. What about the opposite end of the spectrum? I am referring to Neonatal Diabetes, which occurs in the first 6 months of a newborn’s life.

This week in our Clinical Text, we look at why this is not just polygenic type 1 diabetes, what the determining factors are, and how the proper treatment regimens differ for these patients.

Dave Joffe

Editor-in-chief

Young woman, 15 years of age, presented with class II obesity (BMI 37), irregular periods, hirsutism, and continuing to gain weight. Her first visit was with her mother.

We met and discussed the possibility of her having polycystic ovarian syndrome because of her symptoms. We confirmed with labs.

Andrea Dunaif, M.D., is the Lillian and Henry M. Stratton Professor of Molecular Medicine and Chief of the J. Lester Gabrilove Division of Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine at Mount Sinai, New York, NY. Dr. Dunaif is an internationally recognized expert in endocrinology and women’s health. Her research on polycystic ovary syndrome (PCOS), the most common hormonal disorder of reproductive-age women, has shown that it is a leading risk factor for type 2 diabetes mellitus. Further, this research has revolutionized the treatment of PCOS with insulin sensitizing drugs.

In this week’s Homerun Slides, we round out the Pituitary category in Dr. Claude Lardinois’ Endocrinology Jeopardy. This week’s clue is: 64-year-old male being treated for metastatic melanoma.

Neonatal diabetes (NDM) is defined as monogenic beta-cell diabetes which is diagnosed in the first six months of life. It is rare, affecting one in 200,000 live births. The evidence that a diagnosis before 6 months is the cut-off between monogenic neonatal diabetes rather than polygenic T1DM comes from studies of high-risk type 1 HLA, antibodies, birth weight (reduced before 6 months suggests a reduced insulin secretion in utero) and monogenic genetic studies.

Free potential treatment lowers blood sugars, helps with weight loss, drops blood pressure and cholesterol, and may add at least 10 years of quality of life.

New combination drug has better efficacy in glucose control and weight loss than when taken separately.

The beta-cell preserving properties of short courses of metformin and insulin glargine evaluated in ever-growing population of patients who have diabetes.