Diabetes tech, finest diets, telehealth and extra

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January 21, 2021

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Health inequality, changes resulting from the COVID-19 pandemic, and the future of diabetes care were just a few of the topics discussed by experts in the cover stories of Endocrine Today 2020.

Researchers discussed how insulin delivery could transform diabetes management in the future, the popularity of some diet plans for obesity and diabetes, the move to telemedicine in 2020, and much more.

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Here are some of Endocrine Today’s top cover stories from 2020.

The future of insulin: pills, patches, and weekly formulations could transform diabetes management

2020 marks the 100th anniversary of the discovery of insulin by the Canadian surgeon Frederick Banting and the medical student Charles Best. Today there are six main types of insulin that are manufactured by the three insulin manufacturers for the US market. However, there is still no available insulin that perfectly mimics the body’s physiological production of the hormone, and researchers continue to look for better formulations that do not involve subcutaneous injection.

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Ketogenic diet, intermittent fasting lead to popular eating plans for obesity and diabetes

Lifestyle interventions are the recommended first steps in treating diabetes and other cardiometabolic disorders. Changes in diet and physical activity can ultimately lead to weight loss and its proven benefits. However, weight loss can sometimes be difficult to achieve. The researchers discuss the importance of choosing the right eating plan.

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The shift in telehealth during the COVID-19 pandemic shows the ability to ensure safe and convenient care

As the COVID-19 pandemic began, clinicians across the country had to quickly move from face-to-face visits to telemedicine. Endocrinologists discussed their efforts to find new ways to support people with diabetes who rely on data-driven care and multiple personal visits per year, as well as patients with other chronic endocrine diseases who require close follow-up care.

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Inequalities in health outcomes lead to renewed calls for change

Generational racial discrimination has had profound health consequences for Black Americans and other underrepresented populations. The results on maps show high rates of obesity and type 2 diabetes that overlap with areas of marginalized communities. The disproportionate rate of diabetes, especially in black communities, coupled with the COVID-19 pandemic shows structural inequalities that providers are trying to change.

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The label “Metabolic Syndrome” is imprecise, but the cardiometabolic risk is real

International health groups disagree on what specifically constitutes metabolic syndrome. The term could include waist circumference, increased triglycerides or blood pressure, low HDL cholesterol, or glucose abnormalities. Individually or combined, these conditions can quintuple the risk of developing type 2 diabetes and double the risk of developing cardiovascular disease in the 5 to 10 years after diagnosis.

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New genetic discoveries may provide clues to predict and prevent type 1 diabetes

The etiology of type 1 diabetes continues to be debated, although experts believe it is likely to be a mix of genetic and environmental causes. Today more than 50 regions of the human genome are involved in type 1 diabetes. In each region, researchers are identifying new genes, biological pathways, and potential therapeutic targets for intervention, but a cure or way to prevent type 1 diabetes remains difficult to find.

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The options for lipid management are expanding with novel drugs and new goals

Lipid management and residual cardiovascular risk are a growing problem in endocrinology. However, new data in this area is encouraging. Studies showing the effectiveness of active ingredients like Ikosapent-Ethyl and Bempedoic Acid and others in development show similar prospects in early studies. Other research has shown the success of PCSK9 inhibitors as a supplement to statin therapy.

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With a new name, diabetes advisors are positioned to meet the growing health challenges

The role of diabetes advisors continues to evolve to address the increasing prevalence of diabetes and to meet new population-level diabetes performance measurement needs. The American Association of Diabetes Educators has changed its name to the Association of Diabetes Care & Education Specialists to reflect this change. Diabetes care and education specialists are now working in new ways with people with diabetes.

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New treatments offer “optimism,” a potential cure for Cushing’s disease

More than a century has passed since Cushing’s disease was first described, but it is only recently that several important discoveries have offered real hope for a cure to patients with the disease. New targets for treatment are emerging, and newly discovered molecules show promise to decrease adrenocorticotropic hormone secretion, decrease pituitary tumor size, or suppress the production or effects of adrenal cortisol.

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Advanced diabetes technology that will play a bigger role in care and management

The pace of development of diabetes technology continues to advance as the calendar changes to 2021. In 2020, the FDA approved expanded indications for a smart insulin pen, next generation continuous glucose monitor, and interoperable insulin pump that enable a bespoke automated insulin delivery system. With the COVID-19 pandemic, endocrinologists are relying more than ever on diabetes devices to help patients control glucose levels and make decisions.

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More common and undetected primary aldosteronism requires more targeted screening and treatment

Primary aldosteronism, an adrenal disease and a secondary cause of high blood pressure, has historically been considered a rare condition. Most high blood pressure is considered idiopathic by many clinicians. Treatment rarely targets an underlying mechanism such as primary aldosteronism. New research can change this thinking.

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Controversy persists over the diagnosis, treatment of GH deficiency and short stature in children

Diagnosing GH deficiency in childhood – whether congenital or acquired, idiopathic or organic – remains a challenge in large part, according to experts, due to the lack of a true gold standard and the relatively poor performance of the diagnostic tests available. In the US, the lack of relevant and consistent criteria for GH therapy approval from insurance companies has made it difficult to continue GH therapy. The social pressure surrounding the desired height adds to the complexity.

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