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Growth Hormone and Aging
Growth hormone (GH) secretion declines with aging (somatopause). One of the most controversial issues in aging is GH treatment of older adults without evidence of pituitary pathology. Although some clinicians have proposed reversing the GH decline in the older population, most information comes from not placebo-controlled studies. Although most animal studies reported an association between decreased GH levels (or GH resistance) and increased lifespan, human models have shown contradictory reports on the consequences of GH deficiency (GHD) on longevity. Currently, GH treatment in adults is only indicated for individuals wi...
Source: Endocrinology and Metabolism Clinics of North America - November 15, 2022 Category: Endocrinology Authors: Camille Hage, Roberto Salvatori Source Type: research

Physiology Reconfigured: How Does Bariatric Surgery Lead to Diabetes Remission?
Bariatric surgery improves glucose homeostasis and glycemic control in patients with type 2 diabetes. Over the past 20 years, a breadth of studies has been conducted in humans and rodents aimed to identify the regulatory nodes responsible for surgical remission of type 2 diabetes. The review herein discusses central mechanisms of type 2 diabetes remission associated with weight loss and surgical modification of the gastrointestinal tract. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - November 14, 2022 Category: Endocrinology Authors: Vance L. Albaugh, Christopher Axelrod, Kathryn P. Belmont, John P. Kirwan Source Type: research

Intervention with Therapeutic Agents, Understanding the Path to Remission in Type 2 Diabetes
Type 2 diabetes is characterized by progressive decline in pancreatic β-cell function. Studies in adult subjects with newly diagnosed type 2 diabetes have reported that intensive insulin therapy followed by various antihyperglycemic medications can delay β-cell decline. However, this improvement is lost after cessation of therapy. In contrast, youth with type 2 diab etes experience a more rapid loss in β-cell function compared with adults and have loss of β-cell function despite being on insulin and other antihyperglycemic medications. In part one of this two-part review, we discuss studies aiming to achieve diabetes r...
Source: Endocrinology and Metabolism Clinics of North America - November 14, 2022 Category: Endocrinology Authors: Shuai Hao, Guillermo E. Umpierrez, Tanicia Daley, Priyathama Vellanki Source Type: research

Remission in Ketosis-Prone Diabetes
Heterogeneous forms of Ketosis-prone diabetes (KPD) are characterized by patients who present with diabetic ketoacidosis (DKA) but lack the typical features and biomarkers of autoimmune T1D. The A- β+ subgroup of KPD provides unique insight into the concept of “remission” since these patients have substantial preservation of beta-cell function permitting the discontinuation of insulin therapy, despite initial presentation with DKA. Measurements of C-peptide levels are essential to predict remission and guide potential insulin withdrawal. Further studies into predictors of remission and relapse can help us guide patien...
Source: Endocrinology and Metabolism Clinics of North America - November 4, 2022 Category: Endocrinology Authors: Nupur Kikani, Ashok Balasubramanyam Source Type: research

Islet Cell Therapy and Stem Cell Therapy for Type 1 Diabetes
To date, people living with type 1 diabetes depend on external subcutaneous insulin while waiting for a cure, or a feasible method to preserve, replace, and generate fully functioning β cells that secrete appropriate insulin in response to glucose. Current work includes evaluating renewable sources of β cells, transplantation methods without immunosuppressives, and methods to preserve β-cell function. Such methods include β-cell encapsulation, scaffolding, immune modulation, gene editing, and disease-modifying therapies. The purpose of this article is to review the progress and describe β-cell therapies over the past ...
Source: Endocrinology and Metabolism Clinics of North America - November 4, 2022 Category: Endocrinology Authors: Betul Hatipoglu, Julia Blanchette Source Type: research

The Patient Experience of Thyroid Cancer
The 3 phases of thyroid cancer care are discussed: diagnosis, management, and survivorship. Drivers of quality of life (QOL) in each phase are described, and suggestions are made for mitigating the risk of poor QOL. Active surveillance is another emerging management strategy that has the potential to improve QOL by eliminating upfront surgical morbidity but will need to be studied prospectively. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Susan C. Pitt, Kyle Zanocco, Cord Sturgeon Source Type: research

Quality of Life in Primary Hyperparathyroidism
Quality of life is impaired in primary hyperparathyroidism (PHPT), regardless of the severity of the disease. Clinical studies have employed different instruments, including standardized and disease-specific questionnaires, and including patients with different phenotypes of PHPT. Neuropsychiatric symptoms and decline in cognitive status are common in PHPT. Patients may complain of these issues or they can be ascertained by questionnaires; they include depression, anxiety, impaired vitality, social and emotional functions, sleep disturbances, and altered mental function. Randomized controlled trials on the effects of surgi...
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Cristiana Cipriani, Luisella Cianferotti Source Type: research

Patient-Reported Outcomes in Endocrinology
The importance of the patient ’s perspective on disease has recently gained salience among clinical investigators and clinicians. Patient-reported outcomes (PROs) are those that pertain to a patient's health, quality if life, or functional status, that are associated with health care or treatment, and reported directly by the patient, without interpretation by a clinician. In any condition, PROs are critical tools to assess disease severity and the benefits and risks of a given treatment. Disease-specific, generic, and symptom-specific assessments each contribute valuable perspectives on the short- and long-term burden o...
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Eliza B. Geer Tags: Preface Source Type: research

Physiology of the Weight-Reduced State and Its Impact on Weight Regain
Obesity is a chronic disease characterized by long duration, slow progression, and periods of remission and relapses. Despite the development of effective medical and surgical interventions and millions of people conducting tremendous personal efforts to manage their weight every year, recidivism remains a significant barrier to attaining long-term weight maintenance. This review aimed to explain the underlying physiology of the weight-reduced state including changes in energy balance, adipose tissue, genetic, environmental, and behavioral factors that may predispose individuals to weight regain following weight loss. (Sou...
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Samar Hafida, Caroline Apovian Source Type: research

Importance of Patient-Reported Outcomes in Endocrinology
We dedicate the current issue of the Endocrinology and Metabolism Clinics of North America to patient-reported outcomes (PROs), an emerging field in health care delivery and research. Patients ’ perception about health and disease, including their quality of life (QoL) and the effects of treatment on their functional status, can be evaluated with general and disease-specific parameter instruments. Implementation of the PROs in the management of various endocrine disorder is currently un folding and offers opportunities for improved patient-clinician communication, education, and research. (Source: Endocrinology and Metab...
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Patient-Reported Outcomes in Endocrine Diseases
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Authors: Eliza B. Geer Source Type: research

Copyright
Elsevier (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Source Type: research

Contributors
ADRIANA G. IOACHIMESCU, MD, PhD, FACE (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Source Type: research

Contents
Adriana G. Ioachimescu (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Source Type: research

Forthcoming Issues
Diabetes Remission (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - October 14, 2022 Category: Endocrinology Source Type: research