The annual meeting of The Endocrine Society was held virtually from March 28 to 31 and attracted participants from around the world, including clinicians, academicians, allied health professionals, and others interested in endocrine and metabolic disorders. The conference highlighted recent advances in the diagnosis and management of obesity, endocrine disorders, diabetes, growth hormone, and thyroid diseases.
In one study, Adnin Zaman, M.D., of the University of Colorado Anschutz Medical Campus in Aurora, and colleagues found that baseline fitness is a potentially individual-specific factor that might account for the significant variability in weight loss seen in participants enrolled in a behavioral weight loss program.
The investigators measured cardiovascular fitness during a graded exercise test on a motorized treadmill using indirect calorimetry and categorized based on published age and sex norms. Participants wore an armband that measured free-living physical activity during one week at months 0, 6, 12, and 18. The researchers found that baseline fitness may moderate 18-month weight loss, as those with poor or better fitness lost nearly twice the amount of weight as those who had very poor fitness at baseline.
“Those with poor or better fitness at baseline achieved significantly higher mean levels of moderate-to-vigorous physical activity at 18 months compared to those with very poor fitness,” Zaman said. “Therefore, participants with very poor fitness at baseline may require additional exercise support during a behavioral weight loss program to achieve the high levels of moderate-to-vigorous physical activity recommended for weight loss and weight loss maintenance.”
In another study, Mita Shah Hoppenfeld, M.D., of Stanford University in Palo Alto, California, and colleagues surveyed 125 Stanford University internal medicine residents at multiple primary care clinic sites to evaluate residents’ comfort with, knowledge of, and practices regarding managing obesity in their clinics.
“Although 81 percent of resident physicians described feeling comfortable or somewhat comfortable with counseling patients about lifestyle changes such as diet and exercise, only 33 percent reported consistently providing such counseling to patients with obesity,” Hoppenfeld said. “Barriers to providing lifestyle counseling included lack of time (93 percent), poor familiarity with resources (50 percent), and lack of training in motivational interviewing (36 percent). The top barrier (84 percent) to prescribing weight loss medications was unfamiliarity with them.”
In addition, the investigators found that nearly one-third (31 percent) of residents correctly identified medically advisable indications for bariatric surgery, but only 9 percent of those reported referring patients they considered appropriate for surgical evaluation.
“Greater resident comfort with management of obesity leads to more clinical action and likely improved patient outcomes. Greater comfort can likely come from focused and directed teaching regarding management of obesity through lifestyle changes, weight management medications, obesity and bariatric specialist referrals, and resource identification,” Hoppenfeld said. “We must call on our residency programs to help implement a focused curriculum for obesity treatment to increase physician comfort with the topic.”
Puliyur S. MohanKumar, Ph.D., of the University of Georgia in Athens, and colleagues described the effects of exposure to environmentally relevant levels of common bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF) in pregnant rats and how it impacts blood pressure in adult female offspring.
“Based on the results from this study, we concluded that exposure to 5 µg/kg body weight of BPA or 5 µg/kg body weight of BPS or 1 µg/kg body weight of BPF in pregnant rats during gestation days six to 21 rendered the female offspring hypertensive during their adulthood,” MohanKumar said.
Zoe Quandt, M.D., of the University of California in San Francisco, and colleagues found that thyroid dysfunction following treatment with immune checkpoint inhibitors is very common and could be related to a patient’s type of cancer. This finding could provide insight into the underlying mechanism tied to this adverse event.
“It is very important to monitor these patients as they go through therapy, and we need to better understand who will experience this side effect,” Quandt said. “Thyroid function should be monitored while on treatment and small changes should be taken into account as they may be indicators of problems to come.”
Ali Al-Khazaali, M.D., of Saint Louis University, and colleagues analyzed available cardiovascular and kidney data from 10 major studies with more than 85,000 patients evaluating glucagon-like peptide 1 (GLP-1) and sodium-glucose transport protein 2 (SGLT2) inhibitor medications.
“We found out that both classes are equally effective in reducing the combined heart events, including heart attacks, strokes, and death from cardiovascular disease, but only one class of medication — the SGLT2 inhibitors — showed benefits in reducing hospitalization for heart failure,” Al-Khazaali said.
In terms of kidney outcomes, the investigators noted that both classes of medications demonstrated kidney benefit.
“Additionally, we shed the light on the adverse events of both classes. Yeast infection was found to be very common in SGLT2. Also, diabetic ketoacidosis is more common in patients on SGLT2,” Al-Khazaali said. “Regarding the side effects of the GLP-1 class, we found a high incidence of stomach upset, which physicians will need to balance against the possible weight loss benefits of this medicine.”
ENDO: Real-World Data Analyzed for Use of Insulin Pump in T1DM
TUESDAY, March 31, 2020 (HealthDay News) — Real-world data support the benefit of using the Medtronic MiniMed 670G insulin pump system for glycemic control in type 1 diabetes, according to a study presented at the virtual meeting of The Endocrine Society, held from March 28 to 31.
ENDO: Glycemic Control Good for Regular Human Insulin With V-Go
WEDNESDAY, April 1, 2020 (HealthDay News) — For patients with type 2 diabetes, glycemic control is similar with use of regular human insulin and rapid-acting insulin when delivered with a wearable insulin delivery device, V-Go, according to a study presented at the virtual meeting of The Endocrine Society, held from March 28 to 31.
ENDO: Thyroid Hormone Use May Up Mortality Risk in Older Adults
TUESDAY, March 31, 2020 (HealthDay News) — Synthetic levothyroxine is associated with an increased risk for death among older adults, according to a study presented at the virtual meeting of The Endocrine Society, held from March 28 to 31.
ENDO: Diabetes Diminishes Weight Loss Effect of Bariatric Surgery
TUESDAY, March 31, 2020 (HealthDay News) — The presence of diabetes seems to diminish the weight loss effect of bariatric surgery among obese patients, according to a study presented at the virtual meeting of The Endocrine Society, held from March 28 to 31.
ENDO: HbA1c Tied to Cognition in T2DM Patients After Lacunar Stroke
MONDAY, March 30, 2020 (HealthDay News) — Among individuals with diabetes, hemoglobin A1c is associated with cognitive scores after a lacunar stroke, according to a study presented at the virtual meeting of The Endocrine Society, held from March 28 to 31.
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