Abstract：
:With apparent failure of SU drug therapy, the management of NIDDM patients becomes even more challenging. The following sequence of actions is recommended. 1. Situational dietary noncompliance (eg, a prolonged vacation or a recent period of family or occupational stress) should be treated first by renewed regular contacts with the dietician. 2. Occult infection, hyperthyroidism, and prescription of hyperglycemic drugs by another physician should be ruled out. 3. If true secondary failure exists, the patient should be started on insulin therapy alone and the program optimized to lower fasting plasma glucose to less than 140 mg/dL (8 mM) and subsequently postprandial glucose levels to less than 200 mg/dL (11 mM). NPH, Lente, or Ultralente insulin given only in the evening may be considered for patients with some indication of preservation of postprandial insulin release. 4. If the patient refuses to accept insulin therapy initially, a temporary switch to another second generation SU drug may be tried, primarily to convince the patient that oral drugs alone are inadequate. 5. If optimized insulin therapy fails to achieve therapeutic goals, if multiple insulin injections are not feasible, or if goals are achieved only at the expense of very large insulin doses, then combination therapy with an SU drug may be tried.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Genuth Ssubject
Has Abstractpub_date
1992-06-01 00:00:00pages
351-70issue
2eissn
0889-8529issn
1558-4410journal_volume
21pub_type
杂志文章,评审abstract：:Diuretics and beta-blockers have a strong tendency to affect serum lipids adversely, whereas the peripherally acting alpha-blocking agents consistently result in beneficial effects. Most of the other antihypertensive agents (calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, and drugs that ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70033-5
更新日期：1998-09-01 00:00:00
abstract：:Renal artery stenosis, particularly related to advancing atherosclerotic disease, is a common concern to internists seeing patients with worsening hypertension and deteriorating renal function. Understanding the hormonal and hemodynamic consequences of critical vascular lesions allows better selection of antihypertens...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 00:00:00
abstract：:Pheochromocytomas cause the most dramatic life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome that may be characterized by either severe hypertension associated with cerebral, cardiac, and renal complications or hypotension, or even shock and sudden death. Other emergenc...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-06-01 00:00:00
abstract：:The degree of hyperglycemia may be an important predictor of morbidity and mortality among patients with MI or stroke, and in those undergoing surgical procedures including coronary artery bypass. Hyperglycemia should be aggressively controlled from the time of hospital admission regardless of the patient's primary me...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70162-6
更新日期：2000-12-01 00:00:00
abstract：:Aging in men is associated with a decrease in serum testosterone levels due to attrition in testicular Leydig cells and slowing of the hypothalamic GnRH pulse generator. The practicing endocrinologist is frequently consulted for consideration of testosterone therapy in older men with late-onset hypogonadism (LOH), a c...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2013.02.012
更新日期：2013-06-01 00:00:00
abstract：:Hypertension is an important and modifiable risk factor for the macrovascular and microvascular complications of diabetes. Prior literature outlines the significance of lowering blood pressure and subsequent cardiovascular and microvascular benefits. Blood pressure targets of less than 140/90 mm Hg are recommended in ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.10.008
更新日期：2018-03-01 00:00:00
abstract：:Serum prolactin is reliably elevated by the antipsychotic drugs. Prolactin levels have been followed in psychotic patients during the use of these drugs as an indicator of underlying pathophysiology or as a reflection of drug activity. Considerable research is underway to elucidate further the potential clinical and r...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-03-01 00:00:00
abstract：:In this article, new avenues in the understanding of immunologic processes involved in hypothyroidism have been explored. The discovery of a family of TSH-R directed antibodies, including TSI-block, TGI, and TGI-block, has afforded perspectives on the etiology of autoimmune thyroid disorders. Thus, whereas TSI and TSI...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-06-01 00:00:00
abstract：:Parathyroid hormone (PTH) is the major secretory product of the parathyroid glands, and in hypocalcemic conditions, can enhance renal calcium reabsorption, increase active vitamin D production to increase intestinal calcium absorption, and mobilize calcium from bone by increasing turnover, mainly but not exclusively i...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2018.07.003
更新日期：2018-12-01 00:00:00
abstract：:The incidence, clinical presentation, and types of thyroid cancers presenting in childhood are reviewed. The role of antecedent radiation in papillary and follicular thyroid cancers and genetics of medullary thyroid carcinoma are discussed. Unique aspects of therapy and prognosis for the pediatric patient with thyroid...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-09-01 00:00:00
abstract：:Only two drugs are currently approved for long-term use in the treatment of obesity and four others for short-term use. Evaluating the risk-benefit profile is an essential first step. For individuals who have a low body mass index for whom the risk is small, the risk profile must make the drug acceptable for almost ev...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2008.08.004
更新日期：2008-12-01 00:00:00
abstract：:Primary aldosteronism used to be considered a rare cause of secondary hypertension. However, accruing evidence indicates that primary aldosteronism is more common than previously recognized. The implications of this increased prevalence are important to public health because autonomous aldosterone production contribut...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2019.08.002
更新日期：2019-12-01 00:00:00
abstract：:The pathogenesis of atherosclerosis in human immunodeficiency virus (HIV)-infected individuals is incompletely understood and appears to be multifactorial. Proatherogenic changes in blood and tissue lipids are associated with an increased risk of cardiovascular disease among HIV-infected subjects, and these changes ma...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2014.06.003
更新日期：2014-09-01 00:00:00
abstract：:All of the actions of atrial natriuretic factor (ANF) can be explained on the basis of ANF's interaction with specific receptors on the plasma membrane of cells in target tissues. These receptors have been identified. Binding to these receptors by ANF is time dependent and specific and occurs with high affinity. Numer...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 00:00:00
abstract：:The most recent elucidation of an inherited disorder of the pancreas concerns the Johanson-Blizzard syndrome (JBS). Positional cloning identified loss-of-function mutations in the UBRI gene on the long arm of chromosome 15 to be the cause of JBS in more than a dozen patients. In patients with JBS the absence of UBRI r...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.02.013
更新日期：2006-06-01 00:00:00
abstract：:In the last few years, there have been remarkable advances in the development of new and more sophisticated genetic techniques. These have allowed a better understanding of the molecular mechanisms of genetically determined pediatric endocrine disorders and are paving the way for a radical change in diagnosis and trea...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2009.06.001
更新日期：2009-09-01 00:00:00
abstract：:Osteoporosis and diabetes mellitus are chronic diseases with significant associated morbidity and mortality. Recent evidence suggests that both type 1 and type 2 diabetes are associated with an increased fracture risk. Fracture as a complication of diabetes must be considered when evaluating and treating patients with...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2013.09.004
更新日期：2014-03-01 00:00:00
abstract：:This article summarizes the effects of catecholamines and vasopressin on the cardiovascular system, focusing on their metabolic and immunologic properties. Particular attention is dedicated to the septic shock condition. ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.09.012
更新日期：2006-12-01 00:00:00
abstract：:The study of genetic syndromes associated with adrenocortical tumors (Beckwith-Wiedemann, Li-Fraumeni, McCune-Albright, Carney, and multiple endocrine neoplasia type 1) has shed light on the molecular basis of tumorigenesis. Abnormalities at the 11p15 locus appear as crucial and frequent events found specifically in m...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70112-2
更新日期：2000-03-01 00:00:00
abstract：:The Athlete Biological Passport (ABP) is an individual electronic document that collects data regarding a specific athlete that is useful in differentiating between natural physiologic variations of selected biomarkers and deviations caused by artificial manipulations. A subsidiary of the endocrine module of the ABP, ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ecl.2009.11.003
更新日期：2010-03-01 00:00:00
abstract：:Lipoproteins are spherical macromolecular complexes in which hydrophobic molecules of triglyceride and cholesteryl ester are enveloped within a monolayer of amphipathic molecules of phospholipids, free cholesterol, and apoproteins. The major lipoprotein classes include intestinally derived chylomicrons that transport ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70023-2
更新日期：1998-09-01 00:00:00
abstract：:Glucose intolerance and diabetes are common complications of cystic fibrosis (CF), affecting up to 75% of the adult population. This article discusses the prevalence and pathophysiology of glucose tolerance abnormalities in CF, and reviews recent recommendations for diagnosis, screening, and management of CF-related d...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70102-x
更新日期：1999-12-01 00:00:00
abstract：:Ethnicity is a complex yet important construct and an independent risk factor for diabetic heart disease (DHD) with paramount clinical significance. Clinicians should try to better understand the role of ethnicity through more questions. The risk of DHD is modified by ethnicity through more questions. The risk of DHD ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.06.004
更新日期：2006-09-01 00:00:00
abstract：:Glucocorticoid-induced bone loss has been recognized for almost 50 years, yet it remains an important medical problem and a common cause of fracturing. Loss of skeletal mass may occur early in the course of glucocorticoid therapy and appears to be related to the cumulative dose of steroid, as well as to the usual risk...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:Laboratory tests are the most commonly used aids in the diagnosis and monitoring of individuals who have thyroid disease. This article briefly summarizes the common methods of laboratory testing relating to thyroid disease and discusses specific information for individual tests on methods of analysis, their limitation...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.04.003
更新日期：2007-09-01 00:00:00
abstract：:Lifestyle modification is the cornerstone treatment of type 2 diabetes in the obese patient, and is highly effective at promoting glucose regulation. However, many individuals struggle over time to maintain optimal glycemic control and/or body weight with lifestyle modification. Therefore, additional therapeutic appro...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.04.007
更新日期：2016-09-01 00:00:00
abstract：:The presence of vitamin D receptors in diverse tissues like immune cells, beta-cells in the pancreas, and cardiac myocytes has prompted research to evaluate the impact of vitamin D deficiency on the occurrence of immune diseases, diabetes, and cardiovascular disease (CVD). The expression of receptors not only in norma...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.05.004
更新日期：2012-09-01 00:00:00
abstract：:Health care providers and patients have lots of choice to treat type 2 diabetes, but the blood glucose improvement is limited. The one therapy with unlimited potential (at least theoretically) is insulin. Many studies show that glucose control is achievable with insulin safely in most patients with type 2 diabetes. Ef...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.03.004
更新日期：2012-03-01 00:00:00
abstract：:Osteoporosis is prevalent in transplant recipients and is related to pre- and post-transplantation factors. Low bone density and fractures may antedate transplantation, related to traditional risk factors for osteoporosis, effects of chronic illness, and end-stage organ failure and its therapy, on the skeleton. Bone l...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.07.008
更新日期：2007-12-01 00:00:00
abstract：:The familial and genetic nature of multiple endocrine neoplasia type 1 (MEN 1) syndrome was first pointed out by Wermer in 1954, who suggested that an autosomal dominant gene with high penetrance controls the trait. The clinical picture is variable, depending mainly on which glands are involved and whether the tumors ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
