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The European Society of Endocrinology (ESE) and the Union Européenne des Médecins Spécialistes (U.E.M.S.) Section and Board of Endocrinology have produced a Curriculum and Training Recommendation in Endocrinology to provide updated recommendations concerning the content and structure of postgraduate training. Cornerstones of the Curriculum are the integrity of Endocrinology not to be divided into subspecialties such as diabetology or thyroidology, recommendation of 6 years full-time training comprising 1–3 years (preferably 2–3 years) of General Internal Medicine followed by 3–5 years of specialist training in Endocrinology across 13 core areas. In addition to knowledge and experience in the many fields of Endocrinology, the Curriculum includes specific attitudes, communication skills, training to work in and lead multidisciplinary teams, resource management, quality assurance, human-error management, and critical incidents reporting as well as the commitment to life-long learning expected from a trainee and from an Endocrinologist. The Curriculum also includes requirements for training centres, for assessment of training and for competencies of trainers. The aim of the ESE Curriculum and Training Recommendation in Endocrinology is to harmonise postgraduate training and help provide the best medical care for patients with endocrine diseases across Europe. [ABSTRACT FROM AUTHOR]

The article is dedicated to the 90th year of the birth of Professor Mikhail Ivanovich Balabolkin. He was a well-known endocrinologist, Doctor of Medical Science, Director of the Institute of Diabetes of The National Medical Research Center for Endocrinology of the Russian Academy of Medical Sciences, Head of the Departments of Endocrinology at the Moscow Medical and Dental Institute named after N.A. Semashko, and subsequently at the Moscow Medical Academy named after I. M. Sechenov. Mikhail Ivanovich will forever remain in the memory of all his students and colleagues. The article contains not only biographical data on the professor’s professional and scientific activities, the history of the creation of the departments of endocrinology, which he headed, but also memories of people who were well acquainted with Mikhail Ivanovich. Particular attention in the article is paid to the personal qualities of M.I. Balabolkin, his family, attitude towards his professional team and hobbies.

Colours of India is an annual cultural phenomenon that transcends the boundaries of professional conferences, uniting endocrinologists through the universal language of music and dance. Since its inception in 2016, this vibrant event has brought together teams from across India and other participating countries, showcasing diverse dance forms while fostering friendships, promoting wellness, and celebrating cultural diversity within the medical community.

Objective: Hypothyroidism is a common endocrine condition usually managed with levothyroxine (LT4). However, controversy remains around the use of liothyronine (LT3). We aimed to investigate the practices of Australian endocrinologists when managing patients with hypothyroidism, their use of LT3 + LT4 combination therapy and use of thyroid hormones in euthyroid patients. Design and Participants: Members of the Endocrine Society of Australia (ESA) were invited to participate in an online questionnaire. Measurements: We analysed questionnaires that had complete demographic data. Results: Eighty‐seven questionnaires fulfilled the criteria. LT4 was used as first line treatment for hypothyroidism by all respondents. Only 45% reported that their patients were dispensed the brand of LT4 that they recommend. LT3 (alone or in combination) was prescribed by 44% in their clinical practice. Although 49% of respondents would consider LT3 + LT4 in patients with normal TSH who had ongoing symptoms of hypothyroidism, the inability of LT4 to restore normal physiology was ranked the least likely explanation for persistent symptoms and only 32% would consider it for themselves if they were diagnosed with hypothyroidism. The majority (55%), in accordance with evidence, would not prescribe thyroid hormone to euthyroid individuals but 39% would consider use in euthyroid female infertility with high levels of thyroid antibodies and 11% in euthyroid patients with a simple goitre growing over time. LT4 use in pregnancy was variable among members. Conclusions: Australian endocrinologists mostly follow international guidelines when prescribing thyroid hormone therapy and many prescribe combination LT3 and LT4 therapy, particularly for patients who remain symptomatic on LT4 monotherapy. Prescribing practices are largely similar to other countries who have completed similar questionnaires. [ABSTRACT FROM AUTHOR]

Colours of India is an annual cultural phenomenon that transcends the boundaries of professional conferences, uniting endocrinologists through the universal language of music and dance. Since its inception in 2016, this vibrant event has brought together teams from across India and other participating countries, showcasing diverse dance forms while fostering friendships, promoting wellness, and celebrating cultural diversity within the medical community. [ABSTRACT FROM AUTHOR]

Introduction: Medications used to treat type 2 diabetes (T2D) often require dose escalation to optimize effectiveness. Physician and patient perceptions of treatment characteristics of T2D medications have previously been examined, but little is known about perceptions of escalation to the optimal dose for each patient. This study examined physicians' perceptions of dose escalation for medications used to treat T2D. Methods: Data on dose escalation and other factors influencing decision-making for treatment of T2D were collected via an online survey of endocrinologists and primary care physicians in the USA. Results: The sample included 501 physicians (348 primary care physicians and 153 endocrinologists). Dose escalation was not frequently considered by physicians as a primary factor keeping patients' from reaching treatment goals (mentioned as a factor by only 7.6% of the sample) or a barrier to prescribing T2D medication (16.2%). Factors more likely to keep patients from reaching treatment goals included an unhealthy diet (86.6%) and medication adherence (77.4%). The most common reasons that physicians reported for escalating dose levels were the need for better glycemic control (reported by 89.8% of the sample), ability to decrease the total number of medications by increasing the dose of one medication (39.9%), and the need for the patient to lose weight (39.3%). Data reported by primary care physicians and endocrinologists followed similar patterns. Conclusions: Although common with T2D treatments, escalating the dose of T2D medication was not perceived by physicians to be a significant barrier to attaining treatment goals or prescribing medication. Multiple factors contribute to the decision to escalate the dose of T2D medication. Plain Language Summary: In early phases of initiating medication treatment for a patient with type 2 diabetes (T2D), it is common for physicians to increase from a lower initial dose to a higher end dose to maximize treatment benefit. This process is known as dose escalation. The purpose of this study was to examine physicians' perceptions of dose escalation for medications used to treat T2D. An online survey was designed to identify reasons why physicians in the US may choose to escalate or not escalate a dose of medication for T2D. In addition, physicians were asked about factors that keep patients from reaching treatment goals to identify whether the requirement for dose escalation is perceived to be a common barrier to successful treatment. The sample included 501 physicians (348 primary care, 153 endocrinologists). Dose escalation was not frequently considered to be a primary factor keeping patients' from reaching treatment goals or a barrier to prescribing medication for T2D. Dose escalation decisions are complex, driven by a range of factors such as glycemic control medication tolerability, the patient's body mass index, treatment guidelines, comorbidities, characteristics of the patient's entire treatment regimen, and potential cardiovascular benefits. [ABSTRACT FROM AUTHOR]

Background: A collaborative prescribing (CP) practice model, established by the endocrinologists, pharmacists, and advanced practice nurses, aims to provide for the postoperative monitoring and medical and nutritional management of stable patients after bariatric surgery. Method: Under the CP agreement, endocrinologists refer patients who have undergone bariatric surgery with stable medical conditions to CP practitioners, comprising senior pharmacists and advanced practice nurses. CP practitioners review the patient's weight loss progress, blood test results and vitals, the sufficiency of micronutrient repletion, adherence to supplements and medications, and chronic disease control. CP practitioners can prescribe and adjust the medications and supplements, in accordance with a clinical evaluation and standard guidance. Patients who require immediate attention due to complications or red flags are referred to the primary endocrinologist for further management. Results: From 5 May 2020 to 30 September 2023, CP practitioners provided 672 consultations. At least 68% and 80% of patients achieved appropriate weight loss post-surgery during the acute and maintenance phases, respectively. Less than 10% of the patients presented with anaemia and iron deficiency, and vitamin B12, folate and vitamin D deficiency. More than 80% of patients achieved a HbA1c of less than 7%. Conclusions: The CP practice framework provides a sustainable and viable model to facilitate optimal outcomes after bariatric surgery. [ABSTRACT FROM AUTHOR]

Epidemiologists indicate that about half of the couple’s infertility cases are due to a male factor. Despite this, the role of andrologists or endocrinologists in assisted reproductive technique (ART) centers is still underestimated. According to our literature review, this reduces the chance of a thorough clinical evaluation of the male partners, which, sometimes consists only in a mere semen analysis, usually performed by laboratory technicians. A more complete diagnostic process could lead to the identification of potentially treatable causes of infertility, the recognition of diseases that require immediate treatment, and to the discovery of genetic diseases and, therefore, transmissible to the offspring. It can also increase the success rate of ART resulting in less psychological and financial burden for both public health resources and infertile couples. The presence of medical personnel with andrological and endocrinological skills in the ART centers represents the first step in creating ‘precision medicine’. We hope that the guidelines of the various scientific societies will clearly contemplate this possibility.

Intracranial germ cell tumors (iGCTs) are rare malignant neoplasms that mainly affect children and adolescents. The incidence, clinical presentation, and prognosis of iGCTs exhibit high heterogeneity. Previous studies have primarily focused on eliminating tumors, reducing tumor recurrence, and improving survival rates, while neglecting the impact of the tumors and their treatment on neuroendocrine function. Throughout the entire course of the disease, neuroendocrine dysfunction may occur and is frequently overlooked by oncologists, neurosurgeons, and radiologists. Endocrinologists, however, are more interested in this issue and have varying priorities at different stages of the disease. From onset to the diagnostic phase, most patients with iGCTs may present with symptoms related to impaired neuroendocrine function, or even experience these symptoms as their first indication of the condition. Particularly, a minority of patients with sellar/suprasellar lesions may exhibit typical imaging features and elevated tumor markers long after the onset of initial symptoms. This can further complicate the diagnosis process. During the peritumor treatment phase, the neuroendocrine function shows dynamic changes and needs to be evaluated dynamically. Once diabetes insipidus and dysfunction of the hypothalamic–pituitary–adrenal and hypothalamic–pituitary–thyroid axes occur, hormone replacement therapy should be administered promptly to ensure successful tumor treatment for the patient. Subsequently, during the long-term management phase after the completion of tumor treatment, the evaluation of growth and development as well as corresponding hormone replacement therapy are the most concerning and complex issues. Thus, this paper reviews the interest of endocrinologists in iGCTs at different stages. [ABSTRACT FROM AUTHOR]

Epidemiologists indicate that about half of the couple’s infertility cases are due to a male factor. Despite this, the role of andrologists or endocrinologists in assisted reproductive technique (ART) centers is still underestimated. According to our literature review, this reduces the chance of a thorough clinical evaluation of the male partners, which, sometimes consists only in a mere semen analysis, usually performed by laboratory technicians. A more complete diagnostic process could lead to the identification of potentially treatable causes of infertility, the recognition of diseases that require immediate treatment, and to the discovery of genetic diseases and, therefore, transmissible to the offspring. It can also increase the success rate of ART resulting in less psychological and financial burden for both public health resources and infertile couples. The presence of medical personnel with andrological and endocrinological skills in the ART centers represents the first step in creating ‘precision medicine’. We hope that the guidelines of the various scientific societies will clearly contemplate this possibility. [ABSTRACT FROM AUTHOR]

Background: A collaborative prescribing (CP) practice model, established by the endocrinologists, pharmacists, and advanced practice nurses, aims to provide for the postoperative monitoring and medical and nutritional management of stable patients after bariatric surgery. Method: Under the CP agreement, endocrinologists refer patients who have undergone bariatric surgery with stable medical conditions to CP practitioners, comprising senior pharmacists and advanced practice nurses. CP practitioners review the patient’s weight loss progress, blood test results and vitals, the sufficiency of micronutrient repletion, adherence to supplements and medications, and chronic disease control. CP practitioners can prescribe and adjust the medications and supplements, in accordance with a clinical evaluation and standard guidance. Patients who require immediate attention due to complications or red flags are referred to the primary endocrinologist for further management. Results: From 5 May 2020 to 30 September 2023, CP practitioners provided 672 consultations. At least 68% and 80% of patients achieved appropriate weight loss post-surgery during the acute and maintenance phases, respectively. Less than 10% of the patients presented with anaemia and iron deficiency, and vitamin B12, folate and vitamin D deficiency. More than 80% of patients achieved a HbA1c of less than 7%. Conclusions: The CP practice framework provides a sustainable and viable model to facilitate optimal outcomes after bariatric surgery.

Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention. [ABSTRACT FROM AUTHOR]

Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.

Aims: Diabetes case conferencing is where an endocrinologist visits a general practitioner (GP) to advise on the care of patients with diabetes. Past case conferencing studies have reported improved diabetes management and clinical outcomes in primary care. This study investigated the effectiveness of a diabetes case conferencing program in South Western Sydney, Australia. Methods: Complex diabetes cases were referred by general practitioners to a visiting endocrinologist for review after obtaining patient consent. The patient was not usually present. After the case discussion, a diabetes management plan was developed jointly by the general practice/specialist team. Clinical data were compared at baseline and each year up to three years (2017--2020) after the consultation using paired t-test. The primary outcome was HbA1c. Results: Clinical data were collected for 645/775 patients (mean age 64 ± 15(SD) years; 351 (54.4%) males from 40/43 general practices; 96.4% had type 2 diabetes; 6.5% were insulin treated, 54.3% non-insulin treated, 31.5% both insulin and noninsulin treated and 3.4% diet only. There were reductions in HbA1c by 1.0 ± 1.7% (11 ± 19 mmol/mol) (p < 0.001), systolic blood pressure 8.2 ± 18.1 mmHg (p < 0.001), diastolic blood pressure 2.7 ± 11.6 mmHg (p < 0.001), total cholesterol 0.2 ± 1.7 mmol/l (p = 0.007), low-density lipoprotein 0.2 ± 1.0 mmol/l (p < 0.001), weight 3.3 ± 10.1 kg (p < 0.001) and body mass index (BMI) 1.3 ± 3.5 kg/m2 (p < 0.001). Conclusions: Glycaemia, weight and cardiovascular risk factors improved following case conferencing consultations in a primary care setting. [ABSTRACT FROM AUTHOR]

Background: The influence of provider density and access on well-differentiated thyroid cancer (DTC) survival is uncertain.Methods: We used the SEER18 database to study DTC patients undergoing surgery from 2000-2012. County-level endocrinologist and surgeon density were calculated. We evaluated the relationship between provider density and cause-specific survival controlling for demographic, socioeconomic, and treatment characteristics.Results: Median endocrinologist density was 1.4/100 000 residents, with 15.5% of patients living in a county with no endocrinologist. Survival increased by 11% for each endocrinologist/100,000 people (P = .007). Median surgeon density was 14.8/100 000 residents, with only 1.7% of patients living in a county with no general surgeon or otolaryngologist. No significant association between surgeon density and survival was identified (P = .06). Rural residence was independently associated with lower survival (P = .009).Conclusions: County-level endocrinologist density is associated with improved DTC survival. Results may reflect endocrinologist expertise, earlier diagnosis, or represent surrogacy for higher county-level access to specialized care. [ABSTRACT FROM AUTHOR]

On January 1, 2023, Head of the Diabetes Prediction and Innovation Department of the Endocrinology Research Centre, the leader of the public patient organization «Russian Diabetes Association», Doctor of Medical Sciences, Professor ­Alexander Mayorov, died at the age of 59.

Context: Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent and reduce the risk of long-term complications. It requires an array of investigations to provide an accurate picture of the condition and its management accordingly by a qualified doctor. Aims: This study was conducted to understand the treatment received by type 2 diabetes (T2DM) patients from various categories of health care professionals and awareness about diabetes reversal by lifestyle modification and prevention of complications. Settings and Design: This was a community-based cross-sectional study. Subjects and Methods: The link of the semi-structured questionnaire in Google form with e-consent was sent to all members in the selected groups of “World free of obesity and diabetes” campaign on their personal WhatsApp account. Statistical Analysis Used: A total of 3082 participants were included, and the data obtained were analyzed using SPSS v26. Results: The mean age of the participants was 50.26 ± 9.78 years ranging from 18 to 81 years. A total of 35.8% of the study population was diabetic for 1–5 years. A total of 54.9% were started with antidiabetic medication on the same day of diagnosis. Only 1.5% of the patients had complete investigation profile for T2DM, 50.2% of the patients were briefed about hypoglycemia, and only 15.8% of the patients were checked for retinopathy. Conclusions: Most doctors, qualified as well as nonqualified, did not follow the standard guidelines for diagnosis, treatment, and patient education regarding T2DM; therefore, it is necessary to train all medical practitioners regarding these guidelines. Diabetes reversal by lifestyle modification must be prescribed as the first line of treatment in patients with T2DM.

On April 18, 2022, Honored Doctor of the Russian Federation, Honorary Head of the Department of Pediatric Endocrinology of the Russian Medical Academy of Postgraduate Education, Doctor of Medical Sciences, Professor Elvira Petrovna Kasatkina, died at the age of 93.

Objectives to improve the quality and efficiency of primary endocrinological care for patients with diabetes mellitus by formalizing outpatient admission and optimizing the professional time of an endocrinologist spent on documentation. Material and methods.A protocol of examination, developed according to the specifity of care of outpatients with diabetes mellitus, was introduced into practice of endocrinologists. To assess the usability of the protocol, the timing of outpatient admission and the quality control of outpatient medical care was carried out. Results.The trial of the formalized protocol in clinical settings have confirmed its convenience for doctor's daily work. It does not require extra time for patient registration, while significantly improves the quality of outpatient appointment records, ensures the complete primary medical data recording, eliminates inaccuracies in the formulation of the diagnosis, program of dispensary observation and treatment. Conclusion.The formalization of the outpatient endocrinologist appointment allows for development of an automated workplace of an endocrinologist with the prospect of its further implementation as a software module for collecting primary medical data in the regional integrated electronic medical record.

BACKGROUND: The prevalence of dysnatremia varies widely (from 1 to 63%), and depends on comorbidities, the effects of more than 18 hormones and hormone-like substances, which confirms the importance of maintaining blood sodium levels in the tight physiologic range and makes it possible to consider its deviations as an endocrine pathology. Both hypo- and hypernatraemia are associated with a multiple increase in mortality, risk of fractures, and gross balance disturbances. At the same time, the clinical manifestations of dysnatremia are not specific, reflect an osmotically mediated decrease in brain function, which potentially may be missed in clinical practice. AIMS: to study the specifics of diagnosis, differential diagnosis and treatment of dysnatremia states by specialist doctors using a sociological survey method. MATERIALS AND METHODS: A cross-sectional sociological uncontrolled study was conducted by questioning doctors about hypo- and hypernatremia using the online questionnaire “Questionnaire on hypo-and hypernatremia in clinical practice” created on the Google forms platform. The invitation to fill in the questionnaire was sent to the email addresses included in the database of the Russian Association of Endocrinologists. A total of 353 completed questionnaires were received. RESULTS: The poll demonstrated a low frequency of determining blood sodium levels - less than 38% of specialists prescribe sodium in more than half of the cases, including the cases of diseases associated with dysnatremia, which correlates with less practical experience of doctors. The overwhelming majority of endocrinologists (82%) in their clinical practice encounters deviations of the sodium levels in patients, but only 6% recognize the possession of the competence of managing patients with dysnatremia. The discrepancy between the lower limit of normal range to 135-136 mmol/l was observed in 22% (62/278), the inconsistency of the upper normal limit to 145-146 mmol/l - in 47% (131/278) of laboratories, and in 33% (41/278) laboratories, which are used by doctors, there was a discrepancy along both limits of the reference interval. The presence of a hypertonic solution (3%) of sodium chloride in a hospital was noted only by 38% of respondents. Conclusions: There is an unphysiological variation in reference intervals for blood sodium concentration in 55% of laboratories, a low frequency of sodium levels evaluation in the blood (in more than half of clinical situations only 38.2% of doctors prescribe the estimation of blood sodium level) and the lack of educational competence in managing patients with syndromes of hypo- and hypernatremia in 94% of endocrinologists.

Context: Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent and reduce the risk of long-term complications. It requires an array of investigations to provide an accurate picture of the condition and its management accordingly by a qualified doctor. Aims: This study was conducted to understand the treatment received by type 2 diabetes (T2DM) patients from various categories of health care professionals and awareness about diabetes reversal by lifestyle modification and prevention of complications. Settings and Design: This was a community-based cross-sectional study. Subjects and Methods: The link of the semi-structured questionnaire in Google form with e-consent was sent to all members in the selected groups of "World free of obesity and diabetes" campaign on their personal WhatsApp account. Statistical Analysis Used: A total of 3082 participants were included, and the data obtained were analyzed using SPSS v26. Results: The mean age of the participants was 50.26 ± 9.78 years ranging from 18 to 81 years. A total of 35.8% of the study population was diabetic for 1–5 years. A total of 54.9% were started with antidiabetic medication on the same day of diagnosis. Only 1.5% of the patients had complete investigation profile for T2DM, 50.2% of the patients were briefed about hypoglycemia, and only 15.8% of the patients were checked for retinopathy. Conclusions: Most doctors, qualified as well as nonqualified, did not follow the standard guidelines for diagnosis, treatment, and patient education regarding T2DM; therefore, it is necessary to train all medical practitioners regarding these guidelines. Diabetes reversal by lifestyle modification must be prescribed as the first line of treatment in patients with T2DM. [ABSTRACT FROM AUTHOR]

Vladimir Vasilievich Potemkin is one of the leading endocrinologists in our country, the founder and leader of the first course of endocrinology in the USSR (1973–2017), and then the specialized department of the Russian National Research Medical University named after N.I. Pirogov, Honorary Professor of the Russian National Research Medical University named after N.I. Pirogova, Professor of the Department of Endocrinology of the Medical Faculty, Honored Doctor of the Russian Federation, Honored Worker of the Higher School of the Russian Federation.

Objective To investigate the cognition of endocrinologists and diabetic patients on periodontitis and the correlation between periodontitis and diabetes. Methods Random sampling was used to send questionnaires to hospitals in Haikou City, Hainan Province, in order to understand the cognition of doctors and patients on the two-way relationship between periodontitis and diabetes. Results Only 48.9% of the doctors agreed that periodontitis may affect the normal blood glucose level, 86.2% of the patients did not know that “treating periodontitis is beneficial to prevent the occurrence of diabetes”, and the cognitive level of periodontitis decreased with the increase of age and the decrease of education level, the difference was statistically significant (P All were < 0.05). 93.6% of the doctors said they would pay attention to the oral condition of the patients, but only 23.6% of the patients said they had been recommended by doctors for oral health examination. Conclusion The public, represented by the endocrinologists and diabetic patients in Haikou City, has a low level of cognition about the correlation between periodontitis and diabetes, so we should strengthen the education of the correlation between periodontitis and diabetes in the process of clinical treatment and management of patients. [ABSTRACT FROM AUTHOR]

While growth charts depicting 7 percentile lines for height and weight are useful for healthcare workers and pediatricians, endocrinologists need indication-specific z score cutoffs to plan investigations and treatment. The current Indian charts do not offer lower percentile/z scores (−2.25, −2.5, and −3 z score) lines. Also, increasing prevalence of childhood overweight and obesity necessitates a quick screening of nutritional status without calculations while using the same growth chart. Our objectives were to produce extended and user-friendly growth charts for 0–18-year-old Indian children that depict −2.25, −2.5, and −3 z score height lines in addition to the standard 7 lines and to add a quick BMI assessment tool as an inset. LMS values from IAP 2015 growth charts (5–18 years) and WHO 2006 MGRS charts (<5 years) were used to generate −2.25, −2.5, and −3 z score height lines (1.2, 0.6, and 0.1 percentiles, respectively) from 0–18 year for boys and girls. These newly generated lines were added to standard 7 (3, 10, 25, 50, 75, 90, 97) percentile lines for height charts. In addition, modified BMI quick screening tool was incorporated as an inset. The extended height charts (with 10 lines), standard (7 lines) weight charts, and quick BMI assessment tool are presented in a single unified chart for use by endocrinologists. These charts will help in defining specific height z score cutoffs as well as screen for overweight and obesity without any calculations in Asian Indian children. [ABSTRACT FROM AUTHOR]

Objective: To assess the current management of prolactinoma among endocrinologists in China. Methods: An online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed. Results: A total of 290 valid questionnaires were collected, and the response rate was 40%. When hyperprolactinemia occurred, 97% of the respondents would test thyroid-stimulating hormone routinely. 22% of the respondents considered that prolactin levels 250 ng/mL could occur in all the following situations as macroprolactinoma, mircoprolactinoma, macroprolactinemia and drug-induced hyperprolactinemia. Surgery was not recommended by 272 (94%) endocrinologists as the first choice for treating microprolactinomas. 58% and 92% of endocrinologists would start drug treatment for microprolactinomas and macroprolactinomas at diagnosis. 70% and 40% chose to withdraw treatment after 2–3 years of prolactin normalization in microprolactinomas and macroprolactinomas. In case of pregnancy, 57% of the respondents considered bromocriptine as choice for women patients. Drug discontinuation after pregnancy was advocated in 63% and 27% for microprolactinoma and macroprolactinoma. Moreover, 44% of endocrinologists believed that breastfeeding was allowable in both micro- and macroprolactinoma. Conclusion: This is the first study to investigate the management of prolactinomas among endocrinologists in China. We found that the current clinical treatment was not uniform. Therefore, it is necessary to strengthen the training of endocrinologists to improve clinical diagnosis and treatment practices.

Objective: To evaluate the use of preoperative vitamin D levels and postoperative vitamin D supplementation among endocrinologists for the prevention of post‐thyroidectomy hypocalcaemia. Methods: Endocrinologist members of the American Thyroid Association (ATA) were contacted via email to complete a 21‐question survey, which included both questions about demographic information, and preventing and managing postoperative hypocalcaemia after thyroidectomy. Univariate and multivariate analysis was performed to determine the respondents' use of preoperative vitamin D levels, dose and duration of preoperative vitamin D repletion, decision to delay surgery for low vitamin D levels in the case of a benign or malignant disease, and routine prescription of postoperative calcium or vitamin D supplementation. Results: 225 endocrinologists who were ATA members responded to the questionnaire. When compared to endocrinologists practicing in other countries, those that practice in the United States were 2.5 times more likely to check preoperative vitamin D levels (95% CI[1.404, 4.535], P =.002), significantly more likely to replete vitamin D deficient patients with high‐dose vitamin D (ie ≥50K IU/week), 4.458 times more likely to prescribe prophylactic supplemental calcium (95% CI[2.446, 8.126]; P <.0001) and 3.48 more likely to prescribe supplemental vitamin D (95% CI [1.906, 6.355]; P <.0001). Endocrinologists who have been in practice for >10 years were also 1.915 times more likely to prescribe supplemental vitamin D (95% CI (1.080, 3.395); P =.0263). Physicians that treat >50 thyroidectomy cases/year were 2.083 more likely to recommend a vitamin D repletion duration of >1 month than those that treat ≤50 cases/year ([1.036, 4.190], P =.0395). Lastly, if the patient has low preoperative vitamin D levels, 47.05% of respondents chose to delay surgery in a benign disease, while only 11.61% of respondents would do so in a case of malignant disease. Conclusions: Approximately one‐half of surveyed endocrinologists reported using preoperative vitamin D levels to assess a patient's risk for post‐thyroidectomy hypocalcaemia. Endocrinologists practicing in the United States, compared to those practicing in other countries, were more likely to both test for preoperative vitamin D levels and to recommend prophylactic post‐thyroidectomy calcium and vitamin D supplementation. [ABSTRACT FROM AUTHOR]

Objective: An increasing number of trans and gender diverse (TGD) individuals are seeking gender‐affirming hormone therapy for gender transition. Little is known about the levels of training, experience and confidence of endocrinologists in providing care and lack of training and experience is a potential barrier to individuals seeking appropriate and timely health care. We aimed to assess the level of training and confidence of Australian endocrinologists and trainees in the endocrine management of trans and gender diverse individuals in a representative sample. Design: Endocrinologist and trainee members of the Endocrine Society of Australia were invited to participate in an anonymous 14‐item survey. Of the 545 members, 147 clinicians (95 adult endocrinologists, 2 paediatric endocrinologists and 50 endocrinology trainees) responded. Results: When presented with a scenario regarding commencement of gender‐affirming hormone therapy, only 19% felt confident providing clinical care to TGD individuals. Compared to other areas of endocrinology, 75% felt less or not at all confident in commencing hormone therapy in a TGD patient. No training in transgender medicine during medical school or during their endocrinology training was reported by 96% and 60%, respectively. There were significantly higher levels of confidence in all aspects including performing a consultation in those who had previously seen a TGD patient. The desire for more training was high (91%). Conclusions: These results highlight the shortfall in training in TGD health care amongst endocrinologists and show that prior clinical experience is associated with higher levels of confidence. Medical schools and endocrinology fellowship training programmes will need to adapt to meet the increasing demand for quality TGD health services. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes is taking the form of a pandemic. All ages and all sections of society are affected by it and physicians are no exception to it. Aim: To know the glycaemic status and level of glycaemic control among the physicians who were attending a National Diabetes Conference. Materials and Methods: A cross-sectional study was conducted at a national conference “Diabetes India” held in Delhi in February 2017. Physicians and Endocrinologists were the delegates. All physicians willing for assessment of their Glycaemic status were included and HbA1C was done. Data was analysed and mean, percentage and p-value were calculated. Results: Out of 108 physicians, 3 (2.78%) had impaired glucose tolerance, 54 (50%) had diabetes mellitus and 51 (47.22%) were euglycaemic. Out of 51 physicians, only 3 physicians (5.88%) had HbA1C less than or equal to 5.6, 9 (17.65%) had HbA1C more than 6.5, 39 (76.47%) had impaired glucose tolerance. Conclusion: Very high incidence of diabetes mellitus and impaired glucose tolerance was found among physicians and endocrinologist in this study and the alarming result warrants further research with more participants.

Primary hyperparathyroidism is a common condition that affects 0.3% of the general population in which excessive production of PTH is there. With changing trends it is diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, we reported series of three cases of 30-40-year-old women with osteolytic lesions and bone resorption in maxilla or mandible. Two of presented cases demonstrated evidence of lesions in both mandible and maxilla which is a very rare event. A thorough diagnostic work-up emphasizing on biochemical and radiographic investigations were discussed. We highlighted the role of endocrinologist, oral and maxillofacial surgeons, general practitioner dentists, and radiologists in diagnosing and managing such patients.

Objective (s): Shortage in human resources is an important challenge for health sector. It is the main cause of demand rationing and queues to receive services. Proper information about the present situation helps to manage queues and waiting time. This study aimed to estimate waiting time to visit an endocrinologist and provide practical solution for its management.Method: This was a cross - sectional study. Samples were selected from participants of the annual Iranian endocrinologist conference, 2008 in Tehran. Twenty four endocrinologist completed the questionnaires. The research tool was a self - administered questionnaire. Results: The study findings showed that the median and mean waiting time of endocrinologists was 15 and 30 days for first visit respectively (0 -135 days). Number of endocrinologists' activity was the only variable that had positive correlation with waiting time (P= 0.027). About % 41.7 of endocrinologists had the possibility of increasing their clinical working hours by 10.8 hours per week.Conclusion: Waiting time to visit an endocrinologist seems occurred due to inappropriate distribution of patients and not the shortage of workforce.

On June 5 2017 we have lost one of the most famous Russian endocrinologists member of Diabetes Mellitus journal Editorial board – Professor Sagdulla A. Abusuev.

Background Despite a shift in diabetes care internationally from secondary to primary care, diabetes care in the Republic of Ireland remains very hospital-based. Significant variation in the facilities and resources available to hospitals providing outpatient diabetes care have been reported in the UK. The aim of this study was to ascertain the structure of outpatient diabetes care in public hospitals in the Republic of Ireland and whether differences existed in services provided across hospitals. Methods We conducted a cross sectional observational study of the 36 public general hospitals providing adult outpatient diabetes care in the Republic of Ireland. Data relating to numbers of specialist medical, nursing and allied health professionals, waiting times for new and return patients, patterns of discharge back to primary care and engagement in quality improvement initiatives were recorded. Results Thirty-five of the 36 eligible hospitals participated in the study. Sixty percent of these had at least one consultant endocrinologist in post, otherwise care delivery was led by a general physician. Waiting times for newly diagnosed patients exceeded six months in 30% of hospitals and this was higher where an endocrinologist was in place (47% V 7%, p = 0.013). Endocrinologists were more likely to have developed subspecialty clinics, access to allied health professionals and engage more in quality improvement initiatives but less likely to discharge patients back to primary care than general physicians (76 v 29%, p = 0.005). Conclusions Variations exist in the structure and provision of diabetes care in Irish hospitals. Endocrinology-led services have more developed subspecialty structures and access to specialist allied health professionals and engage more in quality improvement initiatives. Nonetheless, waiting times are longer and discharge rates to primary care are lower than for non-specialty led services. Further studies to determine the extent to which case-mix variation accounts for these observations are warranted. Aspects of hospital-based outpatient care could be developed further to ensure equitable services are provided nationally. At a time when the delivery of diabetes services in primary care is being promoted, further research is warranted on the factors influencing the successful transition to primary care. [ABSTRACT FROM AUTHOR]

Primary hyperparathyroidism is a common condition that affects 0.3% of the general population in which excessive production of PTH is there. With changing trends it is diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, we reported series of three cases of 30-40-year-old women with osteolytic lesions and bone resorption in maxilla or mandible. Two of presented cases demonstrated evidence of lesions in both mandible and maxilla which is a very rare event. A thorough diagnostic work-up emphasizing on biochemical and radiographic investigations were discussed. We highlighted the role of endocrinologist, oral and maxillofacial surgeons, general practitioner dentists, and radiologists in diagnosing and managing such patients. [ABSTRACT FROM AUTHOR]