The endocrine system, through its organs and glands, produces and secretes hormones which control and regulate several body functions: reproduction and sexual differentiation, development and growth, homeostasis, regulation of metabolism and nutrient supply.1,2
The thyroid, for example, through the secretion of the hormones T4 and T3, regulates the development of different organs, notably the brain (neuronal...
Cancer can develop within the thyroid gland. Although it is a seldom cancer with 1% of all malignancies registered in UK, it constitutes more than 90% of the cancers of the endocrine glands.3 Thyroid cancer is more common in women than in men, with an incidence around 2.5 times more in the UK in 2010 (1900 new cases for women versus 700 for men).4 There are 4 main types of thyroid cancer: papillary thyroid cancer (60% of the thyroid cancers), follicular thyroid cancer (15%), medullary thyroid cancer (5-10%) and anaplastic thyroid cancer (5%).2
The incidence of many endocrine-related diseases has been increasing in humans (breast cancer, prostate cancer, testicular cancer, obesity, diabetes and infertility) for the last 50 years.5,6
With 347 million people worldwide having diabetes, this condition constitutes the main endocrine disease. Of this number 10% are suffering from type 1 and 90% from type 2.7 Type 2 diabetes is even diagnosed in children and adolescents.1
Moreover, although preventable by diet and physical activity, overweight and obesity have increased twice since 1980 and now represent the 5th leading risk for global death.8 According to WHO, overweight is defined by a body mass index (BMI) ≥ 25 kg/m2 and obese by a BMI ≥30 kg/m2.
In 2008, 1.4 billion adults were overweight and 500 million were obese.
In 2011, more than 40 million children under 5 years old were overweight. WHO estimates that “44% of the diabetes burden, 23% of the ischaemic heart disease burden and 7 to 41% of certain cancers burden are attributable to overweight and obesity”.8
Additionally, some endocrine-related effects in wildlife populations have been observed and some chemicals with endocrine disrupting properties linked to disease outcomes have been identified in the laboratory.1,6
Those chemicals are called “Endocrine Disruptors Chemicals” (EDCs). The International Programme on Chemical Safety (IPCS) is a joint programme of WHO, United Nations Environment Programme (UNEP) and the International Labour Organization, giving the following definitions: “An endocrine disruptor is an exogenous substance or mixture that alters function(s) of the endocrine system and consequently causes adverse health effects in an intact organism, or its progeny, or (sub) populations” and “A potential endocrine disruptor is an exogenous substance or mixture that possesses properties that might be expressed to lead to endocrine disruption in an intact organism or its progeny, or (sub) populations”.6
The endocrine disruptors can be natural, like the phytoesrogens (e.g. isoflavonoids in soya beans) or synthetic like pesticides (e.g. dichlorodiphenyl trichloroethane (DDT)). Exposure can be by ingestion, inhalation, dermal absorption, transplacental or by breast milk.1
The endocrine disruptors can act: directly on the hormone receptors, alter the synthesis and the metabolism of the hormones or of the hormone receptors or possibly change the cell sensitivity to a specific hormone.1,6
They can act on nuclear receptors, non-nuclear steroid hormone receptors, non-steroid receptors, orphan receptors, enzymatic pathways involved in steroid biosynthesis and/or metabolism and they can have simultaneous actions on different receptors.5,6
The severity of the effects related to the endocrine disruption depends on different factors, notably age. As fetuses and infants are in development, they are more sensitive.1,5,6
The effects of the endocrine disruptors may appear later as there is latency of exposure and some synergistic effects are possible, even when the EDCs are combined at low doses that individually do not produce observable effects.1,6 These molecules are lipophiles and accumulate in adipocytes.1,5,6 They also produce non-linear dose responses and show tissue specific effects.6
The effects of EDCs can be various. Precocious puberty has been associated to exposure to DDT, Polychlorinated Biphenyls (PCBs) and phtalates (used as a plasticizers in polyvinyl chloride (PVC), cosmetics and fragrance).1
The thyroid gland which regulates the brain development can be disrupted, by, for example: PCBs, detergent derivative monylphenol, plasticiser dibutylphtalate, plastic triclosan, polybromintaed phenyls and some UV-filters.1
The main messages given by WHO and UNEP are that the EDCs are everywhere and their numbers are increasing. People are exposed to mixtures occurring at early life stages. All sources of EDCs aren’t known.6
Currently, around 800 chemicals are considered as EDCs or potential EDCs but just a few of them have been studied to assess their impact.6 According to WHO, it is important that the physicians “report cases that can be related to environmental exposure as they may be sentinel cases”.1
1. World Health Organization. Children’s Health and the Environment: Endocrine Disorders and Children. October 2011. Available at: http://www.who.int/ceh/capacity/endocrine.pdf, accessed the 11th of March 2013.
2. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003 ; 937-975.
3. Vanderpump M.P.J. The epidemiology of thyroid diseases. Br Med Bull (2011) 99 (1): 39-51.
4. Cancer Research UK. Thyroid Cancer key facts. Available at: http://www.cancerresearchuk.org/cancer-info/cancerstats/keyfacts/thyroid-cancer/ accessed the 11th of March 2013.
5. De Coster S. et al. Endocrine-Disrupting Chemicals: Associated Disorders and Mechanisms of Action. J Environ Public Health. 2012; 2012: 713696.
6. World Health Organization / United Nations Environment Programme. State of the Science of Endocrine Disrupting Chemicals – 2012. Available at: http://www.who.int/iris/bitstream/10665/78101/1/9789241505031_eng.pdf, accessed the 11th of March 2013.
7. World Health Organization. Diabetes - Fact Sheet N° 312, March 2013. Available at: http://www.who.int/mediacentre/factsheets/fs312/en/, accessed the 11th of March 2013.
8. World Health Organization. Obesity and overweight - Fact Sheet N° 311, March 2013. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html, accessed the 11th of March 2013.
Content on this page
Diabetes is a disease that currently affects approximately 285 million people worldwide and this figure is only expected to increase1. For Europe, the IDF estimates that 55.2 million, or 8.5% of the population aged 20 to 79 years, have diabetes. This is expected to rise to 66.2 million (10.0%) by 2030. Further information on the scale of the type 2 diabetes problem can be found in the overview section of the knowledge centre.
Complications associated with diabetes mellitus include hypertension, cardiovascular disease, retinopathy, kidney damage, foot ulceration and nerve damage. Discover more about the complications connected to diabetes mellitus, as well as acceptable blood glucose and HbA1C levels and how these differ in people with diabetes mellitus here.
The majority of patients with type 2 diabetes are obese and/or have an increased proportion of visceral fat, factors which in themselves are associated with insulin resistance. Other risk factors include increasing age and sedentary lifestyle. There is also a strong genetic predisposition to type 2 diabetes2.
Chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction and failure of various organ systems. Early diagnosis, adequate treatment to control hyperglycaemia, and management of associated risk factors and complications therefore are all essential to reduce the burden of diabetes. Effective screening strategies are therefore of particular importance in reducing this burden. Discover the diagnostic tests necessary to diagnose type 2 diabetes mellitus and intermediate hyperglycaemia or pre-diabetes.
The early and aggressive treatment and management of diabetes mellitus is important for a successful long term outcome in patients with diabetes mellitus. The use of oral agents and lifestyle changes are the generally accepted early treatments followed later by insulin therapy. Current treatment algorithms and IDF guidelines should be used to find the appropriate treatment regime for individual patients.
As with many diseases, our knowledge of diabetes mellitus is increasing through research. Recent developments include the use of new treatments and guidelines in clinical practice. There has been an update to the IDF guidelines concerning GLP-1 agonists. DPP-4 inhibitors are now used in the treatment of diabetes, and SGLT-2 inhibitors are being investigated for this use.
1. Unwin, N. et al. The IDF Diabetes Atlas: Providing Evidence, Raising Awareness and Promoting Action. Diabetes Res Clin Pract 87, 2-3 (2010).
2. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 33 Suppl 1, S62-9 (2010).
As a disease topic Men's Health covers a broad set of issues affecting men of all ages. Some of the issues requiring greater focus and more thorough dissemination of information amongst the healthcare community, are those that have the potential to go undetected in the early stages. Diseases where early detection and more regular health checks not only improve prognosis and efficacy of treatment outcomes, but also quality of life.
Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. Although not considered a part of the aging process, it is associated with certain physiologic and psychological changes related to age. ED is most common in men between 40-70 years of age. However incidence is also higher amongst men with certain medical conditions which include, diabetes, heart disease, and hypertension. ED can also be a warning sign/symptom of these underlying conditions. 1
Testosterone is an essential male hormone produced in the testes that plays a crucial role in the health and well being of male bodies. It is responsible for typical male sexual characteristics and is required by all men for a healthy life physically and psychologically.
Low testosterone, clinically known as hypogonadism, consists of decreased functional activity of the testes with diminished production and action of testosterone. Although there is a progressive decline in testosterone levels as men age, hypogonadism can occur in men of any age.
Men with low testosterone are also at increased risk of cardiovascular disease, diabetes and metabolic syndrome and osteoporosis.
For your information, the Mens Health knowledge centre concentrates on the understanding, management and treatment of erectile dysfunction and hypogonadism. The website also provides extensive details on up-coming conferences as well as an extensive library of useful resource. You can also access the knowledge centre via www.menshealthfocus.com.
1. McVary, Kevin T. Erectile. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL et al., editors. Harrison's Internal Medicine. 16th ed. New York: McGraw-Hill; 2005. p. 272-274
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For adult patients with type 2 diabetes mellitus, Januvia is indicated to improve glycaemic control: as monotherapy • in patients inadequately controlled by diet and exercise alone and for ...
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In 2005 the first IDF Global Guideline for type 2 diabetes was developed. This presented a unique..
Treatment of hypothyroidism is today predominantly with L-T4: its long half-life of 1 week is..
Due to the high frequency of activation of PI3K and downstream effectors in progressive, recurrent and poorly differentiated cancers, inhibition of the PI3K signaling pathway with BKM120, a potent pan class I PI3K inhibitor, represents a particularly relevant therapeutic target and should be properly evaluated in..
Pancreatic Carcinoma: Chemoradiation Compared With Chemotherapy Alone After Induction Chemotherapy (CONKO-007)04-04-2013
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Exogenous insulin requirements do not differ between youth and adults with cystic fibrosis related diabetes
Objective: To examine whether insulin requirements and diabetes control differ between adolescents and adults with cystic fibrosis related diabetes (CFRD). Methods: All CFRD patients on insulin therapy seen at the University of Minnesota outpatient clinic from 1 January 2011 to 1 June 2012 were identified. Hemoglobin..
Background: As the presence of fetal hemoglobin (HbF) affects the accuracy of hemoglobin A1c (HbA1c) analysis methods, HbA1c measurement may not be a good indicator for patients with neonatal diabetes mellitus, whereas glycated albumin (GA) may be a good indicator. Objective: To investigate whether total glycated..
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Can hypoglycaemia occur in otherwise normal folk?on doc2doc
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Can hypoglycaemia occur in otherwise normal folk?on doc2doc
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