Endocrinology

Timing of Therapy in Osteoporosis: Does it Matter?

Osteoporosis is a common condition encountered in general practice and is significantly undertreated. Tailoring the type and timing of treatment to the individual patient is important to improve outcomes and minimise potential side effects. Bisphosphonates, denosumab and hormonal therapies are effective in decreasing hip, vertebral and nonvertebral fractures. First-line treatment selection depends on individual patient factors and preferences.

Modern Medicine – Issue 5 2023

Don’t Over- or Under-treat Hypothyroidism

Hypothyroidism is a condition that is more frequent in women, particularly those older than 60 years of age. It is readily diagnosed by the measurement of blood levels of thyroid-stimulating hormone (TSH) and thyroxine (T4).

Modern Medicine – Issue 4 2023

A Clinical Approach to Managing Obesity in Adults

Obesity is a complex chronic disease that is strongly associated with an increased risk of all-cause mortality. Routine screening is required to assess the complications of obesity. Therapies for managing obesity should be guided by an individual’s body mass index, comorbidities and the presence and severity of obesity-related complications.

Modern Medicine – Issue 4 2023

Early Intervention Alters the Prediabetes Trajectory

Prediabetes is a high-risk state for progression to diabetes with an annualised conversion rate of 5–10%, with a similar proportion converting back to normoglycaemia. Proactive screening and a prompt lifestyle intervention in those with incident prediabetes is effective in preventing the progression to type 2 diabetes in many patients. The addition of metformin has a selectively greater impact in certain categories of patients.

Modern Medicine – Issue 4 2023

Obesity and Diabetes: (Un)comfortable Bedfellows

The term pandemic has been bandied about freely over the past three years with the advent of the COVID pandemic. Although the term refers to an “epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”, it may have had its origins in virology and infectious diseases, the description is equally as appropriate to describe the large numbers of people living with type 2 diabetes mellitus (T2DM) and people living with obesity.1 In fact, COVID highlighted the metabolic and pro-inflammatory states that are the hallmark of these two conditions.

Modern Medicine – Issue 2 2023

Keep Your Eyes Open for Non-anaemic Iron Deficiency

Iron deficiency is one of the most common global nutritional health problems, affecting an estimated 2 billion people. Iron deficiency anaemia affects approximately 20% of the world’s population. Iron deficiency without anaemia is three to four times more common than iron deficiency anaemia and is an under-recognised and under-treated condition.

Modern Medicine – Issue 2 2023

Metabolic Decline can Point to the Thyroid

Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body. Untreated hypothyroidism can contribute to hypertension, dyslipidaemia, infertility, cognitive impairment and neuromuscular dysfunction. Thyroid hormone replacement therapy with levothyroxine, the exogenous form of T4, has been the gold standard for the treatment of primary hypothyroidism for more than 60 years.

Modern Medicine – Issue 1 2023

Stalling the March of Diabetic Retinopathy

Diabeticretinopathy , a common and sight – threatening microvascular complication of diabetes mellitus, is a leading cause of blindness among workingaged adults. Systemic fenofibrate therapy has been shown to be effective in reducing the progression of diabetic retinopathy independently of serum lipid levels.

Modern Medicine – Issue 1 2023

Type 2 Diabetes in Young Adults: A management guide for GPs

Type 2 diabetes is increasing among young adults, who are at higher risk of early complications and mortality and require a nuanced approach to management. Clinicians can be guided by recommendations from the recently published Australian consensus statement on the management of type 2 diabetes in young adults, which highlights areas where management might differ from that of older adults. GPs play an important role in identifying type 2 diabetes in young adults and are encouraged to facilitate access to endocrinologists and specialised multidisciplinary care teams where available. GPs are pivotal in providing support and education, particularly with respect to pregnancy, contraception and psychological health, and in providing continuity of care, especially during transition periods.

Modern Medicine – Issue 1 2023