High Readmission Rate Found For Adults With Type 1 Diabetes Hospitalized for Diabetic Ketoacidosis (Medicine)

Readmitted patients have two times the death rate during second hospitalization

One in five adults with type 1 diabetes who require in-hospital treatment of the life-threatening condition diabetic ketoacidosis has an unplanned repeat hospital visit within a month and is twice as likely to die during the second hospitalization, a new study finds. The results, which will be presented at ENDO 2021, the Endocrine Society’s annual meeting, also identified several factors that increased the readmission risk for these patients.

Diabetic ketoacidosis, which can occur from insufficient insulin medicine or from an infection, is a dangerous accumulation of acid in the blood due to excess glucose, or blood sugar. When severe, DKA can require hospitalization for fluid replacement and insulin therapy.

“Diabetic ketoacidosis is a feared complication of type 1 diabetes because it can lead to a diabetic coma and death,” said the study’s lead author, Hafeez Shaka, M.D., an internal medicine resident at John H. Stroger Jr. Hospital of Cook County, Chicago. “But we were surprised to find that the readmission rate after diabetic ketoacidosis treatment is so high.”

For adults with type 1 diabetes who received diabetic ketoacidosis treatment in a hospital, the researchers studied the 30-day readmission rate and the factors that raised the risk of hospital readmission. They used a nationally representative data bank, the National Readmissions Database (NRD), the largest all-insurance payer database in the country, according to the Healthcare Cost and Utilization Project, the program that operates it.

Using the 2017 NRD database, Shaka and his colleagues found that 91,401 diabetic ketoacidosis-related hospitalizations involved adults with type 1 diabetes who were alive at discharge from the hospital. The rate of 30-day readmissions primarily due to diabetic ketoacidosis was 20.2 percent, involving 18,553 patients, he reported. 

Women were more likely than men to be readmitted, as were patients who left the hospital against medical advice during the first admission. Other risk factors for readmission included having anemia, high blood pressure or chronic kidney disease, Shaka said. 

Why women have higher rates of readmission is unclear, Shaka said. For patients who leave the hospital against medical advice, he speculated that they likely do not receive the education about blood sugar control and managing other medical conditions that they would typically get at discharge.

One reason for the high overall readmission rate could be that patients do not follow up with their diabetes care provider for glucose management, Shaka suggested. Individuals who experience diabetic ketoacidosis are at high risk of repeated episodes, he added.

The patients’ subsequent admissions not only led to double the chance of in-hospital deaths compared with the first hospitalization. The researchers also found that repeated admissions were, on average, longer and generated significantly higher health care costs.

“Efforts should be channeled toward identifying the risk factors for readmission in hospitalized adult patients with diabetic ketoacidosis as well as ensuring proper discharge planning to decrease the burden of readmissions,” Shaka said.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Weekly Insulin Helps Patients With Type 2 Diabetes Achieve Similar Blood Sugar Control to Daily Insulin (Medicine)

Phase 2 clinical trial results show fewer episodes of low blood sugar and comparable safety

A new once-weekly basal insulin injection demonstrated similar efficacy and safety and a lower rate of low blood sugar episodes compared with a daily basal insulin, according to a phase 2 clinical trial. The study results, which will be presented at ENDO 2021, the Endocrine Society’s annual meeting, compared an investigational drug called basal insulin Fc (BIF) with insulin degludec, a commercially available long-lasting daily insulin, in patients with type 2 diabetes.

“These study results demonstrate that BIF has promise as a once-weekly basal insulin and could be an advancement in insulin therapy,” said Juan Frias, M.D., the study’s principal investigator and the medical director of the National Research Institute in Los Angeles, Calif.

The reduced number of injections with weekly insulin may improve adherence to insulin therapy, which could result in better patient outcomes than for daily basal insulins, Frias said. Once-weekly dosing also may increase the willingness of patients with type 2 diabetes to start insulin therapy when oral medication alone no longer gives adequate blood glucose control, he added.

The 32-week clinical trial was conducted in 399 patients and sponsored by Eli Lilly and Company. All patients had type 2 diabetes and were previous users of basal insulin combined with oral antidiabetic medications.

The patients received random assignments to one of three treatment groups: once-weekly injections of BIF at one of two different dosing algorithms (with different goals for fasting blood glucose levels) or the standard once-daily injections of insulin degludec. One fasting glucose target for patients receiving BIF was 140 milligrams per deciliter (mg/dL) or less, and the other was at or below 120 mg/dL. The fasting glucose target for insulin degludec was 100 mg/dL or less.

Compared with insulin degludec, patients taking BIF achieved similar long-term blood glucose control, as measured by hemoglobin A1c, the researchers reported. Study participants had an average A1c of 8.1 percent at the beginning of the study and at the end of the study had an average improvement in A1c of 0.6 percent for BIF and 0.7 percent for insulin degludec, the data showed.

Additionally, BIF use resulted in significantly lower rates of hypoglycemia, or low blood sugar (less than 70 mg/dL). Severe untreated hypoglycemia is a dangerous complication that can cause seizures, loss of consciousness and death. Frias said BIF has “the potential of a flatter and more predictable action than the current daily basal insulins, which may have contributed to the lower rates of hypoglycemia.”

Regarding safety, BIF had a generally comparable adverse event profile to that of insulin degludec, he said.

“Based on our promising data, further research with BIF has been initiated in patients with type 1 diabetes and other type 2 diabetes patient populations,” Frias said. 

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Semaglutide Reduces Excess Body Fat in People With Obesity (Medicine)

Findings suggest drug has potential to reduce risk of heart disease, diabetes and stroke

In adults with obesity or overweight, weekly treatment with the glucagon-like peptide 1 (GLP1) receptor agonist semaglutide leads to reduced excess body fat and increased lean body mass, according to an industry-sponsored study presented virtually at ENDO 2021, the Endocrine Society’s annual meeting.

“Our findings suggest that semaglutide, through body weight loss and improvement of body composition, has the potential to reduce the risk of heart disease, diabetes and stroke in people with overweight or obesity,” said lead researcher John Wilding, D.M., F.R.C.P., of the University of Liverpool.

Obesity poses many health risks. Excess fat in the abdominal area, particularly fat in and around abdominal organs, also called visceral fat, contributes to major causes of death and disability, including heart attacks, strokes, high blood pressure, cancer, fatty liver disease and diabetes.

The study, called STEP 1, included 1,961 adults with a body mass index (BMI) of 27 or higher with at least one weight-related health condition, or a BMI of 30 or higher, without diabetes. A person is classified as overweight if their BMI is 25 to 29.9, and the range for obesity is a BMI of 30 or more.

The study participants were randomly assigned to inject themselves once weekly for 68 weeks with either 2.4 milligrams of semaglutide or a placebo. Semaglutide, already approved by the U.S. Food and Drug Administration at the lower dose of 1 mg weekly as a treatment for type 2 diabetes, is a synthetic version of the naturally occurring hormone glucagon-like peptide 1 (GLP1). It acts on appetite centers in the brain and in the gut, and produces feelings of fullness.

As part of the study, the researchers used dual-energy absorptiometry (DEXA), a technique that is widely used clinically to assess body composition, to monitor the effects of therapy on total body fat and fat around the stomach area in 140 of the participants.

They found treatment with semaglutide improved body composition by reducing excess body fat, including abdominal fat, and increasing the proportion of lean body mass, or the amount of weight someone carries that is not body fat. The more body weight a participant lost, the greater the improvement in body composition.

In February 2021, the researchers published findings from the STEP 1 trial in The New England Journal of Medicine showing that patients who injected semaglutide lost close to 15% of their body weight, on average, compared with 2.4% among patients receiving the placebo. More than one-third of participants receiving semaglutide lost more than 20% of their weight. Many patients experienced improvements in risk factors for heart disease, blood sugar levels and quality of life.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Largest-ever Analysis of its Kind Finds Cushing’s Syndrome Triples Risk of Death (Medicine)

Heart disease and infections rank as top causes of death among those with rare disorder

Endogenous Cushing’s syndrome, a rare hormonal disorder, is associated with a threefold increase in death, primarily due to cardiovascular disease and infection, according to a study whose results will be presented at ENDO 2021, the Endocrine Society’s annual meeting.

The research, according to the study authors, is the largest systematic review and meta-analysis to date of studies of endogenous (meaning “inside your body”) Cushing’s syndrome. Whereas Cushing’s syndrome most often results from external factors–taking cortisol-like medications such as prednisone–the endogenous type occurs when the body overproduces the hormone cortisol, affecting multiple bodily systems.

Accurate data on the mortality and specific causes of death in people with endogenous Cushing’s syndrome are lacking, said the study’s lead author, Padiporn Limumpornpetch, M.D., an endocrinologist from Prince of Songkla University, Thailand and Ph.D. student at the University of Leeds in Leeds, U.K. The study analyzed death data from more than 19,000 patients in 92 studies published through January 2021.

“Our results found that death rates have fallen since 2000 but are still unacceptably high,” Limumpornpetch said.

Cushing’s syndrome affects many parts of the body because cortisol responds to stress, maintains blood pressure and cardiovascular function, regulates blood sugar and keeps the immune system in check. The most common cause of endogenous Cushing’s syndrome is a tumor of the pituitary gland called Cushing’s disease, but another cause is a usually benign tumor of the adrenal glands called adrenal Cushing’s syndrome. All patients in this study had noncancerous tumors, according to Limumpornpetch.

Overall, the proportion of death from all study cohorts was 5 percent, the researchers reported. The standardized mortality ratio–the ratio of observed deaths in the study group to expected deaths in the general population matched by age and sex–was 3:1, indicating a threefold increase in deaths, she stated.

This mortality ratio was reportedly higher in patients with adrenal Cushing’s syndrome versus Cushing’s disease and in patients who had active disease versus those in remission. The standardized mortality ratio also was worse in patients with Cushing’s disease with larger tumors versus very small tumors (macroadenomas versus microadenomas).

On the positive side, mortality rates were lower after 2000 versus before then, which Limumpornpetch attributed to advances in diagnosis, operative techniques and medico-surgical care.

More than half of observed deaths were due to heart disease (24.7 percent), infections (14.4 percent), cerebrovascular diseases such as stroke or aneurysm (9.4 percent) or blood clots in a vein, known as thromboembolism (4.2 percent).

“The causes of death highlight the need for aggressive management of cardiovascular risk, prevention of thromboembolism and good infection control and emphasize the need to achieve disease remission, normalizing cortisol levels,” she said.

Surgery is the mainstay of initial treatment of Cushing’s syndrome. If an operation to remove the tumor fails to put the disease in remission, other treatments are available, such as medications.

Study co-author Victoria Nyaga, Ph.D., of the Belgian Cancer Centre in Brussels, Belgium, developed the Metapreg statistical analysis program used in this study.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Common Drugs For Type 2 Diabetes and Obesity Do Not Increase Breast Cancer Risk (Medicine)

Findings relieve concerns arising from clinical trials of liraglutide

Commonly used medications for type 2 diabetes and obesity called glucagon like peptide-1 receptor agonists (GLP-1 RAs), are not associated with an increased risk of breast cancer, despite previous studies that suggested a possible link, according to a study presented virtually at ENDO 2021, the Endocrine Society’s annual meeting.

“GLP-1RAs can be used as adjunct to diet and exercise in subjects with type 2 diabetes and those without type 2 diabetes and excess weight, without an increased risk of breast cancer or noncancerous masses in the breast,” said lead researcher Giovana Fagundes Piccoli, M.D., of the Universidade Federal do Rio Grande do Sul in Brazil.

GLP-1 RAs have been shown to be effective in treating obesity and type 2 diabetes and in reducing heart disease. These drugs include albiglutide (Tanzeum); dulaglutide (Trulicity); exenatide (Byetta); extended-release exenatide (Bydureon); liraglutide (Victoza, Saxenda); lixisenatide (Adlyxin); and semaglutide (Ozempic, Rybelsus). In clinical trials of liraglutide, subjects treated with the active drug instead of a placebo had a higher number of breast cancers. The new study was designed to assess whether patients treated with GLP-1 RAs had a higher risk of breast cancer or benign growths in the breasts called neoplasms.

Piccoli reviewed 52 randomized controlled trials that compared GLP-1 RAs with non-GLP-1 RAs (either other diabetes or weight-loss drugs or placebos) in adults with overweight, obesity, prediabetes or diabetes. The studies had a minimum follow-up period of 24 weeks and reported at least one event of breast cancer or benign breast neoplasm. They included a total of 90,360 participants.

The analysis found treatment with GLP-1 RAs was not associated with increased rates of breast cancer or benign or premalignant breast neoplasms, compared to placebo or other diabetes or weight-loss drugs. Among 48,267 subjects treated with GLP-1 RAs, 130 developed breast cancer, compared to 107 of 40,755 controls.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Increased Risk of Hearing Impairment With New Thyroid Eye Disease Treatment (Medicine)

Small study finds 65 percent of patients taking teprotumumab report otologic symptoms

More patients than previously reported may experience hearing symptoms such as hearing loss or muffled hearing from a new treatment for thyroid eye disease, teprotumumab (Tepezza), according to a small study presented virtually at ENDO 2021, the Endocrine Society’s annual meeting.

Teprotumumab, approved by the U.S. Food and Drug Administration in January 2020, is the first and only drug to be approved for thyroid eye disease. In two clinical trials conducted prior to FDA approval of the drug, otologic symptoms were reported in 10 percent of patients. The new study found the rate could be as high as 65 percent.

The treatment is administered to patients once every three weeks for a total of eight infusions. It has shown significant improvement in abnormal protrusion of the eyes (proptosis), double vision, soft tissue inflammation and quality of life.

Andrea Lora Kossler, M.D., assistant professor of ophthalmology at the Stanford University School of Medicine, is the senior author on the research. She and fellow researchers state that teprotumumab is an effective therapy for thyroid eye disease, but as with all therapeutics, there are known risks, including hearing impairment. The authors aim to better understand the risk of hearing loss and recommend tests to reduce this risk.

Thyroid eye disease is an autoimmune disease in which the eye muscles and fatty tissue behind the eye become inflamed. Symptoms can include dry, watery, red or bulging eyes, a “stare,” double vision, difficulty closing the eyes, and problems with vision. It is primarily associated with an overactive thyroid gland due to Graves’ disease.

To explore the incidence of hearing symptoms in patients treated with teprotumumab, the researchers evaluated 26 patients treated with at least four infusions of the drug. Seventeen patients (65 percent) complained of otologic symptoms when questioned. The most common symptoms were subjective hearing loss (n=6, 23 percent), tinnitus, or ringing in the ears (n=7, 27 percent), ear plugging sensation (n=3, 12 percent), and autophony, an unusually loud hearing of a person’s own voice (29 percent). Otologic symptoms developed after an average of 3.6 infusions.

Of the 17 patients with new hearing symptoms, four had new or worsening sensorineural hearing loss, a type of hearing loss resulting from damaged hair cells in the inner ear. Three patients had patulous eustachian tube, a disorder in which the channel that runs between the middle ear and back of the nose and throat stays open. Normally, these eustachian tubes remain closed and open only occasionally to regulate air pressure around the ear drum. After three months, symptoms of patulous eustachian tube improved, but did not completely disappear. Two patients with sensorineural hearing loss had improvement in symptoms at one and six months.

The authors aim to raise awareness on the incidence of otologic symptoms & recommend screening precautions, such as baseline audiogram testing to better understand this potential side effect. The follow up period of 3 months after stopping the drug is too short to assess the reported reversibility of otologic symptoms. Future studies will evaluate risk factors for hearing loss and the reversibility of symptoms.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Tubeless Automated Insulin Delivery System Improves Blood Glucose Outcomes (Medicine)

Study finds Omnipod® 5 simplifies diabetes management in type 1 diabetes

People with type 1 diabetes can improve their blood sugar control while reducing time with low blood sugar, or hypoglycemia, using Insulet Corporation’s Omnipod 5 Automated Insulin Delivery System compared to their standard insulin therapy. Results from an industry-sponsored study of the latest Omnipod, the first tubeless, wearable insulin pump, will be presented at ENDO 2021, the Endocrine Society’s annual meeting.

The Omnipod 5 System underwent three months of at-home testing in 128 adults and adolescents ages 14 to 70 years and 112 children ages 6 to less than 14 years. All study participants have type 1 diabetes and were first followed for two weeks using their standard therapy, either multiple daily insulin injections or an insulin pump. Using Omnipod 5, participants experienced significant average improvements in both hemoglobin A1c, a measure of blood glucose (sugar) control over the past several months, and the percentage of time the participants stayed within the recommended target glucose range (70 to 180 milligrams per deciliter), the researchers reported.

“These study results represent an advancement in diabetes therapies with a fully wearable device that enables continuous automated insulin modulation. This will expand the available treatment options for people with type 1 diabetes,” said the study’s senior investigator, Trang Ly, MBBS, FRACP, PhD, Senior Vice President and Medical Director of Insulet Corporation.

Insulet funded this study and manufactures Omnipod 5, which is under review by the U.S. Food and Drug Administration. It is an update to the Omnipod DASH and the original Omnipod System, which are sold in the U.S., Canada, Europe and the Middle East.

The Omnipod 5 System, according to Ly, is the first tubeless automated insulin delivery system integrated with the Dexcom G6 continuous glucose monitoring (CGM) system. She said this commonly used glucose monitor automatically measures glucose levels every five minutes and communicates directly with Omnipod 5. The Pod is now designed with an embedded algorithm that adjusts the pump’s insulin delivery automatically to a customizable glucose target, based on the CGM value and trend.

Users of Omnipod 5 inject insulin into a single-use Pod, which adheres to their skin for 72 hours of continuous infusion of insulin. At mealtimes, the user administers a bolus dose of insulin which is controlled by the Omnipod 5 app on the user’s personal smartphone or a separate wireless controller. Ly said the new system will have the ability to control the Pod from a compatible smartphone, making the wireless controller optional.

Ly reported that the adult/adolescent group’s A1c averaged 0.4 percent lower with Omnipod 5 than when they used their standard insulin therapy, an improvement from 7.2 percent to 6.8 percent.

With Omnipod 5, their average time in the glucose range recommended by the American Diabetes Association (70 to 180 milligrams per deciliter) was 2.2 hours a day longer, or 9.3 percent better, Ly stated. Overall, this group was in target range nearly 74 percent of the time when they used Omnipod 5, while the general population with type 1 diabetes is often in target glucose range 60 percent or less of the time.

“Even though many of the study participants had their diabetes well controlled before the study, they still experienced improved time in the target glucose range, regardless of their baseline control. This shows the potential of the technology in the broader population with diabetes,” Ly said.

One of their most important findings in the adult/adolescent group, according to Ly, was a reduction of time in hypoglycemia, measured on the sensor as glucose levels below 70 milligrams per deciliter, down to a median of 1.1 percent. Hypoglycemia is a dangerous drop in blood glucose levels. Only two episodes of severe hypoglycemia occurred, reportedly after user-initiated bolus doses.

Most study participants chose to continue using the Omnipod 5 during an extension of the original three-month study, which Ly said suggests a preference over their previous therapy.

Children participating in the study also had improved blood sugar control after using Omnipod 5.  The average A1c dropped by 0.7 percent, to 7 percent, and the time in range improved by nearly four hours per day. One event of diabetic ketoacidosis (excessive ketones in the blood due to insufficient insulin) occurred, which Ly attributed to infusion site failure. She said one severe hypoglycemia event occurred that was not attributable to device malfunction.

“Omnipod 5 protects you from both high and low glucose values,” Ly said. “It also is simple, intuitive, and easy to use.”

Sue Brown, M.D., of the University of Virginia in Charlottesville, Va., will present the data for adults and adolescents during an oral presentation at the meeting. Bruce Buckingham, M.D., of Stanford University, will present the pediatric data in a poster presentation.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

‘Hunger Hormone’ Ghrelin Affects Monetary Decision Making (Neuroscience)

High ghrelin levels in healthy females predict more impulsive choices, researchers say

Higher levels of the stomach-derived hormone ghrelin, which stimulates appetite, predict a greater preference for smaller immediate monetary rewards over larger delayed financial rewards, a new study finds. The study results will be presented at ENDO 2021, the Endocrine Society’s annual meeting.

This research presents novel evidence in humans that ghrelin, the so-called “hunger hormone,” affects monetary decision making, said co-investigator Franziska Plessow, Ph.D., assistant professor of medicine at Massachusetts General Hospital and Harvard Medical School, Boston. She said recent research findings in rodents suggested that ghrelin may play a part in impulsive choices and behaviors.

“Our results indicate that ghrelin might play a broader role than previously acknowledged in human reward-related behavior and decision making, such as monetary choices,” Plessow said. “This will hopefully inspire future research into its role in food-independent human perception and behavior.”

Ghrelin signals the brain for the need to eat and may modulate brain pathways that control reward processing. Levels of ghrelin fluctuate throughout the day, depending on food intake and individual metabolism.

This study included 84 female participants ages 10 to 22 years: 50 with a low-weight eating disorder, such as anorexia nervosa, and 34 healthy control participants. Plessow’s research team tested blood levels of total ghrelin before and after a standardized meal that was the same for all participants, who had fasted beforehand. After the meal, participants took a test of hypothetical financial decisions, called the delay discounting task. They were asked to make a series of choices to indicate their preference for a smaller immediate monetary reward or a larger delayed amount of money, for instance, $20 today or $80 in 14 days.

Healthy girls and young women with higher ghrelin levels were more likely to choose the immediate but smaller monetary reward rather than waiting for a larger amount of money, the researchers reported. This preference indicates more impulsive choices, Plessow said.

The relationship between ghrelin level and monetary choices was absent in age-matched participants with a low-weight eating disorder. People with this eating disorder are known to have ghrelin resistance, and Plessow said their finding might be another indicator of a disconnect between ghrelin signaling and behavior in this population.

The study received funding from the National Institutes of Health and a Charles A. King Trust Research Fellowship Award to Plessow. Naila Shiraliyeva, M.D., a research fellow at Massachusetts General Hospital, will present the study findings at the meeting.

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society

Obesity Raises Type 2 Diabetes Risk in Women With PCOS (Medicine)

Findings underscore importance of weight control in women with PCOS

Women with obesity and polycystic ovarian syndrome (PCOS) are at increased risk of developing type 2 diabetes, according to a study presented virtually at ENDO 2021, the Endocrine Society’s annual meeting. Normal-weight women with PCOS are not at increased risk, the researchers found.

Women with PCOS had a more than three-fold increased risk of developing type 2 diabetes during their lifetime, the study found. This risk was evident only in women who met the criteria for overweight or obesity, but not in lean women.

“We strongly suggest weight management in women with obesity and PCOS in an attempt to reduce this major risk of developing type 2 diabetes,” said lead researcher Sarantis Livadas, M.D., Ph.D., of Athens Medical Center in Athens, Greece.

PCOS is a common disorder characterized by irregular menstrual periods, disruption of normal metabolism and excessive hair growth. PCOS affects up to 10% of all women of reproductive age. The disorder can lead to obesity, diabetes and cardiovascular disease, which are often life-long conditions. Between 50%-80% of women with PCOS have obesity, and obesity is known to be a risk factor for diabetes.

The link between PCOS and diabetes has been based on a small number of studies, mostly evaluating women with the condition and obesity.

In the new study, the researchers analyzed 23 previous studies in order to assess the impact of obesity in subsequent type 2 diabetes development in women with PCOS. The studies included a total of 60,336 women with PCOS and 259,444 without the disease. A total of 8,847 women in the studies had type 2 diabetes.

“We conclude that only women with PCOS and obesity have an increased risk for type 2 diabetes development, in contrast to the current notion that all women with PCOS have a significant risk for developing type 2 diabetes,” said Livadas. “This finding underscores the impact of early detection of this PCOS population and prompt lifestyle modification to avert the development of type 2 diabetes.”

###

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


Provided by Endocrine Society