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American Association of Clinical Endocrinologists, May 13-17, 2009

Last Updated: May 21, 2009.

American Association of Clinical Endocrinologists' 18th Annual Meeting

The American Association of Clinical Endocrinologists' 18th annual meeting took place from May 13 to 17 in Houston and attracted about 1,350 attendees from around the world. The meeting's theme was "Exploring New Frontiers in Endocrinology" and highlights included advances in the care of endocrine diseases such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.

"The main point of the meeting is to cover each of the major areas of endocrinology," said program co-chair, Todd Frieze, M.D., a private practitioner based in Biloxi, Miss. "Obviously, diabetes is big focus."

During the first plenary session, three diabetes experts focused on pre-diabetes and urged attendees to aggressively manage a condition that affects an estimated 57 million Americans. "We need to take hold of pre-diabetes and prevent its progression to overt diabetes," Frieze said. "That means not only focusing on glycemic control, but also focusing on other aspects such as hypertension and cholesterol control, all of which can improve microvascular outcomes in terms of diabetes and macrovascular outcomes in terms of cardiovascular disease."

The experts discussed new treatment recommendations developed in July 2008 at the first-ever pre-diabetes consensus conference in Washington, D.C. These include a 5 to 10 percent weight loss; 30 to 60 minutes of exercise at least five days per week; a low-energy diet rich in fiber and low in carbohydrates, salt and alcohol; and pharmaceutical interventions as needed.

"Lifestyle intervention should be the cornerstone of treatment for all patients, and it should be reinforced with each visit to the doctor," Daniel Einhorn, M.D., the AACE vice president, said in a statement.

Einhorn suggested that high-risk patients who fail to respond to lifestyle changes may require treatment with medications such as metformin, TZD's, DDP4, and GLP1. "These medications illustrate a specific 'plan of attack' for treating pre-diabetes, but it's important that caution is exercised," he said in a statement.

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During another session, John Bilezekian, M.D., of Columbia University in New York City discussed new guidelines for the management of asymptomatic primary hyperparathyroidism which were summarized in six articles published in the February issue of The Journal of Clinical Endocrinology & Metabolism.

"We're now using updated criteria to decide who should or shouldn't receive surgery," Frieze said. "We're also moving away from using an arbitrary urinary calcium cutoff point to recommend surgery because we're realizing that a high level is not a specific marker for the development of kidney stones."

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According to Frieze, other meeting highlights included a presentation by Italian researcher, Enrico Papani, M.D., on cutting-edge treatments for thyroid nodules such as laser thermal ablation and high-frequency ultrasound ablation; and a presentation by University of Wisconsin researcher, Neil Binkley, M.D., on the urgent need to increase the recommended daily intake of vitamin D to reduce the risk of osteoporosis and falls in older adults.

"National recommendations from the Food and Nutrition Board are 400 to 600 International Units (IU) a day," Binkley said in a statement. "That's simply not enough. Experts recommend somewhere between 1,500 to 2,600 IU daily. It's considered a very safe vitamin. One would need daily doses of 40,000 IU or higher before seeing negative side effects."

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During the meeting, a consensus group from the AACE and the American Diabetes Association called for major changes in the management of hospital patients with elevated glucose levels. The new recommendations were issued after several randomized controlled trials failed to show a significant benefit from intensive glucose lowering to 80 to 110 mg/dL in critically ill patients, especially critically ill diabetics.

"We are witnessing an evolution in the management of hyperglycemia in inpatient settings," Etie S. Moghissi, M.D., the AACE chair of the Inpatient Glycemic Control Consensus Panel, said in a statement. "Despite some inconsistencies in the clinical trial results, it would be a serious error to conclude that judicious control of glycemia in hospitalized patients is not warranted."

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AACE: Overweight Teen Boys at Risk for Early Heart Damage

THURSDAY, May 14 (HealthDay News) -- Apparently healthy overweight and obese teenage boys may be more likely to have high levels of aldosterone and early evidence of cardiovascular damage, according to research presented this week at the annual meeting of the American Association of Clinical Endocrinologists, held from May 13 to 17 in Houston.

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AACE: Simple Initiative Improves Diabetes Care

THURSDAY, May 14 (HealthDay News) -- In patients with diabetes, simple low-cost care initiatives may lead to significant clinical improvements, according to research presented this week at the annual meeting of the American Association of Clinical Endocrinologists, held from May 13 to 17 in Houston.

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AACE: Exenatide May Lower Insulin Requirements

THURSDAY, May 14 (HealthDay News) -- Patients with type 2 diabetes may be able to safely and effectively reduce their insulin requirements with exenatide therapy, according to research presented this week at the annual meeting of the American Association of Clinical Endocrinologists, held from May 13 to 17 in Houston.

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AACE: Blood Glucose Targets Relaxed for Inpatient Glycemic Control

WEDNESDAY, May 13 (HealthDay News) -- The glucose targets for hospital patients with high blood-sugar levels should be revised to 140 to 180 mg/dL in the intensive care unit setting and 100 to 180 mg/dL for general medical-surgical ward patients, according to recommendations released on May 8 by the American Association of Clinical Endocrinologists and the American Diabetes Association, and published online and in the June issues of Diabetes Care and Endocrine Practice. In addition, members from both associations involved in the Inpatient Glycemic Control Task Force will discuss these guidelines, highlighting the relationship between glycemic control and clinical outcomes, during a special symposium on May 15, at the annual meeting of the American Association of Clinical Endocrinologists, held from May 13 to 17 in Houston.

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