Antidiabetic drugs and kidney disease - Recommendations of the Swiss Society for Endocrinology and Diabetology.

Patients with diabetes are at risk of early renal function decline. Therefore, kidney function needs monitoring at least once per year. Once the glomerular filtration rate (GFR) is less than 60 ml/min, the pharmacokinetics of antidiabetic drugs may be altered. Sulfonylurea and glinide therapies are associated with a risk of hypoglycaemia which is increased in the presence of renal impairment. Most sulfonylureas must be discontinued once GFR is <60 ml/min. Some glinides may be continued beyond this threshold, in particular repaglinide, which may be used in dialysis patients. In the absence of comorbidities, metformin can be continued at lower doses until a GFR of 45 ml/min, but must be withdrawn in case of dehydration or during the administration of a nephrotoxic drug including dye for radiological investigations. Glitazones may worsen water and sodium retention in patients with renal impairment. The pharmacokinetics of all DPP-IV inhibitors except linagliptin are altered with impaired renal function. Only sitagliptin, saxagliptin and linagliptin may be used in advanced kidney disease, but experience is as yet very limited. GLP-1 agonists are contraindicated in moderate to advanced kidney disease.

Some studies on the reproductive endocrinology of tiger prawn Penaeus monodon Fabricius

The growing demand for quality prawn seed from the farmers‘ and entrepreneurs, coupled with uncertainity of their availability from nature at the appropriate time in required quantities has prompted‘ research on problems connected with prawn seed production. Endocrine control of reproduction in the penaeid shrimp _P_. monodon has been investigated in detail by adopting a comprehensive approach to the problem. The major aspects of the study included in depth investigations of the cytological details of the reproductive and neuroendocrine organs in correlation with the process of gonadal maturation. Based on the conclusions drawn from such ultrastructural studies various endocrine manipulations were carried out to see their effects on gonadal maturation. Besides that studies on the reproductive quality of male P_. monodon and the cryopreservation of spermatophores form a part of the present investigation. The shrimp 3; Inonodon used in the present study were collected from the offshore waters of Cochin, Madras and Mandapam and from the culture ponds of Vypeen Island near Cochin (Kerala) . The entire investigation on the cytological aspects were carried out using standard histological and electron-microscopic methods. Endocrine manipulations and cryopreservation studies is also carried out using the standard methods.

Studies on the reproductive endocrinology of the penaeid prawn, Penaeus indicus H. Milne Edward

The present investigation has been carried out to understand the process and events leading to maturation of the ovary and testis in the Indian white prawn Penaeus indicus. The study includes the classification of the ovarian maturity stages based on its colour, gonadosomatic index, oocyte diameter and morphological changes in the oocyte. Further the process of oogenesis has been investigated using light and electron microscopic techniques. A histochemical study of the ovary has also been carried out to determine the sequence in which yolk substances are synthesized or sequestered in the oocytes and also to elicit the nature of the penaeid yolk material. The process of spermatogenesis and the development of the spermatophore has been studied in detail using light and electron microscopic methods. In addition a brief histochemical study on the testis was also made to understand the nature of the organic reserves in the sperm cells.

Physiology and endocrinology symposium: Influence of cattle genotype (Bos indicus vs. Bos taurus) on oocyte and preimplantation embryo resistance to increased temperature

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

[New insights into diagnosis and management of gestational diabetes mellitus: recommendations of the Swiss Society for Endocrinology and Diabetes]

Physiology and current knowledge about gestational diabetes which led to the adoption of new diagnostic criterias and blood glucose target levels during pregnancy by the Swiss Society for Endocrinology and Diabetes are reviewed. The 6th International Workshop Conference on Gestational Diabetes mellitus in Pasedena (2008) defined new diagnostic criteria based on the results of the HAPO-Trial. These criteria were during the ADA congress in New Orleans in 2009 presented. According to the new criteria there is no need for screening, but all pregnant women have to be tested with a 75 g oral glucose tolerance test between the 24th and 28th week of pregnancy. The new diagnostic values are very similar to the ones previously adopted by the ADA with the exception that only one out of three values has to be elevated in order to make the diagnosis of gestational diabetes. Due to this important difference it is very likely that gestational diabetes will be diagnosed more frequently in the future. The diagnostic criteria are: Fasting plasma glucose > or = 5.1 mmol/l, 1-hour value > or = 10.0 mmol/l or 2-hour value > or = 8.5 mmol/l. Based on current knowledge and randomized trials it is much more difficult to define glucose target levels during pregnancy. This difficulty has led to many different recommendations issued by diabetes societies. The Swiss Society of Endocrinology and Diabetes follows the arguments of the International Diabetes Federation (IDF) that self-blood glucose monitoring itself lacks precision and that there are very few randomized trials. Therefore, the target levels have to be easy to remember and might be slightly different in mmol/l or mg/dl. The Swiss Society for Endocrinology and Diabetes adopts the tentative target values of the IDF with fasting plasma glucose values < 5.3 mM and 1- and 2-hour postprandial (after the end of the meal) values of < 8.0 and 7.0 mmol/l, respectively. The last part of these recommendations deals with the therapeutic options during pregnancy (nutrition, physical exercise and pharmaceutical treatment). If despite lifestyle changes the target values are not met, approximately 25 % of patients have to be treated pharmaceutically. Insulin therapy is still the preferred treatment option, but metformin (and as an exception glibenclamide) can be used, if there are major hurdles for the initiation of insulin therapy.

Recent advances in endocrinology.

Previous editions by A. T. Cameron.

Current cancer research on breast cancer : etiology, endocrinology and related biology.

Includes index.