Series of Endocrinology, Diabetes and Metabolism

Volume 5, Issue 2 | JSEDM

Review Article

Gestational Diabetes Diet: Alternative Approaches

Yılmaz E and Öztürk Altuncevahir I*

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Yılmaz E, Öztürk Altuncevahir I. Gestational diabetes diet: alternative approaches. Series Endo Diab Met. 2023;5(2):92-99.
Obesity and type 2 diabetes, which is rapidly increasing prevalence worldwide, are the most common subunits and potential risk factors for gestational diabetes mellitus (GDM). The diet plan is very important in the treatment of diabetes, but it has more importance during pregnancy due to fetal and maternal outcomes. Those patients who suffer from GDM need to have a well-planned diet plan and consultations with a dietitian to learn how to feed themselves during this period. This review emphasizes the effects of diet types on GDM. Most suggested diet types are low glycemic index (GI), low carbohydrate intake, calorie-restricted diet, and Mediterranean diet (MD). They all have specific, individualized points to apply and are effective in GDM treatment. Lastly, when a healthy diet plan and well-done consultation are mixed, the patient will start a new life with a healthy body and baby. The most important macronutrient in diabetes, carbohydrates, was clearly described in the study. The study aimed to investigate the beneficial diet types for GDM.
Article DOI: 10.54178/jsedmv5i2005
Review Article

The Impact of Diabetes Type 2 Treatment Interventions on Cardiovascular Outcomes – A Comprehensive Review

Al Qarni A, AlSubaiee M, Alshaikh Husain M, Alkhazmari G, AlQahtani A, Aldossary I, Gado W, Albahrani Z, AlMukhaylid S, Alarfaj A, Almekhloof S, Alarfaj M, AlTaweel M* and AlMusaad A

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Al Qarni A, AlSubaiee M, Alshaikh Husain M, et al. The impact of diabetes type 2 treatment interventions on cardiovascular outcomes - a comprehensive review. Series Endo Diab Met. 2023;5(2):68-91.
Background: Type 2 diabetes mellitus (T2DM) is a chronic disease with significant cardiovascular (CV) implications. The management of diabetes plays a crucial role in reducing the risk of cardiovascular disease (CVD) and improving patient outcomes. This review examines the impact of various therapeutic strategies and their relevance to specific demographic groups, particularly the elderly and those with chronic kidney disease (CKD). Methods: A comprehensive literature review was conducted focusing on randomized controlled trials (RCTs), meta-analyses, systematic reviews, and large observational studies from PubMed, Cochrane Library, and Google Scholar. Results: Metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors consistently reduced CV mortality by 20–38% compared to other treatments. Incretin-based therapies like liraglutide and semaglutide reduced major adverse cardiovascular events (MACE) by 13–26%. Lifestyle interventions lowered CV risk when combined with medications. SGLT2 inhibitors conferred renal and CV protection in patients with CKD. Bariatric surgery (BS) has been associated with significant improvements in CV outcomes. Conclusion: Metformin, SGLT2 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), BS, and lifestyle modification conferred CV benefits. Management of type 2 diabetes with a view to reducing CV risk requires an individualized approach, taking into account patient characteristics, comorbidities, and the CV risk profiles of various treatment options.
Article DOI: 10.54178/jsedmv5i2004
Review Article

TRT – The Best Treatment for Balancing Testosterone in Middle Aged Men

K Suresh*

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K Suresh. TRT - the best treatment for balancing testosterone in middle aged men. Series Endo Diab Met. 2023;5(2):56-67.
Balance is critical to many aspects of life. Work-life balance ensures that we have time to enjoy the fruits of our labor. Hormones control bodily processes like - metabolism, homeostasis, growth and development, sexual function, reproduction, sleep-wake cycle, and mood. Most men see a gradual and progressive decline of testosterone, the primary male sex hormone, starting around age 30, at a rate of 1–2% per year, though in some men, the decline is faster than the body can adequately compensate. In these cases, the fallout can be felt throughout the body with symptoms that are both disruptive and inconvenient. It is produced in the testicles and the adrenal glands but regulated by the hypothalamic-pituitary-gonadal (HPG) axis, a feedback system that responds to circulating hormone levels. Hormonal imbalance in men closely parallels the aging process. The most effective way of balancing male hormones is using testosterone replacement therapy (TRT). Generally, a value < 300 ng/dL is considered low, leading to a condition called hypogonadism. While one-third of Indian men above 40 years of age suffer from hypogonadism, the proportion of them as appropriate candidates for testosterone therapy (TTh) is not clear, not only in India but also in most countries. TTh helps reverse the effects of hypogonadism, but it's unclear if it would benefit otherwise healthy older men. Primary care physicians encounter clinical conditions of hormonal imbalances in males, such as precocious puberty, delayed puberty, and hypogonadism, in general practice, needing specialists’ consultation and guidance for their management. Quoting half a dozen case reports of hormonal imbalance and their management, this article provides the evidence to prescribe or not to prescribe hormones for men. Materials and Methods: Sample cases of precocious puberty, delayed puberty, male hypogonadism (MH) (general, diabetic, and intracranial hypertension), and a case of complication of TTh cases in adults and how they were diagnosed and managed. Literature review for current evidence for TTh in men globally and in Indian practices.
Article DOI: 10.54178/jsedmv5i2003
Review Article

The Conundrum of Obesity and Heart Failure

AlTaweel M*, Husain MA, AlQahtani A and Al Qarni A

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AlTaweel M, Husain MA, AlQahtani A, et al. The conundrum of obesity and heart failure. Series Endo Diab Met. 2023;5(2):40-55.
Obesity is a significant global health concern; the prevalence continues to rise in developing and developed countries. According to World Health Organization (WHO) data, 39% of the world population over the age of 18 is overweight, including 13% being obese. Numerous studies have identified an association between obesity and cardiovascular diseases (CVD), including heart failure (HF). Obesity is additionally related to an increase in the occurrence of cardiovascular (CV) disorders, including hypertension (HTN), diabetes mellitus (DM), dyslipidemias, and sleep apnea syndrome. This review investigates the various mechanisms and pathogenesis of obesity-related HF and the obesity paradox phenomena, aiming to shed light on futuristic directive approaches in treating HF-related obesity.
Article DOI: 10.54178/jsedmv5i2002
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