Endocrinology

• Diabetes Mellitus
  • Inpatient Management
  • ACCORD: A1c target <6.0% increased CV and all-cause mortality vs standard (7.0-7.9%)
  • RABBIT-2: Basal-Bolus > SSI
  • FREEDOM: All-cause mortality is improved with CABG > PCI w/DES in T2DM
  • NICE-SUGAR: Intensive glucose control increased mortality in ICU patients
  • CREDENCE: Canagliflozin 100mg/d reduces risk of ESRD and death
• DKA
  • Management
• Hypothyroidism
  • Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association
  • Labs
    • TSH then Free Thyroxine (FT4)
      • TSH elevated: overt/subclinical
      • FT4 low: overt only
    • T3 recommended if any:
      • Evaluation of thyrotoxicosis
      • T3 Toxicosis: T3:T4 > 20
    • Assess severity of hyperthyroidism and response to therapy
    • Differentiate hyperthyroidism from destructive thyroidism
      • T3 if low
      • Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists
      • The significance of TSH values measured in a sensitive assay in the follow-up of hyperthyroid patients treated with radioiodine
• Hyperthyroidism
  • General