Internal Medicine

The European Society of Endocrinology and the Endocrine Society have issued joint guidelines for managing glucocorticoid-induced adrenal insufficiency. Key recommendations include:

• No tapering is needed if steroid therapy is <3–4 weeks regardless of the dose.

• For therapy >3–4 weeks, tapering is advised to minimize withdrawal symptoms and aid hypothalamic-pituitary-adrenal recovery.

• For doses >40 mg prednisone equivalent, reduce by 5–10 mg weekly.

• For doses <40 mg, reduce by 2.5 mg every 1–4 weeks for 10–20 mg daily doses, and by 1 mg every 1–4 weeks for <10 mg daily doses.

A nice summary of appetite stimulant therapies in patients with Cachexia

@Everyone In a network meta-analysis of 76 randomized trials, including 39,000 adults with type 2 diabetes and spanning at least 12 weeks, researchers evaluated the efficacy and safety of six U.S. FDA-approved glucagon-like peptide-1 (GLP-1) receptor agonists, three of which are also approved for obesity and overweight management. The findings revealed:

- Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, emerged as the most effective approved agent for managing both diabetes and obesity. Compared to placebo, tirzepatide showed significant mean reductions of -2.1% in glycosylated hemoglobin (HbA1c), -56 mg/dL in fasting blood glucose, and -8.5 kg in body weight.

- Semaglutide ranked as the second most effective for these indications, with mean differences of -1.4% in HbA1c, -36 mg/dL in fasting blood glucose, and -3.1 kg in body weight when compared to placebo.

- The combination of semaglutide and the amylin analog cagrilintide, still under investigation, was…

https://knowablemagazine.org/content/article/health-disease/2024/cholesterol-and-heart-disease-explained @Everyone