Showing 1-20 of 54 for: Essential Evidence Topics > Endocrine and nutrition 
- Acromegaly
Essential Evidence Topics, 27-Jul-2021
Overall Bottom Line: Acromegaly carries significant risk of morbidity/mortality and a high index of suspicion should be maintained when considering biochemical screening. Serum IGF-1 level is the best initial biochemical test. If elevated (for age/sex),
- Adrenal insufficiency
Essential Evidence Topics, 13-Oct-2022
Overall Bottom Line: Suspect primary adrenal insufficiency (AI) in a patient with fatigue, hypotension, and hyperpigmentation accompanied by hyponatremia and hyperkalemia. Also suspect primary adrenal insufficiency in any critically ill patient. Seconda
- Anorexia, bulimia, and eating disorders
Essential Evidence Topics, 14-Jan-2020
Overall Bottom Line: Consider eating disorders among young women with low body mass index (BMI); patients who express concern about weight but are not overweight; women with menstrual disturbances or amenorrhea; patients with GI symptoms, physical signs o
- Barrett's esophagus
Essential Evidence Topics, 24-Jun-2022
Overall Bottom Line: Screening for Barrett's esophagus (BE) in the general population is not recommended; it is not addressed by the USPSTF. Screening for BE in high risk populations may be beneficial but clinical trials are lacking. Diagnosis is made
- Carcinoid tumors
Essential Evidence Topics, 7-Oct-2020
Overall Bottom Line: Carcinoid tumors are rare neuroendocrine tumors with an indolent course whose embryologic origins reflect their primary occurrence in the gut. Initial symptoms may include bowel dysmotility syndromes, valvular cardiac disease, and r
- Cushing's syndrome
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: Suspect Cushing's Syndrome (CS) in patients with a constellation of symptoms including central obesity, rounded face ("moon facies"), facial plethora, decreased libido, purple striae, menstrual disturbances, hirsutism, erectile dysfun
- Diabetes insipidus
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: Diabetes insipidus (DI) is characterized by the excretion of large volumes of hypotonic (dilute) urine. DI may result from damage to the hypothalamus or posterior pituitary (central DI) or from resistance to the action of arginine v
- Diabetes mellitus (diabetic ketoacidosis)
Essential Evidence Topics, 22-Nov-2021
Overall Bottom Line: The severity of ketoacidosis is primarily based on the patient's pH level, bicarbonate level, and mental status; not on blood sugar. Regular insulin by continuous intravenous infusion is the preferred treatment for moderate to sever
- Diabetes mellitus (hyperosmolar coma)
Essential Evidence Topics, 19-Apr-2021
Overall Bottom Line: Diagnosis is made with a combination of marked elevation of blood glucose (greater than 600 mg/dL) and elevation in serum osmolarity (greater than 320 mOsm/L) with little or no ketosis. Patients may complain of weakness, visual dist
- Diabetes mellitus (type 1)
Essential Evidence Topics, 13-Mar-2020
Overall Bottom Line: For most, type 1 diabetes mellitus (T1DM) presents abruptly over several days to weeks with the classic triad of polyuria, polydipsia, and weight loss. Under 2 years of age, however, the presentation is more likely to be atypical and
- Diabetes mellitus (type 2)
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: Diabetes mellitus type 2 is common and has a significant public health cost associated with it. Lifestyle and behavior modifications together are effective in preventing or delaying type 2 diabetes in patients with impaired glucose to
- Diabetic nephropathy
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: While guidelines recommend that patients with type 1 DM (T1DM) for >5 years and all patients with type 2 DM (T2DM) be screened annually for microalbuminuria and with a glomerular filtration rate (GFR) estimate, evidence that this r
- Diabetic neuropathy
Essential Evidence Topics, 13-Jan-2023
Overall Bottom Line: Diabetic peripheral neuropathy (DPN) is an important risk factor for gait disturbance, falls, foot ulcers, infection, and subsequent amputations. Control glucose to prevent the development of DPN. Patients with diabetes should be
- Diabetic retinopathy
Essential Evidence Topics, 26-Dec-2022
Overall Bottom Line: Type 1 diabetes: dilated, comprehensive eye examination by an ophthalmologist or optometrist within 3 to 5 years of onset of diabetes followed by annual eye examinations. Type 2 diabetes: dilated, comprehensive eye examination by an
- Diabetic skin ulcer
Essential Evidence Topics, 5-Jul-2021
Overall Bottom Line: Annual screening foot examination by a trained professional and daily self-foot examination is recommended for all patients with diabetes. Proper wound care is paramount to prevention. Infected ulcers require either oral or system
- Goiter
Essential Evidence Topics, 23-Sep-2021
Overall Bottom Line: Iodine deficiency remains the most common preventable cause of nontoxic multinodular goiter and adequate iodine intake is effective in decreasing its incidence. Clinical assessment and measurement of thyroid-stimulating hormone (TSH
- Growth hormone deficiency
Essential Evidence Topics, 17-Jun-2021
Overall Bottom Line: Consider growth hormone deficiency (GHD) in adults who have a history of hypothalamic/pituitary disease, intracranial surgery, or irradiation, and in children who are more than 2 standard deviations (SDs) below average height for age.
- Gynecomastia
Essential Evidence Topics, 19-Oct-2020
Overall Bottom Line: Gynecomastia can be physiologic or pathological. Pathological gynecomastia has to be differentiated from physiological gynecomastia, which is very common among adolesent boys during puberty with the majority resolving within 1-3 years
- Hyperaldosteronism (primary)
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: Evaluate for primary aldosteronism (PA) in patients with hypertension associated with adrenal incidentaloma, spontaneous or diuretic induced hypokalemia, drug resistant hypertension (three or more drugs required for control), hyperten
- Hyperalimentation and nutritional supplementation
Essential Evidence Topics, 23-Apr-2022
BOTTOM LINE: Malnutrition may cause impaired immune response, wound healing, muscle strength (including respiratory), thermoregulation, psychosocial functioning. Candidates for nutrition support include critically ill patients who will not be fed for ov
