No abstract

No abstract

Age modifies the pituitary set point or response to comparably reduced free T4 concentrations, resulting in lesser serum TSH elevation in older individuals. This phenomenon occurs with both spontaneous and iatrogenic hypothyroidism. This may be an adaptive response in normal aging or a pathological alteration of pituitary function with age.

Both days 3 and 5 TSH concentrations were higher in older individuals after rhTSH administration. This finding did not appear to be related to body weight, body mass index, or glomerular filtration rate in a simple manner. The TSH concentration achieved may be a result of complex interactions between distribution within fat and muscle body compartments, hepatic function, and renal function. Prospective studies could examine whether the magnitude of the TSH elevation after rhTSH administration affects diagnostic or therapeutic efficacy.

No abstract

The incretin hormone glucagon-like peptide-1 agonists and dipeptidyl peptidase-4 inhibitors fill an unaddressed therapeutic gap in the treatment of type 2 diabetes mellitus (T2DM) by potentiating insulin secretion in pancreatic beta cells, suppressing glucagon secretion, delaying gastric emptying, and reducing appetite. The incretin therapies, alone or in combination with metformin and/or thiazolidinediones, yield improved glycemic control without risk of hypoglycemia and the potential for weight neutrality or even weight loss. New incretin-based approaches offer promising new strategies for treating T2DM by recruiting new, physiologically based mechanisms of action for glucoregulation in the context of a favorable safety profile.