Recent advances in endocrinology

Ally Prebtani, MD, is a professor of medicine at the Faculty of Health Sciences of McMaster University.

If you were to name the 3 most important recent advances in endocrinology that are relevant for everyday practice, what would they be?

Ally Prebtani, MD: That’s a wonderful question. I think there are many advances, but I would say the top 3 are: number 1 is the use of glucose-lowering medications for diabetes, which are also implicated in reducing cardiovascular outcomes and renal outcomes, specifically with the sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) analogues, which have been a paradigm shift in the way we treat diabetes. And even these agents have been used in patients without diabetes for improving outcomes such as death, and heart failure, and cardiovascular disease.

The second one I would say is with thyroid cancer. We’re using much less radioactive iodine in therapy for most low-risk or intermediate-risk cancers of the thyroid, which has been, again, another paradigm shift of the concept of "less is more" in thyroid cancer management.

Lastly, I would say that the third important advance is with the diagnosis and management of primary aldosteronism, which is often an underrecognized and common condition that patients aren’t aware of. We’re screening, and diagnosis for this condition can actually have changes in therapy, where they might have a surgical cure or even simple medical therapy might control their blood pressure much better than treating them as essential hypertensive patients. We’re just making sure we’re aware of this condition, and then screening for it, and then treating appropriately as we haven’t been doing in the past.