Nutritional therapy constitutes the basis for the integrated treatment of diabetes.It is essential for diabetic dietary management to be an individualized and balanced diet pattern based on total calorie control Carbohydrates is the main dietary ingredient to affect postprandial blood glucose levels.Dietary structure,way of eating,and physical exercise all contribute to the control of postprandial blood glucose levels.

To summarize the clinical data of two cases with severe hyponatremia diagnosed as adrenal insuffiency combined with syndrome of inappropriate secret on of antidiuretic hormone(SIADH),and to review related literatures.Case 1 diagnosed as Addison's disease for 27 years and developed severe hyponatremia again but did not response well to sufficient glucocorticoid.Further examination showed SIADH caused by lung cancer and tolvaptan worked well.Case 2 was diagnosed as SIADH caused by lung cancer and responsed well to tolvaptan.However,hyponatremia reoccurred with the decreasing level of ACTH and cortisol during the chemotherapy.It was thought that hyponatremia was caused by drug-related adrenal insuffiency and glucocorticoid replacement therapy achieved good response.Both primary/secondary adrenal insuffiency and SIADH can lead to severe hyponatremia,but it is rare that the two situations exist in one patient and occur in different time.We should consider the possibility of the situations when we make differential diagnosis of refractory hyponatremia,monitoring the curative effects carefully,then correct the diagnosis timely,and reduce missed diagnosis and misdiagnosis.

Thyroid hormone insensitivity syndrome is an inherited syndrome characterized by high serum concentrations of thyroid hormone,accompanied by normal or slightly high serum TSH concentration due to the reduced responsiveness of target tissues to thyroid hormone.Thyroid hormone insensitivity syndromes are related to gene mutations of thyroid hormone receptors,thyroid hormone cell transport defect,and thyroid hormone metabolism defect.This article reviews the progress of pathogenesis,diagnosis,and therapeutics of thyroid hormone insensitivity syndrome.

In the view of physiology,sleep can be described as an important modulatory factor for hormone release,glucose regulation,and cardiovascular function.The circadian rhythms of hormones is mainly associated with sleep,which is largely mediated by neuroendocrine system.Sleep deprivation will disrupt this rhythm,leading to a series of metabolic diseases.We published an article in 《J Clin Endocrinol Metab》 titled Association between sleep duration,daytime nap duration,and osteoporosis varies by sex,menopause,and sleep quality,which suggested that sleep durations of 7-8 h/day,9-10 h/day,and ≥ 10 h/day,as well as longer daytime napping times,tend to present higher risks of having osteoporosis,and this tendency is especially obvious in postmenopausal women reporting good quality sleep.

Primary aldosteronism (PA) is a common form of secondary endocrine hypertension,which is characterized by hypertension,hypokelamia,myathenia,elevated serum aldosterone concentration and suppressed plasma renin activity.Besides,accumulating research evidences showed that parathyroid hormone (PTH) level was elevated in patients with primary aldosteronism,accompanied by secondary hyperparathyroidism.This review systemically introduces the interaction between aldosterone and PTH in PA patients.

The incidence and prevalence of type 1 diabetes in children and adolescents are increasing around the world,along with the suboptimal glucose control and higher incidence of long-term chronic complications during adulthood.Achieving good glycemic control and avoiding brain function damages induced by hypoglycemia are important when treating type 1 diabetes.Insulin lispro,a rapid-acting insulin used either alone or in combination with basal insulin analogue,can be effective,safety,and flexible.

MicroRNAs (miRNAs) are small endogenous non-coding RNA molecules.They regulate negatively the expression of target genes at post-transcriptional stages by means of affecting the stability of target mRNA or interfering with the transcriptional process.Recently,there is evidence demonstrating that miRNAs play important roles in the gene expressions of thyrotoxic heart diseases.Elevated levels of thyroid hormones profoundly influence the cardiovascular system through the renin-angiotensin system (RAS).As a principal active component of RAS,angiotensin Ⅱ receptor 1 (AT1 R) interacts with miRNAs in promoting or extenuating the progress of thyrotoxic heart disease.In this article,the roles of AT1R-associated miRNAs,miR-21,miR-155,miR-208a/b,and miR-499 in thyrotoxic heart disease were reviewed.

Premixed insulin is currently the most popular insulin starter in China.According to the different ratios of basal and prandial components,premixed insulin analogues could be classified into low-and midmixtures.The former is now mainly used as insulin starter in the patients with type 2 diabetes mellitus after the failure of monotherapy or combination with oral antidiabetic drugs,while the later is usually used as simplified intensive insulin treatment in patients with type 2 diabetes mellitus inadequately controlled on insulin once-or twice-daily.

Human sex glands (ovary and testis) play extremely important roles in reproductive function and sexual behavior by secreting various hormones.However,complex changes in the structure and the function of sex gland occur with ageing,resulting in a series of clinical consequences.This article explores these changes and discuss about their diagnosis and treatment.

To investigate the plasma thioredoxin-interacting protein ( TXNIP ) levels in different glucose tolerance groups and discuss the relationship between TXNIP and insulin resistance/β-cell dysfunction in diabetes and prediabetes, and to investigate the potential relationship between TXNIP and interleukin-1β( IL-1β) . According to oral glucose tolerance test, 93 participants were divided into 3 groups:diabetes mellitus group, prediabetes group, and normal glucose tolerance group. Plasma TXNIP, IL-1β, and other biochemical indices were measured. The relationship between TXNIP and glucose, IL-1β, homeostasis model assessment for insulin resistance ( HOMA-IR) , and homeostasis model assessment forβcell function ( HOMA-β) were analyzed by using multiple linear regression techniques and Pearson’s linear correlation analysis. Plasma TXNIP level was higher in prediabetes group compared with normal glucose tolerance group, but lower in prediabetes group compared with diabetes mellitus group[(355. 35±31. 88 vs 274. 36±33. 86, 426. 16±63. 15)pg/ml, P<0. 01 or P<0. 05]. TXNIP was positively correlated with IL-1βand HOMA-IR, but negatively correlated with HOMA-β. Multiple linear regression analysis indicated that IL-1βexerted significant influence on TXNIP ( P<0. 05 ). Plasma TXNIP level is affected by blood glucose concentration. There is a close relationship between TXNIP and IL-1β. In prediabetes patient, the TXNIP levels have already been raised.