During the past year of 2011,International Diabetes Federation ( IDF),American Association of Clinical Endocrinologists ( AACE),Chinese Diabetes Society,and Chinese Society of Endocrinology,etc had published some guidelines and consensuses on clinical diagnosis,treatment,laboratory test,and complication therapy of diabetes.Characters of diabetic angiopathy in Chinese and death cause of diabetes were also announced by several new studies.Meanwhile,Food and Drug Administration ( FDA ) and The European Agency for the Evaluation of Medicinal Products(EMEA) declared their statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles on standard clinical diagnosis,treatment,and medication.

The effect of adrenomedullin (AM) on insulin sensitivity in normal Wistar rats was investigated by hyperinsulinemic-euglycemic clamp in combination with isotope dilution technique. The infusion rates of AM during the clamp were 0, 0.05, 0.2, 1 ?g?kg~(-1)?min~(-1), rspectively. The glucose disposal rate (GDR) and hepatic glucose output (HGO) were calculated by the plasma 3-~(3)H-glucose specific activity. After AM infusion, the insulin-mediated glucose disposal was reduced in a dose-dependant manner. It indicated that high dose of AM could induce a marked state of insulin resistance, which was mainly characterized by inhibition of the effect of insulin to stimulate peripheral glucose metabolism.

In the past 2013,American Diabetes Association (ADA),American Association of Clinical Endocrinologists(AACE),Chinese Society of Endocrinology,etc.published some guidelines and consensuses on topics such as clinical diagnnsis,treatment,integrated management,and the relationship between reducing body weight and complications.Characters of blood pressure control in diabetic patients were also announced by the Eighth Joint National Committee (JNC 8).Meanwhile,Food and Drug Administration (FDA) declared the statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles in standardizing clinical diagnosis,treatment,and medication.

The relationship between Sulfonylureas(SUs) and cardiovascular (CV) risks has attracted great attention.Previous studies have illustrated that some SUs increase CV risk in type 2 diabetes (T2DM) patients;while others do not.Clinical studies have found that the CV risks of different SUs may be different.Compared with other SUs;glimepiride and gliclazide may have lower CV risks.Here we reviewed evidence-based CV safety of SUs and the recent research progress.

This article reviews a recently d is covered new peptide-growth hormone-releasing peptide: ghrelin. Ghrelin is secr eted by various tissues of body, mainly by gastric tissue. Ghrelin regulates GH release from pituitary, participates in the regulation of energy metabolism, inh ibits the proliferation of tumor cells and influences the cardiovascular functio n and the release of other hormones. The study of ghrelin in many fields is prel iminary and needs further investigation.

Diabetes is characterized by glycemic disorders which play a key role in the risk for complications of diabetes.Glucose variability is an important parameter of glycometabolism.The study of none evidence-based medicine(EBM) has investigated the relationship among glycemic variability and vascular injury and the subsequent development of diabetes complications.Due to deficiency of large clinical interventional tests,this relationship lack the evidence of EBM.In conclusion,particular attention should be paid to glucose variability in our clinical work and meanwhile the EBM studies should also be conducted.

For different individuals with diabetes,blood glucose control varies.In the blood glucose controlling,blood glucose levels are sometimes higher than the target,sometimes the diabetic patients may develop hypoglycemia.In insulin therapy for blood glucose fluctuations,the most important thing is to avoid hypoglycemia.Finding out regular patterns of blood glucose fluctuations,then according to that,we need to choose the right insulin preparations to treat the condition.For the patients with irregular fluctuations of blood glucose,insulin pump therapy should be a proper choice.

[Summary] Thyroid nodules are the most common endocrine and metabolic diseases,and most of them are accidental nodules.How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment.In addition to detailed history collecting and physical examination,highresolution ultrasound,serum thyrotrophin levels,and fine needle aspiration biopsy (FNAB) form the basis for the diagnosis of thyroid nodules.Endocrinologists should grasp the indications of FNAB.When the pathological finding is unable to distinguish between benign and malignant nodules,molecular or genetic diagnosis should be adopted for further diagnosis.Appropriate treatment is selected according to the definitive results.In this article,we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery,so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment.

In type 2 diabetes mellitus,the levels of leptin were higher in female and obese subjects compared with male and non-obese subjects.There was negative relationship in female between leptin and HbA_1c,and negative relationship between leptin and HDL-C in male.Gender and obesity had no effect on TNF-? and NP Y.