EndoDirect - Endocrinologia e Metabologia

Neste FD vamos abordar brevemente desde a epidemiologia do carcinoma adrenocortical até o diagnóstico e tratamento.

Acesse: endodirect.com.br

Referencias usadas:

Fassnacht M, Dekkers OM, Else T, Baudin E, Berruti A, de Krijger R, et al. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2018

Fassnacht M, Assie G, Baudin E, Eisenhofer G, de la Fouchardiere C, Haak HR, et al. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020

Fassnacht M, Puglisi S, Kimpel O, Terzolo M. Adrenocortical carcinoma: a practical guide for clinicians. Lancet Diabetes Endocrinol. 2025

Neste FD vamos discutir sobre a falha de resposta ao tratamento da obesidade e diabetes com uso dos análogos do GLP-1: como definir, o que avaliar e o que fazer.

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Principais referencias:

American Diabetes Association Professional Practice Committee for Obesity. Pharmacologic treatment of obesity in adults: Standards of care in overweight and obesity. BMJ Open Diabetes Res Care. 2026

Kokkinos A, Thethi T, Lee CJ, Neff LM, Stefanski A, Cao D, et al. Tirzepatide efficacy and tolerability according to early weight response: a post hoc analysis of the SURMOUNT-1 and SURMOUNT-2 trials. Diabetes Obes Metab. 2026

Kuryłowicz A, Czupryniak L. Responders vs. non-responders or how to predict the response to GLP-1 or GLP-1/GIP receptor agonist therapy. Diabetes Obes Metab. 2026

Ko D, Kim DH, Tan FXN, Ho GJK, Chandra R, Xuan ZZ, et al. Suboptimal therapeutic responses associated with semaglutide in type 2 diabetes and obesity: a meta-analysis of randomized controlled trials. Cell Rep Med. 2026

Lu D, Li N, Yuan Z, Gao Y. Weight reduction heterogenicity and mediators of GLP-1RAs and dual agonists for individuals with obesity: a meta-analysis. Clin Obes. 2026

Billings LK, Winne L, Sharma P, Gomez-Valderas E, Chivukula KK, Kwan AYM. Comparison of dose escalation versus switching to tirzepatide among people with type 2 diabetes inadequately controlled on lower doses of dulaglutide: a randomized clinical trial. Ann Intern Med. 2025

Neste FD vamos falar sobre a aprovação da combinação icodeca com semaglutida no tratamento de pacientes diabéticos tipo 2 no Brasil.

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Referencias:

Mathieu C, Giorgino F, Kim SG, et al. Once-weekly IcoSema versus once-weekly insulin icodec in type 2 diabetes management (COMBINE 1): an open-label, multicentre, treat-to-target, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2025;13(7):568-79. doi:10.1016/S2213-8587(25)00096-8Lingvay I, Benamar M, Chen L, et al. Once-weekly IcoSema versus once-weekly semaglutide in adults with type 2 diabetes: the COMBINE 2 randomised clinical trial. Diabetologia. 2025;68(4):739-51. doi:10.1007/s00125-024-06348-5Billings LK, Andreozzi F, Frederiksen M, et al. Once-weekly IcoSema versus multiple daily insulin injections in type 2 diabetes management (COMBINE 3): an open-label, multicentre, treat-to-target, non-inferiority, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2025;13(7):556-67. doi:10.1016/S2213-8587(25)00052-XJi L, Benamar M, Mohan V, et al. Once-weekly IcoSema versus once-daily insulin glargine U100 in type 2 diabetes management (COMBINE 4): an open-label, multicentre, treat-to-target, randomised, phase 3b trial. Lancet Diabetes Endocrinol. 2026;14(10):831-40. doi:10.1016/S2213-8587(26)00136-1

Neste FD vamos discutir sobre a recente aprovãção da ANVISA da medicação palopegteriparatida no tratamento de pacientes com hipoparatireoidismo crônico.

Acesse: endodirect.com.br

Referencias

Khan AA et al. JBMR 2023;

Clarke BL et al. JCEM 2025;

Rejnmark L et al. JBMR 2026;

Khan AA et al. JCEM 2022

Khan AA et al. JBMR 2022

Neste FD vamos falar brevemente sobre a hiperferritinemia dismetabólica e a Síndrome de Sobrecarga de Ferro Dismetabólica.

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Referencias utilizadas:

TOFANO, R. J. et al. Association of metabolic syndrome and hyperferritinemia in patients at cardiovascular risk.Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, [s. l.], v. 13, p. 3239-3248, 2020

LAINÉ, F. et al. Metabolic and hepatic effects of bloodletting in dysmetabolic iron overload syndrome: a randomized controlled study in 274 patients. Hepatology, Baltimore, v. 65, n. 2, p. 465-474, 2017. DEUGNIER, Y.; BARDOU-JACQUET, É.; LAINÉ, F. Dysmetabolic iron overload syndrome (DIOS). Presse Médicale, Paris, v. 46, n. 12, pt. 2, p. e306-e311,2017.

Neste FD abordamos resumidamente os principais pontos do guideline de tratamento do diabetes tipo 2 da Sociedade Brasileira de Diabetes atualizado em agosto de 2026.

Siga @endodirect

Acesse: endodirect.com.br

Neste FD vamos falar sobre a mudança do nome de Síndrome dos Ovários Policísticos para Síndrome Ovariana Metabólica Poliendócrina, sobre o histórico de classificação e sobre os fenótipos da doença.

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Referencias:

Teede HJ, Bahri Khomami M, Morman R, Laven JSE, Joham AE, Costello MF, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026

Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023Daan NMP, Louwers YV, Koster MPH, Eijkemans MJC, de Rijke YB, Lentjes EWG, et al. Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk? Fertil Steril. 2014

Neste FD vamos abordar um tema muito frequente na prática clínica: fadiga associada aos análogos do GLP-1.

Acesse a plataforma mais completa de endocrinologia: endodirect.com.br

Referencias usadas:

Nong K, Shi Q, Xie X, Wang Y, Agarwal A, Guyatt GH, et al. Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis. BMJ. 2026;394:e372161. doi:10.1136/bmj-2026-372161Nie Y, Zhang Y, Liu B, Meng H. Glucagon-like peptide-1 receptor agonists for the treatment of suboptimal initial clinical response and weight gain recurrence after bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2025;35(3):808-22. doi:10.1007/s11695-025-07733-8Mohamad AA. A case report of semaglutide induced sarcopenia: causes of fatigue in older adults. Korean J Fam Med. 2025;46(4):288-91. doi:10.4082/kjfm.25.0008Eldor R, Avraham N, Rosenberg O, Shpigelman M, Golan-Cohen A, Cukierman-Yaffe T, et al. Gradual titration of semaglutide results in better treatment adherence and fewer adverse events: a randomized controlled open-label pilot study. Diabetes Care. 2025;48(9):1607-11. doi:10.2337/dc25-0690

Acesse a plataforma mais completa de endocrinologia: endodirect.com.br

Referências do episódio:Ebeling PR, Nguyen HH, Aleksova J, Vincent AJ, Wong P, Milat F. Secondary Osteoporosis. Endocr Rev. 2022Mäkitie O, Zillikens MC. Early-Onset Osteoporosis. CalcifTissue Int. 2022Mancini M, Chapurlat R, Isidor B, et al. Early-OnsetOsteoporosis: Molecular Analysis in Large Cohort and Focus on the PLS3 Gene. Calcif Tissue Int. 2024Vaucher M, Gonzalez Rodriguez E, Efthymiou A, Sagez J. Mastocytose systémique et impact osseux. Rev Med Suisse

Neste FD discutimos um algoritmo diagnóstico de investigação de pacientes com osteomalacia hipofosfatemica.

Acesse: endodirect.com.br

Referencias: Jan de Beur SM, Minisola S, Xia WB, et al. Global guidance for the recognition, diagnosis, and management of tumor-induced osteomalacia. J Intern Med. Florenzano P, Cipriani C, Roszko KL, et al. Approach to patients with hypophosphataemia. Lancet Diabetes Endocrinol. 2020;8(2):163-174Haffner D, Emma F, Seefried L, et al. Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia. Nat Rev Nephrol. 2025;21(5):330-354Trombetti A, Al-Daghri N, Brandi ML, et al. Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia. Nat Rev Endocrinol. 2022;18(6):366-384