The Endocrine Club

The committee agreed that even people witha relatively lower cardiovascular risk should be offered an SGLT-2 inhibitor and metformin, because it is important to reduce this risk, including for those without comorbidities or other CV risk factors

NICE 2026

The 2025 ATA Guidelines revised TSH target in DTC
Initial Post-Operative TSH Targets

High-Risk : TSH < 0.1
Intermediate-Risk: TSH between 0.1- 0.5
Low-Risk : TSH 0.5- 2.0

Under physiological circumstances, insulin most likely acts as a co-gonadotropin to increase LH-induced androgen synthesis in theca cells as well as to enhance FSH-induced estrogen production and LH-induced luteinization in granulosa cells . Insulin can also enhance GnRH-mediated LH and FSH release ). Furthermore, female mice with hyperinsulinemia secondary to diet-induced obesity have increased basal and GnRH-stimulated LH release

Endocr Rev. 2012 Oct 12;33(6)

25 years old female 100 kg with PMOS diagnosed hypothyroidism
What is the starting L thyroxin dose

Indapamide is preference to a conventional thiazide diuretic such as bendroflumethiazide or hydrochlorothiazide

NICE 2026

The committee noted that standard-release metformin can be preferable for people with difficulty swallowing because it can be crushed while modified-release cannot. This may be more useful for some people with dementia and dysphagia .

NICE2026

Based on ACEL-UK study consider treatment of subclinical Hypothyroidism in elderly if 50-70 years willing to monitor closely wit high CV risk profile and withhold treatment if high fragility older than 80 years with history of osteoporosis

Indapamide is preferred over traditional thiazide diuretics by NICE 2026
1. Greater Antihypertensive Potency Roush et al., 2015).
2. Direct Vasodilatory Action (Circelli et al., 2012)
3. prolonged half-life (approximately 14 to 18 hours) ,(Circelli et al., 2012; Patel).
4- Does not adversely affect fasting plasma glucose or HbA1c (P Weidmann 2001)

Just a moment...

The BPROAD trial (Bi et al., 2024) demonstrated that targeting an SBP

For adults with hypertension aged 80 and over, reduce clinic blood pressure to below 150/90 mmHg and ensure that it is maintained below that level. Use clinical judgement for people with frailty or multimorbidity

NICE 2026