ITE 2026 Live (2026003HG)-ITE 2026 Live: Diabetes, Lipids and Obesity, Thyroid

Video Transcription

Video Summary

The session reviewed high-yield endocrinology questions in diabetes, lipids/obesity, and thyroid disorders.<br /><br />In diabetes, key teaching points included recognizing prediabetes on oral glucose tolerance testing and recommending weight loss and exercise rather than diabetes treatment. Another case highlighted when to suspect monogenic diabetes (MODY), especially with strong autosomal dominant family history, preserved C-peptide, normal BMI, and lack of autoimmune markers; HNF4A MODY was the correct diagnosis in a patient with neonatal hypoglycemia and macrosomia. Exercise-related glucose management in type 1 diabetes was discussed, emphasizing that post-exercise hyperglycemia may improve with a low-intensity cool-down rather than a correction bolus. Another case showed that in a patient with erratic glucose control and high variability, diabetes education and nutrition counseling are the best next step. Finally, for type 1 diabetes with gastroparesis and post-meal hypoglycemia, switching rapid-acting lispro to regular insulin better matches delayed carbohydrate absorption.<br /><br />In lipids and obesity, the panel reviewed dysbetalipoproteinemia (apoE2 homozygosity) as the cause of elevated LDL and triglycerides with palmar xanthomas. Post-bariatric surgery patients were emphasized as needing monitoring for micronutrient deficiencies, especially iron deficiency. A patient with minimal response to tirzepatide despite maximal dosing was discussed as an example of heterogeneous response to anti-obesity medications.<br /><br />In thyroid, the speakers reviewed management of benign thyroid nodules with two negative FNAs, noting that continued symptom monitoring is appropriate. Pregnancy-related thyroid testing was interpreted using pregnancy-adjusted ranges, and subclinical hyperthyroidism from Graves’ disease was managed conservatively with repeat labs. Lastly, for a Bethesda III thyroid nodule with NRAS mutation, hemithyroidectomy was recommended over total thyroidectomy.

Keywords

prediabetes

MODY

HNF4A

type 1 diabetes

gastroparesis

dysbetalipoproteinemia

bariatric surgery

tirzepatide

thyroid nodule

Graves disease


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