Contact: Arlyn G. Riskind
Director, Media Relations
Phone: (301) 941-0240
Email: ariskind@endo-society.org

Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
Email: alohr@endo-society.org

1.   Exercise in Pregnancy Reduces Size of Offspring
2.   Considering Diabetes Treatment, Experts Say One Size Does Not Fit All
3.   New Patient Fact Sheet on Primary Hyperparathyroidism Available
4.  Media Registration Now Open for ENDO 2010: The 92nd Annual Meeting and Expo in San Diego, Calif.

1. Exercise in Pregnancy Reduces Size of Offspring

According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), regular moderate-intensity aerobic exercise led to a modest reduction in offspring birth weight without restricting the development of maternal insulin resistance.

There is a large body of evidence demonstrating the influence of the in utero environment on growth trajectory in postnatal life. Increased size at birth is associated with greater risk for the development of obesity in childhood. This study is the first to demonstrate a significant effect of non-weight bearing exercise (such as stationary cycling) on birth weight.

“Our findings show that regular aerobic exercise alters the maternal environment in some way that has an impact on nutrient stimulation of fetal growth, resulting in a reduction in offspring birth weight,” said Paul Hofman, MD, of the University of Auckland in New Zealand and co-author of the study. “Given that large birth size is associated with an increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk in later life.”

This study is also the first to evaluate changes in insulin sensitivity in response to aerobic exercise training during pregnancy. Maternal insulin resistance is essential in increasing nutrient availability to the fetus and has been correlated with birth size. Exercise has been shown to reduce insulin resistance but a major reduction in insulin resistance may adversely affect a pregnancy by severely restricting fetal nutrition. However, findings from this study suggest that regular exercise during pregnancy does not cause the same reduction in insulin resistance that occurs in exercising non-pregnant individuals.

“The physiological response to pregnancy appears to supersede the chronic improvements in insulin sensitivity previously described in response to exercise training in non-pregnant individuals,” said Hofman. “This may be an important finding for athletes who want to continue regular training during their pregnancy as it suggests that training will not have a major adverse impact on insulin resistance.”

In this randomized trial, researchers assigned 84 first-time mothers to either exercise or control groups. Participants in the exercise group utilized stationary cycling and were individually prescribed to a maximum of five sessions of 40 minutes of aerobic exercise per week. The exercise group was instructed to maintain the exercise program until at least 36 weeks gestation. Insulin sensitivity was assessed at 19 and 34-36 weeks gestation using an intravenous glucose tolerance test. Birth weight and BMI at birth were measured within 48 hours of birth.

Exercise training had no effect on maternal body weight or BMI during late pregnancy. Furthermore, exercise had no effect on insulin resistance from baseline to late gestation, and did not affect any other parameters of glucose regulation. Offspring of exercisers were on average 143 ± 94 grams lighter than their control counterparts, however there was no difference in birth length. Exercise training also resulted in lower offspring BMI.

Other researchers working on the study include: Sarah Hopkins, Wayne Cutfield and Lesley McCowan of The University of Auckland in New Zealand; and James Baldi of Northern Arizona University in Flagstaff, Ariz.

The article, “Exercise Training in Pregnancy Reduces Offspring Size without Changes in Maternal Insulin Sensitivity,” will appear in the May 2010 issue of JCEM.

2.  Considering Diabetes Treatment, Experts Say One Size Does Not Fit All

Expert Working Group Makes Recommendations Regarding Individualized Therapies for Patients with Type 2 Diabetes

Patients with type 2 diabetes are generally treated similarly despite the fact that they may have underlying differences that could affect their therapeutic response. Seeking to address this critical health issue, an international multidisciplinary group of experts just issued recommendations for individualized treatment in a consensus statement to be published in the April 2010 issue of the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). The group consisted of experts in diabetes epidemiology, physiology, genetics, clinical trials and clinical care.

Diabetes affects nearly 24 million people in the United States, and close to 250 million people worldwide. Treatment for diabetes is aimed at lowering glycemic levels to as close to the non-diabetic range as safely possible. However, only slightly more than half of patients diagnosed and treated for diabetes reach their glycemic targets leaving a substantial population exposed to prolonged periods of damaging hyperglycemia. Experts believe further insight into the differences between diabetes patients, both physiologic and genetic , should not only help elucidate the pathogenesis of type 2 diabetes, but lead to individualized treatments for patients that will improve glycemic control, maximize individual benefit, minimize risk, reduce diabetes complications, and ultimately provide reductions in global health cost.

“Recent advances in genetics such as the identification of the responsible genes for several forms of Maturity Onset Diabetes of the Young (MODY), now referred to as monogenic diabetes, have established precedents linking specific drug therapies to defined subtypes of diabetes patients,” said Robert Smith, MD, of Brown University in Providence, R.I. and co-author of the statement. “As more genetic factors related to type 2 diabetes are identified and as our understanding of the progression of the disease evolves, we can expect to gain precision in identifying the best drug choices for individual patients and to more effectively halt the progression of diabetes.”

“The progress already seen has stemmed from combining discoveries of specific genetic susceptibilities with clinical observations. As we move forward, we should continue to incorporate these and additional clinical observations with new data on the physiology and genetics of diabetes to assess which patients will benefit most from specific treatments,”  said Robert A. Vigersky, MD, president of The Endocrine Society. “The recommendations in this consensus statement highlight the need for the research community and industry to each play their part in improving our ability to individualize therapy so that patients can get the most accurate and appropriate treatment.”

The consensus statement includes a series of recommendations for increasing understanding of the heterogeneity of diabetes and achieving the goal of individualizing therapy and improving treatment response. Statement recommendations include:

• Extend analysis of existing data and data sources – There are already a plethora of data and data sources that could be potentially valuable in individualizing therapy; however, to date, these have been largely underutilized. Pooled analyses or meta-analyses of such data may provide important insights into the relative effectiveness of specific interventions in subgroups of patients with type 2 diabetes and advance our understanding of individualized therapy.
• Expand existing or develop new data registries – All new and existing diabetes registries should systematically collect data to address phenotypic and genetic heterogeneity measures. Not only should these registries collect material for future biomarker and genetic analysis, but registries should be designed to specifically address the heterogeneity of diabetes with hypotheses generated by examining existing data.
• Develop new clinical trials – Future randomized studies of diabetes therapies should, by design, collect phenotypic information relevant to response to therapy.
• Develop new technologies – Targeting therapy toward more appropriate subgroups of patients will require increasingly accurate and efficient methods to measure markers for diabetes heterogeneity and heterogeneous response to treatment. 
• Expand basic research – Basic research is needed to explore numerous fundamental issues that underlie the heterogeneous response to diabetes therapies.

Other researchers working on the consensus statement include David Nathan of Harvard Medical School in Boston, Mass.; Silva Arslanian of the University of Pittsburgh School of Medicine in Penn.; Leif Groop of Lund University in Malmo, Sweden; Robert Rizza of the Mayo Clinic in Rochester, Minn.; and Jerome Rotter of Cedars-Sinai Medical Center in Los Angeles, Calif.

The statement, “Individualizing Therapies in Type 2 Diabetes Mellitus Based on Patient Characteristics: What We Know and What We Need to Know,” will appear in the April 2010 issue of JCEM.

3. New Patient Fact Sheet on Primary Hyperparathyroidism Available

The Hormone Foundation has published a new bilingual (English/Spanish) patient fact sheet on primary hyperparathyroidism.  The fact sheet describes the role of parathyroid hormone in maintaining blood calcium levels, and the consequences of too much parathyroid hormone.  It explains the causes of primary hyperparathyroidism, its signs and symptoms, and diagnosis.  Surgical and non-surgical treatment options are also covered. The fact sheet is available online at: http://www.hormone.org/Other/upload/primary-hyperparathyroidiam-bilingual-030110.pdf. 

4. News Media Registration Now Open for ENDO 2010: The 92nd Annual Meeting & Expo in San Diego, Calif.

The 92nd Annual Meeting & Expo, taking place in San Diego, CA on June 19-22, 2010, is an unique opportunity for journalists to learn about the latest research in fields as diverse as obesity, endocrine disruptors, diabetes, growth hormones, sex steroids, thyroid cancer and much more. For public information officers, ENDO provides a worldwide stage to promote your institution's research to reporters through news releases and participation by your scientists in news conferences.

News Media Registration Information

Registering as media does not guarantee approval in receiving a press pass. The Endocrine Society will review the credentials of all reporters seeking to attend ENDO to ensure eligibility requirements are met. Media approved for attendance will receive official notification via email from Endocrine Society staff.

Reporter Eligibility

• Working press employed by bona fide news media: must present a press card, business card, or letter of introduction from an editor of a recognized publication.

• Freelance writers: must present a current members card from the American Medical Writers Association or the National Association of Science Writers; evidence of by-lined work pertaining to science, health, medicine, or biomedical research intended for the general public and published within the past two years; or a letter of assignment from a recognized publication.

• Public information officers of scientific societies, medical associations, educational institutions, and government agencies: must present a business card.

• Representatives of for-profit corporations and of the business side of news media must register onsite, pay the appropriate fees, and are not accredited as Press at the meeting.

• Researchers and clinicians who are also reporters and who are presenting at this meeting (oral or poster session) may receive news media credentials if they qualify (see above), but must also register for the meeting and pay the appropriate fee as a presenter.

To register as media for ENDO 2010, visit http://www.endo-society.org/endo2010/audience/media.cfm. Registered news media receive a badge that provides access to all meeting sessions, as well as to the Newsroom and press conferences. No one will be admitted without a valid ENDO badge.

 

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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.