EndoDirect - Endocrinologia e Metabologia

Neste FD discutimos as orientações das diretrizes clínicas sobre meta pressórica no diabético assim como os mais recentes estudos OPTIMAL DIABETES e BPROAD.Acesse: endodirect.com.brSiga: @endodirectReferencias usadas: Santo K, et al. OPTIMAL-DIABETES. N Engl J Med. 2026.Bi Y, et al. BPROAD. N Engl J Med. 2025;392:1155-67.Liu J, et al. ESPRIT. Lancet. 2024;404:245-55.ACCORD Study Group. ACCORD BP. N Engl J Med. 2010;362:1575-85.SPRINT Research Group. SPRINT. N Engl J Med. 2015;373:2103-16.American Diabetes Association. Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S216-45.ADA/EASD. Management of type 2 diabetes, 2026. Diabetologia. 2026.AHA/ACC. Guideline for High Blood Pressure in Adults. 2025.McEvoy JW, et al. ESC Guidelines for elevated blood pressure and hypertension. Eur Heart J. 2024;45:3912-4018.KDIGO. Blood Pressure in CKD Guideline. Kidney Int. 2021;99(3S):S1-87.Sociedade Brasileira de Diabetes. Manejo da hipertensão arterial no diabetes. Diretriz SBD.SBC/SBH/SBN. Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2025.

Neste FD resumimos o estudo TRANSCEND T2D2 (Retatrutida versus semaglutida no tratamento do diabetes tipo 2), cujos resultados foram recentemente publicados em comunicado à imprensa. Siga @endodirect e acesse: endodirect.com.br

Neste FD discutimos sobre o uso da metformina no tratamento do diabetes tipo 2, as recomendações das atuais diretrizes de tratamento (SBD, ADA/EASD) e o mais recente estudo - SMARTEST trial. Siga @endodirect e acesse: endodirect.com.brReferencias:Davies MJ, et al. Management of Type 2 Diabetes, 2026: A Consensus Report by ADA/EASD. Diabetes Care. 2026. DOI: 10.2337/dci26-0141.Sociedade Brasileira de Diabetes. Manejo do Diabetes Mellitus Tipo 2. Diretriz SBD 2026. DOI: 10.29327/5881296.2026-2.Eriksson JW, et al. SGLT2 inhibitor or metformin as standard treatment in early-stage type 2 diabetes? Baseline data in SMARTEST. Diabetes Obes Metab. 2026;28:1327–1338. DOI: 10.1111/dom.70320.

Neste FD vamos discutir sobre um tema frequente na prática clínica hospitalar: quando a glicemia capilar vem falsamente baixa, também conhecido como hipoglicemia artefatual.Acesse: endodirect.com.br e siga @endodirectReferencias:Cryer et al., J Clin Endocrinol Metab 2009Sacks et al., Clin Chem 2023Gambino et al., Clin Chem 2009Tarasova et al., Diabetes Care 2014El Khoury et al., Endocr Pract 2008Amaral et al., Front Endocrinol 2022Nishioka et al., Front Endocrinol 2025Wang et al., CMAJ 2021Rebel et al., J Diabetes Sci Technol 2012Hlupeni et al., AACE Endocrinol Diabetes 2025Lobo, J Diabetes Sci Technol 2026

Neste FD vamos abordar brevemente desde a epidemiologia do carcinoma adrenocortical até o diagnóstico e tratamento. Acesse: endodirect.com.brReferencias 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. 2018Fassnacht 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. 2020Fassnacht 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.Acesse endodirect.com.br e siga @endodirectPrincipais 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. 2026Kokkinos 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. 2026Kuryłowicz 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. 2026Ko 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. 2026Lu 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. 2026Billings 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. Siga @endodirect e acesse: endodirect.com.brReferencias: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.brReferenciasKhan AA et al. JBMR 2023;Clarke BL et al. JCEM 2025;Rejnmark L et al. JBMR 2026;Khan AA et al. JCEM 2022Khan AA et al. JBMR 2022

Neste FD vamos falar brevemente sobre a hiperferritinemia dismetabólica e a Síndrome de Sobrecarga de Ferro Dismetabólica. Siga: @endodirect e acesse: endodirect.com.brReferencias 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, 2020LAINÉ, 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 @endodirectAcesse: endodirect.com.br