Advances in Obesity, Endocrinology, and Diabetes

In 1794, Johann Peter Frank coined the term “diabetes insipidus” to distinguish patients with this condition from those who had diabetes mellitus. A collaborative team of professionals from various international endocrinology and pediatric organizations is now recommending a change in nomenclature. They suggest that "diabetes insipidus" be replaced with “arginine vasopressin deficiency (AVP-D)” for cases of central origin, while proposing the term “arginine vasopressin resistance (AVP-R)” for nephrogenic cases (1)

Background: Cushing’s disease (CD), caused by an ACTH-secreting pituitary adenoma, remains one of the most challenging endocrine disorders to diagnose and treat. The coexistence of resistant hypertension, metabolic complications, and complex vascular anatomy such as “kissing carotids” further complicates management. Case Presentation: We report a 40-year-old man with long-standing hypertension referred for evaluation of resistant blood pressure. Physical examination revealed classical Cushingoid features. Endocrine testing confirmed ACTH-dependent Cushing’s syndrome. Pituitary MRI was limited by a rare vascular variant medialized internal carotid arteries (“kissing carotids”) which obscured visualization of the adenoma. The patient underwent endoscopic transsphenoidal surgery in a specialized neurosurgical center, confirming a corticotroph adenoma. Postoperatively, cortisol levels normalized, and metabolic and cardiovascular comorbidities markedly improved. Conclusion: This case highlights the diagnostic and therapeutic complexity of ACTH-dependent Cushing’s disease with challenging pituitary anatomy. Expert multidisciplinary management remains essential to achieve remission and prevent long-term sequelae.

Background: Bariatric surgery plays a pivotal role in the management of obesity and metabolic disorders, including type 2 diabetes mellitus (T2DM). However, the relative efficacy of different surgical procedures in achieving durable T2DM remission remains unclear. Methods: A systematic review and network meta-analysis (NMA) were conducted according to PRISMA-NMA guidelines. Searches were performed across PubMed, Embase, Scopus, and Cochrane Library (2000–2024). Eligible studies included randomized controlled trials and prospective cohorts comparing sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB). The primary endpoint was complete T2DM remission (HbA1c