Table of Contents Disorders of Glucose Metabolism Diabetes Mellitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Screening for Diabetes Mellitus. . . . . . . . . . . . . . . . . . 1 Diagnostic Criteria for Diabetes Mellitus . . . . . . . . . . 1 Classification of Diabetes Mellitus. . . . . . . . . . . . . . . . 1 Management of Diabetes Mellitus. . . . . . . . . . . . . . . . 7 Drug-Induced Hyperglycemia. . . . . . . . . . . . . . . . . . . . . . 16 Inpatient Management of Hyperglycemia . . . . . . . . . . . . 16 Hospitalized Patients with Diabetes Mellitus. . . . . . 16 Hospitalized Patients Without Diabetes Mellitus. . . . 18 Acute Complications of Diabetes Mellitus . . . . . . . . . . . . 18 Diabetic Ketoacidosis/Hyperglycemic Hyperosmolar Syndrome. . . . . . . . . . . . . . . . . . . . . . 18 Chronic Complications of Diabetes Mellitus . . . . . . . . . 20 Cardiovascular Morbidity. . . . . . . . . . . . . . . . . . . . . 20 Diabetic Retinopathy . . . . . . . . . . . . . . . . . . . . . . . . . 22 Diabetic Nephropathy. . . . . . . . . . . . . . . . . . . . . . . . . 22 Diabetic Neuropathy. . . . . . . . . . . . . . . . . . . . . . . . . . 23 Diabetic Foot Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Hypoglycemia in Patients with Diabetes Mellitus. . . . 23 Hypoglycemia in Patients Without Diabetes Mellitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Hypoglycemia Unawareness . . . . . . . . . . . . . . . . . . . 25
Disorders of the Pituitary Gland Hypothalamic and Pituitary Anatomy and Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Pituitary Abnormalities . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Incidentally Noted Pituitary Masses . . . . . . . . . . . . . 26 Empty Sella . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Other Abnormalities. . . . . . . . . . . . . . . . . . . . . . . . . . 28 Mass Effects of Pituitary Tumors. . . . . . . . . . . . . . . . 28 Evaluation of Pituitary Tumors. . . . . . . . . . . . . . . . . 29 Treatment of Clinically Nonfunctioning Pituitary Tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Pituitary Hormone Deficiency. . . . . . . . . . . . . . . . . . . . . . 29 Panhypopituitarism . . . . . . . . . . . . . . . . . . . . . . . . . 30 Adrenocorticotropic Hormone Deficiency (Secondary Cortisol Deficiency) . . . . . . . . . . . . . . . 30 Thyroid-Stimulating Hormone Deficiency. . . . . . . . 31 Gonadotropin Deficiency. . . . . . . . . . . . . . . . . . . . . . 32
Growth Hormone Deficiency. . . . . . . . . . . . . . . . . . . 32 Central Diabetes Insipidus. . . . . . . . . . . . . . . . . . . . . 32 Pituitary Hormone Excess. . . . . . . . . . . . . . . . . . . . . . . . . 33 Hyperprolactinemia and Prolactinoma . . . . . . . . . . 33 Acromegaly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Thyroid-Stimulating HormoneSecreting Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Excess Antidiuretic Hormone Secretion. . . . . . . . . . 35 Excess Adrenocorticotropic Hormone from Pituitary Source (Cushing Disease). . . . . . . . . 35
Disorders of the Adrenal Glands Adrenal Anatomy and Physiology. . . . . . . . . . . . . . . . . . 36 Adrenal Hormone Excess. . . . . . . . . . . . . . . . . . . . . . . . . 36 Cortisol Excess (Cushing Syndrome Due to Adrenal Mass) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Primary Aldosteronism . . . . . . . . . . . . . . . . . . . . . . . 38 Pheochromocytoma and Paraganglioma. . . . . . . . 40 Androgen-Producing Adrenal Tumors. . . . . . . . . . . 42 Adrenal Hormone Deficiency . . . . . . . . . . . . . . . . . . . . . . 42 Primary Adrenal Insufficiency. . . . . . . . . . . . . . . . . . 42 Adrenal Function During Critical Illness. . . . . . . . . 45 Adrenal Mass. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Incidentally Noted Adrenal Masses. . . . . . . . . . . . . . 45 Adrenocortical Carcinoma. . . . . . . . . . . . . . . . . . . . 46
Disorders of the Thyroid Gland Thyroid Anatomy and Physiology. . . . . . . . . . . . . . . . . . . 47 Thyroid Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Structural Disorders of the Thyroid Gland. . . . . . . . . . . . 47 Thyroid Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Goiters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Thyroid Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Evaluation of Thyroid Function. . . . . . . . . . . . . . . . . . . . . 52 Disorders of Thyroid Function. . . . . . . . . . . . . . . . . . . . . . 53 Thyroid Hormone Excess (Hyperthyroidism and Thyrotoxicosis). . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Thyroid Hormone Deficiency . . . . . . . . . . . . . . . . . 56 Drug-Induced Thyroid Dysfunction. . . . . . . . . . . . . 58 Thyroid Function and Dysfunction in Pregnancy. . . . . . 58 Nonthyroidal Illness Syndrome (Euthyroid Sick Syndrome) . . . . . . . . . . . . . . . . . . . . . . . 59
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