Endocrinology and Diabetology

Endocrinology deals with diseases affecting the hormone-producing glands, namely the thyroid, pancreas, pituitary, adrenal, parathyroid, ovary, and testis. There are appropriate treatments for each endocrine disease and each form of diabetes mellitus.

Among the most commonly treated diseases are:

• thyroid diseases: conditions in which nodules or tumors form within the gland, or in which the gland produces its hormones (T3 and T4) in excess or deficiency, resulting in disorders for the entire body;
• diabetes mellitus: alteration in the regulation of the body's glucose levels that may result from the poor production of the hormone insulin (diabetes mellitus type 1) or its ineffectiveness (diabetes mellitus type 2);
• pituitary gland diseases: diseases caused by excess or deficient production of pituitary hormones, with or without formation of nodules within the gland;
• parathyroid diseases: diseases caused by the enlargement of the parathyroids, small glands close to the thyroid gland, resulting in increased production of their hormones and complications that may mainly involve the bones (osteoporosis) and kidneys (stones);
• osteoporosis: a disease in which bones become more fragile, also as a direct result of impaired function of endocrine glands;
• diseases ofthe adrenal glands: diseases that include an excess or defect in the production of their hormones (cortisol, aldosterone, adrenaline), sometimes associated with an increase in their volume.

Endocrinologists in the Servizio di Endocrinologia e Diabetologia EOC take on patients with any pathology of the hormone glands, working, where appropriate, in multidisciplinary collaboration with other dedicated medical specialties.

• Thyroid: blood tests allow diagnosis of hyperthyroidism and hypothyroidism (including Hashimoto's thyroid), which will then almost always be treated with medication. Ultrasonography is the key examination to detect the presence of nodules in the gland and among them identify those suspicious for cancer that will undergo needle aspiration for cytologic examination. When thyroid cancer is diagnosed, its treatment involves surgery first.
• Diabetesmellitus: diabetes is suspected on the basis of symptoms. In the case of type 1, the main symptoms are rapid weight loss accompanied by increased thirst and urine volume. Blood tests are used to confirm this form of diabetes, which will be treated by administering insulin. In the case of type 2, the diagnosis is generally made on the basis of the measurement of blood glucose (circulating blood glucose value) and glycated hemoglobin (i.e., the average blood glucose over the past few months). Treatment for type 2 is based on drugs that help lower blood glucose.
• Diseases of the pituitary gland: the pituitary gland produces several hormones that regulate the function of other hormone glands. MRIs are used to reveal the presence of nodules within the pituitary gland, and blood tests are used to identify whether any of the various pituitary hormones are being overproduced.
• Parathyroid diseases: the parathyroids produce a hormone called parathormone or PTH that regulates the body's calcium. The finding of increased PTH and calcium values indicates that one of the parathyroids may be producing excess PTH so it will be necessary to try to locate which of the 4 parathyroids is responsible. Ultrasonography is the test used in the first instance, and if this test is negative, other tests (scintigraphy, MRI, PET/CT, etc.) will be used.
• Osteoporosis: this condition can be diagnosed with densitometry, a radiological examination that studies the density of calcium in the bone. Its treatment involves medicines that will increase calcium in the bones to lower the risk of fractures.
• Diseases of the adrenal glands: poor functioning of these glands is diagnosed with targeted blood tests. The presence of nodules within these glands, on the other hand, is revealed by radiological examinations, first and foremost MRI.