As endocrine and metabolic disorders are on the rise, it is vital for primary care providers (PCP) to have a role in patient management. Many endocrine patients have lifelong conditions that require long-term surveillance and co-management with endocrinologists. To help PCP care teams stay up to date with the latest advancements in clinical practice guidelines, interventions, and patient care, we’ve asked our leading endocrine experts to share clinical pearls of knowledge when it comes to common endocrine disorders screening, diagnosis, and treatment options.

10 things primary care teams need to know about common endocrine disorders:

1. Patients with hypothyroidism do not require routine thyroid imaging, Thyroid Peroxidase (TPO) antibody, or Triiodothyronine (T3) testing.
2. Levothyroxine (T4) is guideline-recommended standard-of-care treatment choice for hypothyroidism.
3. The full diabetes diagnosis is made with a fasting glucose of ≥ 126 mg, random plasma glucose of ≥ 200 mg, and/or an A1C of ≥ 6.5%. Don’t wait to make the diagnosis.
4. Simultaneous treatment is more effective than sequential treatment for diabetes. Metformin only addresses one of the 8 metabolic defects of Type 2 diabetes (T2DM).
5. Obesity is a chronic relapsing disease, multifactorial in origin, linked to genetics and epigenetic influences as well as the biological influence of hormones from adipose tissue and the gastrointestinal tract.
6. Obesity pharmacotherapy is safe, effective and FDA approved. When combined with diet and exercise, patients can expect to achieve 6-12% total body weight loss. Weight loss results are variable, however.
7. Postmenopausal osteoporosis (PMO) is common in women, yet a high percentage are not screened using guideline-recommended bone mineral density (BMD) as a ‘surrogate’ of fracture risk after age 65.
8. An elevated total alkaline phosphatase level may be due to increased bone turnover from inadequate intake/absorption of calcium and/or vitamin D, hypogonadism/menopause, primary hyperparathyroidism (HPT), recent fracture, or Paget’s disease.
9. Hyperlipidemia treatment goals for low-density lipoprotein cholesterol (LDL-C) less than 55 mg/dL for patients with atherosclerotic cardiovascular disease (ASCVD) plus diabetes or stage 3-5 chronic kidney disease, or LDL-C less than 70 mg/dL for patients with ASCVD or diabetes with 1 or more CV risk factors or stage 3-5 CKD with albuminuria.
10. Add statins to reduce CVD events in patients with and without diabetes.