Andreas Leiherer, Axel Muendlein, Sylvia Mink, Arthur Mader, Christoph H Saely, Andreas Festa, Peter Fraunberger, Heinz Drexel
Machine Learning Approach to Metabolomic Data Predicts Type 2 Diabetes Mellitus Incidence
International journal of molecular sciences
clinical practice guideline addresses diagnosis treatment primary adrenal insufficiencythe task force included chair selected clinical guidelines subcommittee endocrine society eight additional clinicians experienced disease methodologist medical writer cosponsoring associations european society endocrinology american association clinical chemistry participating members task force received corporate funding remuneration connection reviewthis evidencebased guideline developed using grading recommendations assessment development evaluation grade system determine strength recommendations quality evidencethe evidence used formulate recommendations derived two commissioned systematic reviews well published systematic reviews studies identified task force guideline reviewed approved sequentially endocrine societys clinical guidelines subcommittee clinical affairs core committee members responding web posting endocrine society council stage task force incorporated changes response written commentswe recommend diagnostic tests exclusion primary adrenal insufficiency patients indicative clinical symptoms signs particular suggest low diagnostic therapeutic threshold acutely ill patients well patients predisposing factors also recommended pregnant women unexplained persistent nausea fatigue hypotension recommend short corticotropin test 250 g gold standard diagnostic tool establish diagnosis short corticotropin test possible first instance recommend initial screening procedure comprising measurement morning plasma acth cortisol levels diagnosis underlying cause include validated assay autoantibodies 21hydroxylase autoantibodynegative individuals causes sought recommend oncedaily fludrocortisone median 01 mg hydrocortisone 1525 mgd cortisone acetate replacement 2035 mgd applied two three daily doses adults children hydrocortisone 8 mgm2d recommended patients educated stress dosing equipped steroid card glucocorticoid preparation parenteral emergency administration followup aim monitoring appropriate dosing corticosteroids associated autoimmune diseases particularly autoimmune thyroid disease