Metabolic and endocrine diseases - is our approach always rational?

ABSTRACT

Choosing wisely in metabolic and endocrine diseases shows the inutility of some, in clinical practice often used, ways of management. In diabetology, the routine recommendation for selfmonitoring of type 2 diabetic patients not treated with insulin represents a contraversial issue. On the contrary, there is a consensus on rational targets of glycemic control in elderly frailty patients with limited life expectancy. In endocrinology (thyroid diseases), the iniciative fights against the overuse of some laboratory examinations and ultrasonography. The recommendations on the rational indications of densitometry are discussed. In conclusion, these recommendations within Choosing wisely initiative of different professional associations usualy arise from expert views, supported by relevant clinical studies. They represent a challange to think over rational management of care.