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In this issue of Update in Endocrinology specialists discuss topics which include hyperthyroidism during pregnancy, preparing adolescents and young adults for lifelong diabetes management, and welcoming transgender and gender-nonconforming patients into your practice. 

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Identify options for treatment of hyperthyroidism in pregnancy 
  • Describe the rationale for a program to prepare adolescent and young adult patients with diabetes for the transition from pediatric to adult health care services.
  • List developmentally-appropriate management strategies for adolescent and young adult patients with diabetes. 
  • Increase empathy for transgender and gender non-conforming patients by learning about the social, cultural, economic, and psychological barriers that they face.
  • Learn appropriate and respectful ways to address transgender and gender non-conforming patients including preferred pronouns and terminology. 
  • Improve the clinical experience of transgender and gender non-conforming patients with practical approaches to making a practice more welcoming to them. 

Reading Resources:

  1. Marx H, Amin P, Lazarus JH. Pregnancy plus: hyperthyroidism and pregnancy. BMJ: British Medical Journal. 2008 Mar 22;336(7645):663.
  2. Goodwin TM, Montoro MA, Mestman JH, Pekary AE, Hershman JM. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. The Journal of Clinical Endocrinology & Metabolism. 1992 Nov 1;75(5):1333-7.
  3. Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocrine reviews. 1997 Jun 1;18(3):404-33.
  4. Tan JY, Loh KC, Yeo GS, Chee YC. Transient hyperthyroidism of hyperemesis gravidarum. BJOG: An International Journal of Obstetrics & Gynaecology. 2002 Jun 1;109(6):683-8.
  5. Männistö T, Mendola P, Grewal J, Xie Y, Chen Z, Laughon SK. Thyroid diseases and adverse pregnancy outcomes in a contemporary US cohort. The Journal of Clinical Endocrinology & Metabolism. 2013 Jul 1;98(7):2725-33.
  6. Krall, J, Libman I, Siminerio L. The emerging adult with diabetes: Transitioning from pediatric to adult care. Pediatr Endocrinol Rev 2017;14(Suppl2):422-8.
  7. Garvey KC, Foster NC, Agarwal S, et al. Health care transition preparation and experiences in a U.S. national sample of young adults with type 1 diabetes. Diabetes Care 2017;40(3):317-24.
  8. Peters A, Laffel L. Diabetes care for emerging adults: Recommendations for transition from pediatric to adult diabetes care systems: A position statement of the American Diabetes Association. Diabetes Care 2011;34(11):2477-85.
  9. World Professional Association for Transgender Health. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, 7th version:
  10. 10.  James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
  11. 11.  Schuster MA, Reisner SL, Onorato SE. Beyond Bathrooms – Meeting the Health Needs of Transgender People. N Engl J Med 2016; 375 (2): 101-103.


Doctors Krall, O’Doherty, Codario, Ali, and Mahmud report no relationships with any entities producing health care goods and services. Doctor Siminerio is a consultant for Beckton Dickinson Advisory Board. Dr. Libman is a consultant for Novo Nordisk.

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 10/11/2017 | Last Modified On: 10/11/2017 | Expires: 10/11/2018

This course has been expired.