title: [The Choosing Wisely Initiative of the German Society of Internal Medicine : Recommendations of the German Society for Endocrinology and the German Society for Geriatrics].
abstract: A. After osteoporotic fractures in the elderly, as a rule specific antiosteoporotic therapy should be initiated. a. Osteoporosis as a disease of the elderly should be diagnosed and treated (recommendation of the German Society for Geriatrics). B. All patients with diabetes mellitus should complete a specific diabetes training program when antidiabetic drug medication is initiated. C. In Germany, all pregnant women should be advised to undertake iodine supplementation. D. Endocrine causes of hypertension should be ruled out in younger patients and in patients on multiple antihypertensive drugs. E. All unclear cases of hypercalcemia should be clarified.
  A. Testosterone substitution therapy should not be initiated on the basis of only one measurement of a reduced testosterone level without clinical signs and clarification of the underlying cause. B. Imaging procedures should only be used after the existence of hormonal disease has been confirmed. C. Sonographic screening for thyroid disease is not advised in the elderly. D. Long-term therapy with levothyroxine for nodular goiter should be avoided. E. In relevant stress situations hydrocortisone replacement therapy should not be continued without dose adjustment in patients with adrenal or pituitary insufficiency.
authors.affiliation: Klinik für Allgemeine Innere Medizin, Endokrinologie und Diabetologie, Pneumologie, Infektiologie, Klinikum Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland. joachim.feldkamp@klinikumbielefeld.de.
authors.forename: J
authors.initials: J
authors.lastname: Feldkamp
authors.affiliation: Funktionsbereich Spezielle Endokrinologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schott
authors.affiliation: Klinik für Geriatrie, Krankenhaus Lindenbrunn, Coppenbrügge, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Gogol
authors.affiliation: Endokrinologiepraxis am Stuttgarter Platz, Berlin, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Quinkler
authors.affiliation: Klinik und Poliklinik für Endokrinologie und Nephrologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Blüher
authors.affiliation: Medicover Berlin-Mitte MVZ, Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Diederich
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Reincke
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000628:therapy*; D004704:Endocrinology / Q000592:standards*; D005853:Geriatrics / Q000592:standards*; D005858:Germany; D006801:Humans; D007388:Internal Medicine / Q000592:standards*; D008659:Metabolic Diseases / Q000175:diagnosis / Q000628:therapy*
keywords: Diabetes mellitus; Hormone replacement therapy; Hypercalcemia; Hypertension; Osteoporosis