Less known but still real – let’s talk about hypoparathyroidism

We are in Madrid, at the Hospital Universitario Puerta de Hierro of Majadahonda. It’s barely four o’clock and everything seems pretty quiet at the Endocrinology Department. Dr. Juan José Díez, who is the head of the deparment welcomes us in his office and next to him we get to know Dr. Isabel Huguet, from the Endocrinology Deparment of the Hospital Universitario Infanta Leonor. Both of them will be in charge of a new program that we will show at the end. 

But for the moment we start to prepare the filming set. Tripods, table, sound… We are going to film some content for the new program focused on the updates and treatment of hypoparathyroidism. 

Are you familiar with it? Keep reading!

When we ask Dr. Díez about it, he explains to us that hypoparathyroidism is “more than a hormonal deficiency. Is it a chronical condition that affects life quality of thousands of patients, with a big social and economical impact”.

In fact, data confirms this. Hypoparathyroidism is a rare disease which is affecting 100 cases per million people. In the majority of times, it tends to be a seque lof a thyroid surgery. 50% of patients had transitory hypoparathyroidism after surgery. 

When the problema doesn’t dissappear, it transforms into a burden that the patient will have to deal with for the rest of its life. 

“Proper management can drive to chronical complications, hospitalizations and a very high sanitary cost”, Dr. Díez says. 

Clearly, endocrine disorders management presents a series of challenged for the clinical practice. 

Chronical pathologies in the Endocrinology area are characterized by being a lot and very heterogenical. 

That’s why Dr. Huguet is so clear about it: “As professionals I would say that the main challenge with chronical endocrine diseases, is to be able to individualize the treatment and to adapt that individualization during the different stages of patient’s life”. 

We are talking about disorders with increasing prevalence and multimorbidity. Patients have to live with: 

• Cardiovascular diseases. 

• Metabolic disorders.

• Bone alterations. 

• Neurological and emotional problems. 

• Reproductive disorders.

• Other self-immune diseases. 

On hypoparathyroiodism cases we include hipocalcemia, tetany, calcifications, etc.

For Dr. Díez the most complicated thing to manage these diseases is the coordination of the multidisciplinary management and healthcare barriers. “There’s a big lack of specific protocols”. 

This leads to problems with knowledge updates and adherence to clinical guidelines. 

“To attend chronical endocrine diseases we are talking about an echonomical load which absorbs a big important part of echonomical resources, for direct costs and hospitalizations as well as chronical complications”, explains Dr. Huguet. “Also, we must count the efficiency of resources, which has to integrate the use of digital tools, active prevention and structured following”. 

When we ask them about the importance of giving the patients a precise instruction about their condition, they both say yes. 

“It is fundamental”, Dr. Díez recognizes. “Endocrine diseases are chronic, so they require the patient to understand its condition to achieve a good control and prevent complications”. 

He also talks about the benefits you can obtain by doing it so: 

• It improves the adherence to the treatment. 

• Reduces mistakes. 

• Trains the patient to make decisions with good information about the new lifestyle they should follow. 

“They must know as much as possible about their condition, because is going to be part of their lives. They have to be aware of the potential consequences of a bad management or adherence”, explains Dr. Huguet. “There will be situations where they might have a descompensation and they’ll requiere quick assitance. Our role as endocrinologists is essential at this point, as well as trying to combine all of this with the least possible mental burden for the patient.”

So it’s been clarified how important the endocrinologist is as an educator and coordinator. 

• Explains the condition and its evolution, adapting the information depending on the patient’s level of comprehension. 
• Instructs on the treatment, its possible advert effects and the importance of fullfilment. 
• Promotes self care and healthy habits, like a good diet, do some exercise and monitorization. 
• Coordinates with other health professionals, like nurses, nutritionists, psychologists… to be able to affer a comprehensive approach. 

Dr. Díez dares to predict an Endocrinology very different from the one we know today. The arrival of new technologies will change the way these professionals work. He himself lists several tools that are already gaining importance:

• Artificial Intelligence, which is transforming diagnosis and clinical decision-making, acting like a travel companion.
• Automated interpretation of images and data, using machine learning (computer programs that learn from health data) to help diagnose thyroid nodules, endocrine tumors and laboratory patterns.
• Telemedicine and digital health, already visible through the integration of teleconsultations, continuous glucose monitoring and connected devices.
• Personalized diagnosis thanks to advances in clinical genetics studies.

“Along the same lines,” says Dr. Huguet, “I would say that the future is moving toward individualized treatments and greater professional subspecialization, since this helps achieve better resource management.”

Without a doubt, changes in educational and training trends play a major role.

“Continuing education is essential given how fast medicine is advancing,” she concludes.

Both doctors agree that continuing education is changing. Trends are evolving and new ideas and tools are joining the field of continuing medical education.

Professional reinforcement is undoubtedly one of the key factors to consider. Strategies to ensure there will be enough well-trained endocrinologists in the future remain a priority, as does securing a pipeline that goes from medical students to fully established specialists.

We offer training in Artificial Intelligence and digital health, as well as online case-based learning.

“Accredited and interactive courses are also still very useful,” says Dr. Díez. “When hybrid sessions are offered—both in-person and virtual—along with debates, case studies and multidisciplinary sessions, knowledge is updated much more effectively.”

Precisely for this reason, both doctors are coordinating a new educational program: Advanced Management of Hypoparathyroidism. A course with official content from the Endocrine Society and endorsed by the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Society for Bone and Mineral Metabolism Research (SEIOMM).

The course includes 5 learning modules, with scientific reviews in e-learning format, covering:

1. Chronic hypoparathyroidism (definition, etiology, prevalence)
2. Diagnosis and follow-up of hypoparathyroidism
3. Treatment of hypoparathyroidism (conventional treatment, hormone replacement and future options)
4. Comorbidities of hypoparathyroidism and their management
5. Special situations in children, pregnancy and older adults

If you pass all the tests, you will receive your official diploma with credits from the National Health System.

If you’re still not convinced, we want you to meet the Scientific Committee:

• Dr. Paula Sánchez Sorbino, Galician Health Service (SERGAS), Vigo
• Dr. Pedro Rozas, General University Hospital of Ciudad Real
• Dr. María Cortés Berdonces, Ruber Juan Bravo University Hospital, Madrid
• Dr. Aida Orois, Hospital Clínic of Barcelona

Don’t miss the opportunity to learn about this new initiative supported by so many key opinion leaders, such as Drs. Díez and Huguet.