Programme Day 1

• Opening
  Feng-Hsuan LiuTaiwan Speaker
• Standard and Advanced Technique for Thyroid RFA
  Jung Hwan BaekSouth Korea Speaker Standard and Advanced Techniques for Thyroid RFAThermal ablation, especially radiofrequency ablation (RFA), is promising technique not only for benign thyroid nodules but also for thyroid cancers. In various thyroid tumors, RFA effectively improves tumor-related symptoms and cosmetic problems by reducing tumor volume. RFA is recently adopted to recurrent and primary thyroid cancers. In terms of complication, major complication rate was reported as 1.4% - 8% according to the types, locations and size of the thyroid tumors. Therefore, proper techniques and experience of operators are key factors to achieve effective and safe RFA. To maximize efficacy and to minimize complications, the Korean Society of Thyroid Radiology Guidelines (KSThR Guidelines 2012, 2017, and 2025) recommend the use of standard techniques; the perithyroidal lidocaine injection to control pain, trans-isthmic approach, moving-shot technique and hydrodissection (HD) technique. Furthermore, KSThR Guidelines recommend advanced techniques, such as vascular ablation, bolus injection of cold water (to manage nerve damage problems) or tracheal stent assisted RFA. In this lecture, therefore I will introduce various standard and advanced techniques to maximize the ablation zone and to minimize injury of surrounding critical structures. Furthermore, I will briefly touch “how to combine proper device and techniques” for thyroid RFA.The Efficacy and Safety of RFA for PTMC in Long-Term Cohort Study: Do Above and BeyondThe incidence of thyroid cancer has increased not only in Korea, but in worldwide. This situation is mainly due to an increase in the over detection of small papillary thyroid carcinomas (PTCs) using high-resolution ultrasonography (US). Almost all newly detected thyroid cancers are small papillary thyroid cancers (PTCs), while the incidence of large PTCs and aggressive histological types has remained stable. In addition, mortality of thyroid cancer has remained stable in Korea. Therefore, several studies have suggested over-diagnosis of small thyroid cancers, especially papillary thyroid microcarcinomas (PTMC). Since the majority of PTMCs progress slowly and show excellent outcome and considering the drawbacks of surgery including voice change or hypoparathyroidism, it is time to re-evaluate the role of surgery (especially immediate surgery) for all biopsy proven PTMCs. According to publications from South Korea and other countries, the incidence of thyroid carcinoma had increased 15-fold between 1993 and 2011; however, its mortality rate did not decrease. Moreover, the number of patients who suffered from surgical complications increased significantly. Considering the exceedingly low disease-specific mortality rate of PTMCs and the potential complications of thyroidectomy, it is imperative to consider alternative management strategies for PTMC management. Therefore, this lecture will review the current oncologic outcome (in both short and long-term follow-up studies) of thermal ablation in PTMC and compare it with the results of active surveillance and surgery.
• The Efficacy and Safety of Thyroid RFA: The Latest Updates
  Hendra ZufryIndonesia Speaker The Efficacy and Safety of Thyroid RFA: The Latest Updates
• Discussion
• Coffee Break
• How to Manage Complications of Thyroid RFA
  Kai-Lun ChengTaiwan Speaker How to Manage Complications of Thyroid RFA
• RFA for Structural Abnormality of Parathyroid Gland : A Novel Entity and Technique Advances
  Wei-Che LinTaiwan Speaker
• Discussion

• Advancing Toward a Cure for Diabetes: Insights from iPSC-Derived Islet Cell Transplantation Trial
  Daisuke YabeJapan Speaker Advancing toward a Cure for Diabetes: Insights from iPSC-Derived Islet Cell Transplantation TrialType 1 diabetes is characterized by absolute insulin deficiency and marked glycemic variability, creating a constant challenge for individuals who must maintain strict glycemic control to prevent complications and severe hypoglycemia. To address these persistent unmet medical needs, transplantation of pancreatic islet–like cells derived from embryonic stem (ES) or induced pluripotent stem (iPSC) cells has emerged as a promising therapeutic strategy. Encouraging advances have recently been reported from the United States and China. Notably, a world-first autologous transplantation of patient-specific iPSC-derived islet-like cells in China achieved insulin independence with near-normal glycemic control. Despite its promise, concerns remain regarding long-term safety, durability, and broad applicability, underscoring the need for further rigorous clinical evaluation. This lecture will provide an overview of current progress and ongoing challenges in β-cell replacement therapy aimed at curing type 1 diabetes. In addition, I will introduce the study design of our clinical trial at Kyoto University Hospital evaluating allogeneic transplantation of iPSC-derived islet cell sheets (OZTx-410). Through these insights, we aim to highlight both the steady steps already taken and the horizon of possibilities ahead in the pursuit of a functional cure for diabetes.Incretin-Based Therapeutics: Bridging Theory and Practice, and Exploring New HorizonsThe landscape of type 2 diabetes management has been transformed by the advent of incretin-based therapies, including dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. In Japan—where more than 70% of individuals with diabetes are aged 65 years or older and commonly present with a non-obese phenotype and reduced insulin secretory capacity—DPP-4 inhibitors continue to serve as a fundamental treatment option, offering effective glycemic control with minimal risk of hypoglycemia. In contrast, among younger adults with obesity, GLP-1 receptor agonists have emerged as essential agents that not only improve glycemic control but also promote weight reduction and confer cardiovascular and renal benefits. A major advance in 2023 was the approval of tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist that engages both receptors. Tirzepatide has demonstrated robust glucose-lowering and weight-reducing effects in both clinical trials and real-world practice in Japan, further expanding therapeutic opportunities across the region. However, incretin-based therapies are not without challenges: gastrointestinal adverse events remain common, and potential associations with pancreatic and biliary diseases continue to require caution. In older adults, concerns regarding their impact on frailty and sarcopenia demand careful clinical judgment. Furthermore, inappropriate discontinuation of insulin therapy after initiating incretin treatment has occasionally resulted in severe clinical consequences, highlighting the critical need for decision-making that extends beyond the evidence from controlled trials. In response to these issues, the Japan Diabetes Society (JDS) Committee for the Safe Use of Medications released the Recommendations for the Safe Use of Incretin-Related Agents, Second Edition in 2024. Disseminating these recommendations across East Asia and the broader Asia–Oceania region will be essential to ensure the safe and effective application of incretin-based therapies in diverse clinical settings. In this plenary lecture, I will explore strategies to optimize type 2 diabetes management in Asia by harnessing the therapeutic potential of incretin-based agents while proactively mitigating associated risks. Together, we aim to build a future in which innovation, safety, and patient-centered care advance hand in hand.
• AI-Driven Precision Drug Therapy: Tailoring Personalized Treatment for Type 2 Diabetes
  Kang-Chih FanTaiwan Speaker AI-Driven Precision Drug Therapy: Tailoring Personalized Treatment for Type 2 Diabetes Type 2 diabetes (T2D) is a highly heterogeneous syndrome where "one-size-fits-all" algorithms often fail to address individual pathophysiological variations. While recent guidelines prioritize cardiorenal protection, the choice between second-line agents—particularly SGLT2 inhibitors versus GLP-1 receptor agonists—remains largely empirical. This "trial-and-error" paradigm frequently results in therapeutic inertia and suboptimal glycemic durability. Artificial Intelligence (AI) and machine learning (ML) offer a paradigm shift from population-based guidelines to precision diabetology. By integrating high-dimensional data from electronic health records (EHR), continuous glucose monitoring (CGM), and omics profiles, AI models can now quantify heterogeneous treatment effects (HTE) at the individual level. In this presentation, I will discuss: 1. Phenotypic Stratification: Moving beyond classic classification to identify data-driven clusters (e.g., severe insulin-resistant vs. age-related clusters) that dictate distinct disease trajectories. 2. Predictive Pharmacotherapy: Reviewing recent evidence where ML algorithms predict individual glycemic response and weight loss outcomes for specific drug classes. We will highlight how AI-driven decision support can optimize the selection between SGLT2 inhibitors and GLP-1 receptor agonists, maximizing efficacy while minimizing adverse events. 3. Real-World Implementation: Discussing the potential of leveraging large-scale longitudinal datasets, such as Taiwan’s National Health Insurance Research Database, to build robust, population-specific prediction models. Bridging the gap between data science and clinical practice, this session aims to demonstrate how AI can empower clinicians to prescribe the right drug for the right patient at the right time, fundamentally transforming T2D management.Anti-Obesity Medications: Clinical Use Obesity is a chronic, relapsing neurobehavioral disease requiring long-term management. Recent guidelines have shifted the treatment goal from BMI-centric weight loss to a "health-centered" approach, focusing on the remission of weight-related complications. With the advent of nutrient-stimulated hormone-based therapies, we have entered an era where pharmacotherapy can achieve double-digit weight loss comparable to bariatric surgery, offering systemic organ protection. In this session, we will navigate the clinical use of anti-obesity medications (AOMs) through three key dimensions based on the latest evidence: 1. Efficacy and Organ Protection: We will review the landmark trials establishing GLP-1 and dual GIP/GLP-1 receptor agonists as the cornerstone of treatment. Highlights include Semaglutide (STEP, SELECT, ESSENCE) and Tirzepatide (SURMOUNT, SUMMIT, SURMOUNT-OSA), demonstrating not only 15–20% weight loss but also breakthrough benefits in cardiovascular outcomes (MACE), heart failure with preserved ejection fraction (HFpEF), metabolic dysfunction-associated steatohepatitis (MASH), and obstructive sleep apnea (OSA). 2. Comorbidity-Directed Strategy: A practical framework for drug selection will be proposed, distinguishing between "Fat Mass Disease" (e.g., OSA, osteoarthritis), which benefits primarily from mechanical weight reduction, and "Sick Fat Disease" (e.g., T2D, CVD, MASH), which requires correction of adipose dysfunction. We will discuss how to prioritize agents like Semaglutide and Tirzepatide for high-risk profiles, while utilizing Naltrexone/Bupropion for emotional eating or Orlistat for patients requiring non-systemic options. 3. Asian Perspectives & Practical Management: We will present data confirming that Asian populations, who are highly sensitive to metabolic risks, achieve weight loss efficacy comparable to Western populations with Semaglutide and Tirzepatide (STEP-7, SURMOUNT-CN/J). Finally, we will address practical strategies for dose titration to mitigate GI adverse events and emphasize the necessity of chronic treatment to prevent weight regain. This presentation aims to equip clinicians with a precision medicine approach, ensuring the right AOM is prescribed to maximize both weight reduction and holistic health outcomes.
• Closing the Type 2 Diabetes Gap in Cardiovascular and Renal Disease
  Jenny GuntonAustralia Speaker Closing the Type 2 Diabetes Gap in Cardiovascular and Renal DiseasePeople with type 2 diabetes die, on average, 6-7 years earlier. This is mostly due to excess cardiovascular events. This presentation will discuss options for lowering cardiovascular and renal risk in people with type 2 diabetes.Managing Hyperglycaemia in Patients Receiving Immune Checkpoint InhibitorsIt is estimated that >20% of people treated with Immune Checkpoint Inhibitors (ICI) for their cancer will experience new or worsening hyperglycaemia. This presentation will discuss the differential diagnoses for the cause of hyperglycaemia in people treated with ICI and treatment strategies

• Preoperative Molecular Testing for Thyroid Nodules
  Guodong FuCanada Speaker Preoperative Molecular Testing for Thyroid Nodules
• Harnessing Molecular Diagnostics in Cytologically-Indeterminate Thyroid Nodules
  Samantha Peiling YangSingapore Speaker Harnessing Molecular Diagnostics in Cytologically-Indeterminate Thyroid NodulesRe-Differentiation Therapy in RAI-Refractory Thyroid Cancer
• Preoperative Diagnosis of Thyroid Cancer
  Kiyomi HoriuchiJapan Speaker Preoperative Diagnosis of Thyroid Cancer

• Endocrine Disruptors
  Narendra KotwalIndia Speaker Endocrine Disruptors
• Endocrine Disrupting Chemicals Exposure and Human Health Outcomes in Different Populations
  Ching Chang LeeTaiwan Speaker Endocrine Disrupting Chemicals Exposure and Human Health Outcomes in Different PopulationsUp to now, public concerns about the impact of EDCs on human health is growing steadily. Phthalates are thyroid, reproductive and developmental toxicants. Maternal hypothyroidism during pregnancy can cause adverse effects in the fetus. Study 1 investigates the association between phthalate exposure and thyroid hormones in pregnant women. After adjusting for age, BMI and gestation, urinary MBP levels showed negative associations with FT4 and T4 (FT4:  = -0.110, P < 0.001; T4:  = -0.112, P = 0.003). Exposure to di-n-butyl phthalate (DBP) may affect thyroid activity in pregnant women. Study 2 evaluates the association between maternal urine excretion, the exposure of fetus to phthalates in amniotic fluid, and the health of newborns. We found a significant positive correlation between creatinine adjusted urinary MBP and amniotic fluid MBP (R2=0.156, P <0.05) in all infants and, only in female infants, a significantly negative correlation between amniotic fluid MBP, AGD (R = −0.31, P <0.06), and the anogenital index adjusted by birth weight (AGI-W) (R = −0.32, P <0.05). Our data clearly show that in utero exposure to phthalates in general has anti-androgenic effects on the fetus. Study 3 investigates the association between exposure to phthalates and female puberty, and assesses the effect of leuprorelin acetate treatment on kisspeptin-54 secretion in girls with CPP. All seven urinary phthalate metabolites in the CPP group were significantly higher than in prepubescent controls. Serum kisspeptin-54 level were higher (P = 0.022) in the CPP group than control group and still significantly higher after adjusting for age (P = 0.03). There was a significant increasing trend (Ptrend = 0.005) between levels of kisspeptin and the stages of puberty. Significantly positive correlation between kisspeptin-54 and urinary MBP (R2 = 0.109, P = 0.024) was found. Study 4 explores the biomarkers of altered testicular function associated with exposure to phthalates: the testosterone and INSL3 secretion of adult men with different fertility states. In multiple regression models controlled for potential confounders, there is an inverse association between urinary levels of MMP), mono-iso-butyl phthalate (MiBP), MEHP, MEHP% and serum TT (P = 0.001, 0.007, 0.042 and 0.012). The inverse associations were also found between urinary levels of MiBP, MBzP, MEHP, MEHP% and serum fT (P = 0.028, 0.017, 0.045 and 0.027). Urinary MBzP and MEHP% were negatively associated with a decrease in serum INSL3 (P = 0.049 and 0.001). We also observed a strong inverse relationship between MEHP% quartiles and serum TT, fT, the TT : LH ratio and INSL3 (Ptrend = 0.003, 0.080, 0.002 and 0.012). Serum INSL3, TT, fT and the TT : LH ratio were lower for men in the highest MEHP% quartile than in the reference group (P = 0.007, 0.002, 0.090 and 0.001). In conclusion, the present study showed that infertile men had poor Leydig cell functionality, higher levels of urinary phthalate metabolites and lower concentrations of androgens or INSL3, or both, which implied that being exposed to phthalates might affect human testicular steroidogenesis by impairing the function of Leydig cells. Study 5 investigated the active mechanisms of how being exposed to phthalates affects the imbalance of androgen and estrogen and the generation of ROS to determine whether both mediated phthalate-induced effects are involved in prostatic enlargement. DEHP metabolite levels, particularly urinary MEHP, were positively associated with androgen, estrogen, hormone ratios, inducible nitric oxide synthetase (iNOS), 8-OHdG, prostate specific antigen (PSA), and prostate volume (PV) (P < 0.05). PV and PSA were positively associated with androgen, estrogen, hormone ratios and oxidative stress markers (P < 0.05). The estimated percentages of exposure to phthalates in prostatic enlargement mediated by androgen, estrogen, and OS markers ranged from 3.5% to 63.1%. Exposure to DEHP promoted the progress of BPH by increasing dihydrotestosterone (DHT), estradiol (E2), the converted enzymes aromatase and 5 reductase, and reactive oxygen species (8-OHdG and iNOS) production. Sex hormones and OS might be important hyperplasia-promoters after a patient has been exposed to phthalates, especially to DEHP.
• Environmental Endocrinology: Interactions Between Environment and Hormonal Systems
  Vina Yanti SusantiIndonesia Speaker Environmental Endocrinology: Interactions Between Environment and Hormonal Systems

• Group Instruction
  Chia-Luen HuangTaiwan Speaker
• Hands-On Workshop
• Closing Remarks
  Feng-Hsuan LiuTaiwan Speaker

• Managing Hyperglycaemia in Patients Receiving Immune Checkpoint Inhibitors
  Jenny GuntonAustralia Speaker Closing the Type 2 Diabetes Gap in Cardiovascular and Renal DiseasePeople with type 2 diabetes die, on average, 6-7 years earlier. This is mostly due to excess cardiovascular events. This presentation will discuss options for lowering cardiovascular and renal risk in people with type 2 diabetes.Managing Hyperglycaemia in Patients Receiving Immune Checkpoint InhibitorsIt is estimated that >20% of people treated with Immune Checkpoint Inhibitors (ICI) for their cancer will experience new or worsening hyperglycaemia. This presentation will discuss the differential diagnoses for the cause of hyperglycaemia in people treated with ICI and treatment strategies

• Obesity: What Clinicians Should Know
  Alice KongHong Kong, China Speaker Obesity: What Clinicians Should KnowRapid changes in technology, human behavior and lifestyle over the past few decades have resulted in a dramatic increase in the prevalence of obesity worldwide. Besides social stigmata and psychological consequences, obesity is associated with escalated risks of type 2 diabetes, coined the term "Diabesity", hypertension, dyslipidemia, sleep apnoea, metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), polycystic ovarian syndrome, cancers, cardiovascular diseases and increased mortality. Body mass index (BMI) is a commonly adopted tool to identify people with obesity. Clinicians should note that the cutoff points of BMI for clinical actions are different between people with obesity from the East and the West, as well as the limitations of BMI in diagnosing obesity. Recently, the Lancet Diabetes and Endocrinology Commission proposed a new definition of obesity which differentiates excess adiposity with obesity-related illness (clinical obesity) from those without obesity-related diseases (pre-clinical obesity). Also, people with clinical obesity have many unmet needs requiring personalized treatment regimens, intensive counselling and emotional support. The 5 A's framework including Ask, Assess, Advise, Agree and Assist, provide a patient-centred approach to promote lasting behavioral change in obesity management. In addition to lifestyle modifications and behavioral changes, pharmacological agents for weight reduction, bariatric and metabolic surgeries are therapeutic options requiring careful selections for the appropriate patients with adequate counselling of the risks and benefits. Through case sharing approach, the use of weight reducing drugs and surgical strategies for people with preclinical and clinical obesity will be discussed in this session. Acknowledgement: The work described in this lecture was partially supported by funding from Health and Medical Research Fund (HMRF), Food and Health Bureau, Hong Kong SAR, China (Reference number:21223391), Matching Grant from Research Grants Council (reference number: 8601556), and Area of Excellence Scheme, Research Grants Council, Hong Kong SAR, China (Reference number: AoE/M-401/24-R). Obesity Management: What's New?Obesity is a global health hazard with rising prevalence in most parts of the world. Weight reduction by lifestyle modification remains the cornerstone in the prevention and treatment of obesity. However, weight management by lifestyle therapy alone is difficult to sustain in many obese individuals with rebound of body weight being observed as a common phenomenon. Given the invasiveness of bariatric and metabolic surgeries which are not accepted by many people with obesity, the use of pharmacological agents in weight management is increasingly popular. In 2025, the Lancet Diabetes and Endocrinology Commission proposed a new definition of obesity which differentiates excess adiposity with obesity-related illness (clinical obesity) from those without obesity-related diseases (pre-clinical obesity). Among the various obesity complications, diabetes is well recognized to be closely related to obesity, with the term 'Diabesity' coined to show the strong link between these two important modifiable risk factors of cardiovascular disease and premature death. In recent decades, many new generation anti-diabetic drugs are developed and found to have weight reducing properties. Looking ahead, more new drugs are in the pipeline of clinical trials, and the results may eventually change the landscape of obesity management. Acknowledgement: The work described in this lecture was partially supported by funding from Health and Medical Research Fund (HMRF), Food and Health Bureau, Hong Kong SAR, China (Reference number:21223391), Matching Grant from Research Grants Council (reference number: 8601556), and Area of Excellence Scheme, Research Grants Council, Hong Kong SAR, China (Reference number: AoE/M-401/24-R).

• PFAS Exposure and Human Health: From Ubiquity to Urgency
  Pau-Chung ChenTaiwan Speaker PFAS Exposure and Human Health: From Ubiquity to Urgency

• Novel Biomarkers and Treatment Strategies in Thyroid Eye Disease
  Chia-Hung LinTaiwan Speaker Novel Biomarkers and Treatment Strategies in Thyroid Eye DiseaseThyroid Eye Disease (TED), also known as Graves' orbitopathy, remains a complex autoimmune condition that significantly impacts patients' vision and quality of life. Traditionally, management has relied mainly on non-specific anti-inflammatory therapies. However, as our understanding of its molecular pathogenesis evolves, there is an increasing clinical demand for more precise diagnostic tools and targeted therapeutic interventions. This presentation provides a comprehensive overview of the current landscape and future directions in the management of TED. We will discuss the emergence of novel serum and molecular biomarkers that offer potential for earlier diagnosis and more accurate prediction of disease progression. These biomarkers may bridge the gap between clinical observation and underlying immunological activity. Furthermore, we will explore the shift in treatment paradigms, moving from conventional systemic corticosteroids toward innovative biological agents. By targeting specific signaling pathways involved in orbital inflammation and remodeling, these new strategies aim to provide more effective and durable clinical outcomes. The integration of novel biomarkers and advanced treatment modalities is reshaping the management of TED. Moving toward a more individualized approach will allow clinicians to optimize therapeutic timing and selection, ultimately improving the long-term prognosis for patients with this challenging condition.
• Management of Thyroid Eye Disease: Insights from Clinical Experience and MRI Findings in Japan
  Ichiro YamauchiJapan Speaker Management of Thyroid Eye Disease: Insights from Clinical Experience and MRI Findings in JapanIn Japan, disease activity of thyroid eye disease (TED) is commonly assessed using magnetic resonance imaging (MRI) in addition to clinical activity score (CAS). Recently, we proposed an MRI-guided categorization of active moderate-to-severe TED based on our retrospective data. We retrospectively analyzed TED cases treated at our department between 2015 and 2022 with a combination of daily steroid pulse therapy and orbital radiation. Among 44 cases with diplopia, we classified 17 cases as severe (diplopia in the primary position) and 27 as non-severe (diplopia only in non-primary positions). The severe group was older (median 67 years) and had lower TSAb titers (median 324%) compared to the non-severe group (median 56 years, median TSAb 2443%). CAS was similar between the groups. MRI revealed that proptosis was more pronounced in the non-severe group (median 21.4 mm) than in the severe group (median 17.5 mm), whereas the difference in proptosis between eyes was larger in the severe group (median 2.0 mm) than in the non-severe group (median 0.9 mm). High signal intensity of orbital fat on STIR sequence was more frequently observed in the non-severe group (68.2%) than in the severe group (20.0%). These findings suggest that TED patients with severe diplopia are characterized by older age, lower TSAb titers, and greater asymmetry in proptosis. In contrast, CAS and STIR signal intensity of orbital fat were not indicative of severity. In this context, severe diplopia often develops despite low CAS and mild proptosis. We also present our clinical experience with teprotumumab, an anti–IGF-1 receptor antibody. Since its launch in Japan in 2024, we have treated several patients with severe TED, the majority of whom showed remarkable improvement in clinical features. However, adverse effects such as hearing impairment and hyperglycemia were occasionally observed, highlighting the importance of appropriate management. In conclusion, MRI-guided evaluation provides valuable insights for individualized management of TED. Evidence regarding the efficacy of teprotumumab remains limited in the subtype characterized by severe diplopia, which often presents with low CAS and mild proptosis. The MRI-guided approach may help clinicians select optimal therapeutic strategies, including steroid pulse therapy, teprotumumab, and other emerging agents.
• An Update on Thyroid Eye Disease Management
  Kelvin ChongHong Kong, China Speaker An Update on Thyroid Eye Disease Management

• Application of CGM in GDM During and After Pregnancy
  Ling-Jun LiSingapore Speaker Is Continuous Glucose Monitoring Ready for Screening and Monitoring of Gestational Diabetes in Asian Populations?Gestational diabetes mellitus (GDM) is highly prevalent across Asia, where genetic susceptibility, rapid urbanization, and uneven access to antenatal care contribute to rising maternal and neonatal complications. Current screening and monitoring rely on oral glucose tolerance testing (OGTT) and self-monitored blood glucose (SMBG), but both have limitations, including sparse capture of glycaemic variability, patient burden, and missed postprandial excursions. Continuous glucose monitoring (CGM) provides near real-time glucose profiles that can support more responsive management, and emerging studies suggest that early-pregnancy CGM metrics may help predict GDM diagnosed later in pregnancy. However, the evidence remains heterogeneous, with variation in diagnostic criteria, population characteristics, device type, adherence, and background care pathways. Given Asia’s high and growing GDM burden, region-specific evidence is needed to inform guideline and policy development. This talk will synthesize findings from Asian studies, with a particular focus on work from Singapore, and discuss what is required for CGM to move from promising tool to routine practice in GDM screening and management in Asian populations.
• Characteristics and Management of Gestational Diabetes in Japan
  Hirohito SoneJapan Speaker The Impact of Underweight in Young Women on GDM and the Next Generation In Japan and some neighboring East Asian countries, it is somewhat surprising given their socio-economic level that underweight, rather than obesity, is a significant health issue for young women. According to the National Health and Nutrition Survey in Japan, the proportion of underweight women in their 20s (BMI < 18.5) has remained above 20% for decades. Despite this, many young women overestimate their own body size, with numerous individuals attempting to lose weight even though they are actually within the normal range. This reveals a discrepancy between perceived and actual body size, alongside the existence of a desire to be thin. The ideal thin body shape is influenced by social trends and traditional values that posit thinness as more attractive, as well as the influence of mass media and social media. Entertainers and fashion models are often seen as being too thin. The health effects of being underweight in young women are known to include increased osteoporosis and mortality, but adverse effects on pregnancy and pregnancy outcomes have also been observed. Underweight women have a higher risk of gestational diabetes mellitus (GDM), a higher rate of low birth weight, and a lower birth rate compared to women of normal weight. Indeed, in Japan, the rate of low birth weight infants has been increasing in parallel with the proportion of thin women. Recent findings from DOHaD (Developmental Origins of Health and Disease) and fetal programming research have revealed that low birth weight infants face a higher future risk of developing metabolic diseases such as diabetes and hypertension. Consequently, maternal underweight before pregnancy and weight-control behaviors after pregnancy likely have adverse health effects on future generations. Based on this background, Japan has revised the standards for appropriate weight gain during pregnancy, and discussions are currently underway regarding GDM pregnant women. Furthermore, as part of preconception care, education on the importance of maintaining a healthy weight and body image is being promoted, starting from junior high and high school. The trend toward underweight among young Japanese women, even during pregnancy, is a major national health issue, as it affects not only the health of the women themselves but also the next generation. However, its causes are complex, and multifaceted measures involving society as a whole are required. These countermeasures are also expected to be useful for prevention of same issues in other East Asian countries as well in the future.
• Gestational Diabetes and Perinatal Outcomes in A Large Multi-Ethnic Australian Population
  I-Lynn LeeAustralia Speaker Gestational Diabetes and Perinatal Outcomes in A Large Multi-Ethnic Australian PopulationGestational diabetes (GDM) is highly prevalent in a multi-ethnic Australian population in West Melbourne with high representation from South Asian, South East/Central Asian, Middle Eastern, African and Pacific communities. These ethnicities carry a disproportionate higher risk of GDM with earlier diagnosis in pregnancy. Australia adoped the IADPSG screening method in 2015 for which GDM prevalence rose sharply there after accompanied by rising rates of maternal obesity and changes in migration patterns from high risk ethnicities. GDM education is delivered in a group setting and sometimes individualised for culturally and liguistically diverse women. Dietary advice is also delivered in a culturally specific and sensitive manner. Treatment initiation differed with South Asian women requiring pharmacotherapy earlier and insulin use was highest among Middle Eastern women. A smartphone and internet based interactive glucose management system for managing women with GDM is being trialled with an aim to improve efficiency of care delivery. Despite rising GDM prevalence and maternal obesity, the large for gestational age remains unchanged over time. Maternal BMI remains a dominant risk factor for LGA. Induction of labour rates also rose significantly over the last 10 years. It is important to develop multilingual education resources and delivering culturally adapted nutritional counselling is essential to optimising care for women with GDM living in Melbourne's rapidly growing cultural diverse metropolitan communities.

• 2026 Update in Primary Aldosteronism
  Hirotaka ShibataJapan Speaker 2026 Update in Primary AldosteronismDiagnosis and Management of Adrenal Insufficiency
• Personalizing Hypertension Treatment through Renin-Angiotensin-Aldosterone Physiology: Are We There Yet?
  Edith ChowHong Kong, China Speaker Personalizing Hypertension Treatment through Renin-Angiotensin-Aldosterone Physiology: Are We There Yet?Hypertension is the leading cardiovascular risk factor accounting for the global burden of cardiovascular disease and death. Renin-angiotensin-aldosterone-system takes a crucial role as the regulator in maintaining the body’s electrolyte homeostasis. RAAS overactivity is a key pathophysiological mechanism in hypertension. Dysregulation of the RAAS is closely tied to development of hypertension. Primary aldosteronism is a disorder characterised by renin-independent aldosterone excess, manifesting as hypertension with greater risk of end-organ damage compared to individuals with essential hypertension. Recent guidelines for hypertension and primary aldosteronism have uniformly advocated for an expanded screening strategy for primary aldosteronism to improve awareness and detection of this treatable secondary cause of hypertension. Traditionally, screening for primary aldosteronism has relied on the conception that it is a dichotomous condition. However, increasing evidence have suggested that renin and aldosterone abnormalities may exist on a continuum of clinical severity. In individuals with elevated blood pressure and family history of hypertension, higher levels of aldosterone are associated with greater risks of incident hypertension. Among normotensive individuals, the association between high aldosterone and incident hypertension were only evident among those with a suppressed renin, suggesting a phenotype of subclinical aldosterone excess. On the other hand, among individuals with resistant hypertension, targeting RAAS overactivity with mineralocorticoid antagonists have demonstrated superior blood pressure reduction compared to beta-blockers or alpha-blockers, especially in those with lower renin levels. With the development of novel treatments for hypertension that target RAAS, including aldosterone synthase inhibitors and non-steroidal mineralocorticoid inhibitors, there is growing interest in the role of RAAS hormones or metabolites as biomarkers to guide diagnosis, prognostication and management of hypertension. Building upon this foundation, this talk will explore the potential role of aldosterone, renin and their metabolites as biomarkers in diagnosing and treating individuals with hypertension.
• Update of TAIPAI
  Vincent WuTaiwan Speaker From Taiwan to the World: The TAIPAI Journey Transforming Primary AldosteronismPrimary aldosteronism (PA) is an increasingly recognized cause of secondary hypertension, affecting an estimated 5%-15% of hypertensive patients. This condition, once thought to be rare, is now understood to be a relatively common contributor to high blood pressure, particularly in cases resistant to standard antihypertensive therapies. PA arises primarily from either bilateral adrenal hyperplasia or an aldosterone-producing adenoma. The pathophysiology of PA is characterized by excessive and autonomous secretion of aldosterone, an adrenal hormone that plays a critical role in regulating blood pressure and fluid balance. Diagnosing PA involves a multi-step process, beginning with screening tests to identify at-risk individuals, followed by confirmatory tests, and finally, subtype differentiation to determine the specific cause of the condition. Screening is especially recommended for patients who present with certain risk factors, such as resistant hypertension, unexplained hypokalemia, or an onset of hypertension at a young age (under 40 years). Family history of PA, early signs of target organ damage, the presence of an adrenal incidentaloma, obstructive sleep apnea, unexplained atrial fibrillation, and psychosomatic symptoms are also significant indicators warranting screening. Additionally, patients with hypertension but no other comorbidities should be evaluated for PA, as it could be the underlying cause. PA does not occur in isolation; it is often found to coexist with Mild Autonomous Cortisol Secretion (MACS). This co-occurrence presents a more complex clinical picture, as MACS can further aggravate the cardio-renal-vascular complications already associated with PA. Moreover, it can contribute to abnormalities in glucose metabolism, increasing the risk of diabetes and other metabolic disorders. One of the key challenges in the diagnosis and management of PA, particularly when MACS is present, lies in accurately interpreting the aldosterone-to-cortisol ratios during adrenal venous sampling, a critical step in subtype differentiation.

• Advancement in AI Applications to Thyroid Nodule Detection and Diagnosis
  Argon ChenTaiwan Speaker Advancement in AI Applications to Thyroid Nodule Detection and Diagnosis
• Electronic Dashboard-Based Remote Glycemic Management Program Reduces Length of Stay and Readmission Rate among Hospitalized Adults
  Yi-Jing ShenTaiwan Speaker Electronic Dashboard-Based Remote Glycemic Management Program Reduces Length of Stay and Readmission Rate among Hospitalized AdultsBackground: Inpatient dysglycemia is strongly associated with prolonged length of stay (LOS), increased readmission rates, and higher healthcare costs. Traditional consultation-based models are often insufficient for institution-wide glycemic quality improvement. With advances in electronic medical records (EMRs), real-time digital surveillance offers a scalable solution. We implemented a hospital-wide remote glycemic management program to evaluate its impact on glycemic control and clinical outcomes. Methods: Building on our previously published framework, this institution-wide before-and-after study was conducted in a 1,500-bed tertiary medical center using data from 2016 to 2019 (106,528 hospitalized adults; 878,159 glucose measurements). The core intervention utilized an EMR-integrated dashboard to identify hyper-/hypoglycemia in real-time, enabling endocrinologists to provide daily virtual recommendations without formal consultation. Key components included automated risk stratification, real-time alerts, and department-specific performance feedback. Primary outcomes were LOS and 30-day readmission rates. Analyses were performed using Poisson and joinpoint regression with multivariable adjustment. Results: Program implementation resulted in consistent and clinically significant improvements in hospital-wide glycemic metrics. Rapid improvement in treat-to-target rates was observed within 3–6 months of initiating virtual recommendations. Clinical Outcomes: The program was associated with a significant reduction in LOS, independent of age, sex, and admission department. Notably, patients with high glucose variability exhibited the longest LOS, identifying glycemic instability as a key driver of resource utilization. Furthermore, 30-day readmission rates decreased significantly, particularly among patients achieving stable euglycemia. Operational Efficiency & Pandemic Resilience: As glycemic quality improved, the time required for daily virtual recommendations decreased from ~2 hours to <1 hour. The program significantly reduced the need for formal consultations. Crucially, this established remote workflow proved vital during the COVID-19 pandemic, minimizing clinician exposure and preserving personal protective equipment (PPE) while maintaining high-quality glycemic care without disruption. Conclusion: Integrating real-time EMR-based surveillance with remote endocrinologist-led intervention significantly improves inpatient glycemic control, translating into measurable reductions in LOS and 30-day readmission rates. This model has demonstrated sustained efficacy extending into the COVID-19 era and beyond, proving that an electronic dashboard-based system is a scalable, resilient, and resource-efficient strategy for modern hospital care.
• A New Era of Managing Thyroid Eye Disease
  Jae Hoon MoonSouth Korea Speaker A New Era of Managing Thyroid Eye Disease

• The Efficacy and Safety of RFA for PTMC in Long-Term Cohort Study: Do Above and Beyond
  Jung Hwan BaekSouth Korea Speaker Standard and Advanced Techniques for Thyroid RFAThermal ablation, especially radiofrequency ablation (RFA), is promising technique not only for benign thyroid nodules but also for thyroid cancers. In various thyroid tumors, RFA effectively improves tumor-related symptoms and cosmetic problems by reducing tumor volume. RFA is recently adopted to recurrent and primary thyroid cancers. In terms of complication, major complication rate was reported as 1.4% - 8% according to the types, locations and size of the thyroid tumors. Therefore, proper techniques and experience of operators are key factors to achieve effective and safe RFA. To maximize efficacy and to minimize complications, the Korean Society of Thyroid Radiology Guidelines (KSThR Guidelines 2012, 2017, and 2025) recommend the use of standard techniques; the perithyroidal lidocaine injection to control pain, trans-isthmic approach, moving-shot technique and hydrodissection (HD) technique. Furthermore, KSThR Guidelines recommend advanced techniques, such as vascular ablation, bolus injection of cold water (to manage nerve damage problems) or tracheal stent assisted RFA. In this lecture, therefore I will introduce various standard and advanced techniques to maximize the ablation zone and to minimize injury of surrounding critical structures. Furthermore, I will briefly touch “how to combine proper device and techniques” for thyroid RFA.The Efficacy and Safety of RFA for PTMC in Long-Term Cohort Study: Do Above and BeyondThe incidence of thyroid cancer has increased not only in Korea, but in worldwide. This situation is mainly due to an increase in the over detection of small papillary thyroid carcinomas (PTCs) using high-resolution ultrasonography (US). Almost all newly detected thyroid cancers are small papillary thyroid cancers (PTCs), while the incidence of large PTCs and aggressive histological types has remained stable. In addition, mortality of thyroid cancer has remained stable in Korea. Therefore, several studies have suggested over-diagnosis of small thyroid cancers, especially papillary thyroid microcarcinomas (PTMC). Since the majority of PTMCs progress slowly and show excellent outcome and considering the drawbacks of surgery including voice change or hypoparathyroidism, it is time to re-evaluate the role of surgery (especially immediate surgery) for all biopsy proven PTMCs. According to publications from South Korea and other countries, the incidence of thyroid carcinoma had increased 15-fold between 1993 and 2011; however, its mortality rate did not decrease. Moreover, the number of patients who suffered from surgical complications increased significantly. Considering the exceedingly low disease-specific mortality rate of PTMCs and the potential complications of thyroidectomy, it is imperative to consider alternative management strategies for PTMC management. Therefore, this lecture will review the current oncologic outcome (in both short and long-term follow-up studies) of thermal ablation in PTMC and compare it with the results of active surveillance and surgery.

• Update in Primary Aldosteronism
  Mitsuhide NaruseJapan Speaker Update in Primary AldosteronismPrimary aldosteronism (PA) is linked to significantly greater cardiovascular morbidity and mortality than essential hypertension, yet it offers a more favorable prognosis when appropriately treated. Early detection and targeted therapy are therefore essential for achieving optimal long-term outcomes and preserving quality of life. Since the release of the Endocrine Society’s guidelines in 2010, several countries—including Japan—have developed national recommendations (e.g., Endocrine Journal, 2021). This reflects growing awareness and research momentum, with over 3,500 publications in the past decade. In Japan, we have established a national PA registry and conducted multicenter studies under the Japan Primary Aldosteronism Study (JPAS), supported by AMED, resulting in more than 40 publications as Japan-originated evidence. Diagnostic protocols have become increasingly standardized, encompassing initial screening, confirmatory testing, subtype classification via adrenal venous sampling (AVS), and tailored treatment—mineralocorticoid receptor (MR) antagonists for bilateral PA and adrenalectomy for unilateral PA. The integration of PA screening into routine hypertension care, alongside the standardization of diagnostic methods, has led to substantial improvements in clinical practice. However, key challenges remain. These include variability in assay methods (e.g., PRA vs. ARC for renin; CLEIA vs. RIA for aldosterone), which affects diagnostic thresholds; uncertainty regarding optimal cutoffs for screening and confirmatory tests; lack of consensus on AVS protocols (with or without cosyntropin); and ongoing debates over the role of non-invasive imaging and advanced surgical approaches (laparoscopic vs. robot-assisted adrenalectomy). These unresolved issues warrant evaluation through a cost-effectiveness lens. As PA diagnostics become increasingly integrated into hypertension management, a fundamental question emerges: How far should we go in diagnosing PA? This presentation will provide an updated overview of clinical practice and address these critical challenges in PA management.Do We Still Need Confirmatory Testing?

• History of Asia Oceania Congress of Endocrinology
  Takashi AkamizuJapan Speaker History of AOCE