Conventional nuclear medicine techniques can be tools for problem solving in Endocrinology. Investigations should be tailored to answer specific clinical query. Regular interaction between Nuclear Medicine and Endocrinology departments is essential to develop optimum strategies.

Routine screening of asymptomatic diabetics for silent ischemia is not recommended. Stress myocardial perfusion imaging (MPI) has high sensitivity for detecting silent ischemia. Positron emission tomography (PET) coronary flow rate may be useful to detect nonocclusive coronary artery disease (CAD).

According to the ACCF/AHA guidelines, asymptomatic diabetics over age 40 should be screened for coronary heart disease (CHD) with coronary artery calcium (CAC) scan. For those with CAC score <400, medical therapy can be considered and for those with a score >400, stress imaging study should be considered.