Endocrine Abstracts

Pituitary metastasis has been reported in about 6–8% of the breast cancer patients. Diabetes insipidus is the most common initial presentation in metastatic lesions of the pituitary. Anterior pituitary lobe lacks a direct blood supply and involvement usually is due to spread from the posterior lobe. We present a case of a 68-year-old female with known stage IV breast cancer with bone metastasis on trastuzumab, lapatinib and anastrozole who presented with hypotension, leth...

Background: In any given week, 2.5% of diabetic patients have a foot ulcer. In the United Kingdom (UK), there are 7000 lower limb amputations in people with diabetes every year and the annual NHS expenditure on diabetic foot-related healthcare amounts to £1 billion. As per the National Institute for Health and Care Excellence guidelines in the UK, a person with diabetes needs to be referred to an MDT within 24 h of finding a foot ulcer. The National Diabetes Footcare Audi...

The advances in cancer therapy over the past two decades have led to remarkable improvements in survival rates, but treatments such as chemotherapy, radiotherapy and/or surgery can induce premature ovarian insufficiency (POI) in some circumstances. Fertility preservation (FP) is therefore a key challenge for these women. At diagnosis, all women affected by cancer should benefit from an informed consultation on the threat of compromising their fertility with planned cancer trea...

Background: Pancreatic Neuroendocrine Tumors (PanNETs) are highly prevalent in Multiple Endocrine Neoplasia type 1 (MEN1) and one of the main causes of mortality. Conventional imaging is the mainstay of PanNET screening/surveillance in MEN1. This study aims to assess the diagnostic accuracy of conventional pancreatic imaging studies and to determine the added value of pancreatic fine needle aspirations (FNA) for the diagnosis of MEN1-related PanNETs.Meth...

IntroductionDiabetic nephropathy is the leading cause of end-stage-kidney disease (ESKD). Clinical practice guidelines recommend prescribing renin–angiotensin aldosterone system inhibitors (RAASi) to prevent diabetic nephropathy at any stage. We conducted this extensive meta-analysis to compare the effects of RAASi with placebo and other antihypertensives in adults with diabetes on binary and continuous renal outcomes to provide a comprehensive revi...

Background: Patients with adrenal insufficiency (AI) require glucocorticoid replacement therapy. Current Endocrine Society guidelines recommend thrice-daily hydrocortisone (15-25mg) or once-daily prednisolone (3-5mg). Concerns around prednisolone use have been based on evidence using higher doses. We have been using low-dose (2-4mg) once-daily prednisolone since 2014 for glucocorticoid replacement in adult patients with AI. This study aimed to compare the effe...

Background: To assess whether the improved service provision introduced under the new Paediatric Diabetes Best Practice Tariff, which includes increased contact with the multi-disciplinary team and greater access to psychology support, has impacted positively on the quality of life (QoL) and glycaemic control of young people with diabetes.Method: In 2011, n=55 children and young people with diabetes completed the Generic Paediatric Quality of Li...

Introduction: Pregnancy under the age of 19 is considered high-risk1; and a pregnancy with diabetes at this age further increases that risk2,3. With the correct advice and counselling, these risks can be greatly reduced. Here we describe a strategy to raise awareness by addressing this as part of regular clinic visits.Method: Prior knowledge of potential complications of pregnancy was assessed as part of a clinical consultation. Evi...

Ovarian neuroendocrine tumours are rare (< 2% gynaecological tumours) and first described in 1939 by Stewart et al. The occurrence of carcinoid heart disease alongside this is anecdotal. We present a previously fit 66 year old female, with a 6 month history of shortness of breath and ankle oedema. Echocardiogram revealed severe fixed tricuspid regurgitation, pulmonary valve disease, dilated right heart chambers and preserved left ventricular function. Carcinoid heart disea...

Introduction: The current guidelines state that the goals of growth hormone (GH) therapy should be an appropriate clinical response and avoidance of side effects. The target level for IGF1 is commonly the upper half of the reference range, although no published studies offer specific guidance in this regard. Therefore, the aim of the present study is to investigate associations between IGF1 levels within the reference range and several efficacy and safety measures of GH treatm...