Endocrine Abstracts

Introduction: Sri Lanka has been experiencing rapid urbanization, with ~30% of the population residing in urban areas. We report the age and sex-specific prevalence of dysglycaemia and vitamin D (VitD) status, along with the association between the two in an urban community in Sri Lanka.Methodology: Using a stratified random sampling method, 369 subjects (116 men and 253 women) aged 18 years and above, were tested for 25OH VitD3, 75 g OGTT, and HbA1c. De...

A 65-year-old gentleman was referred by his GP because of acute kidney injury and hypercalcaemia, which was associated with low levels of parathyroid hormone. He had been fit and well and was on no regular medications. Whilst his hypercalcaemia was partly correctible with saline rehydration, cautious use of bisphosphonates and cinacalcet were not effective in preventing rebound, and his nephropathy persisted. Curiously, he had longstanding low plasma alkaline phosphatase, but had normal denti...

Clinical interactions with patients are fulfilling and rewarding. We can make a difference to patients’ health and lives by tuning care and attention to their individual needs on a 1:1 basis. Frustrations sometimes emerge from clinicians due to perceived restrictions and limitations in the healthcare system that appear to perversely impact patient care. Those frustrations are often exacerba...

Continuous Glucose Monitoring and Flash Glucose Sensing are exciting new technologies popular with many patients and their parents who are keen to have access to such technologies. However such technologies are costly and it is important that clinicians identify patients who are most likely to benefit and ensure that families have appropriate training in order to optimise their use. The aims of this overview are firstly to review the evidence underpinning CGMS and to discuss t...

The European PARAT group have recently explored a number of practical management issues in parathyroid diseases. Herein, we present expert opinion on areas of controversy in the diagnosis and management of primary hyperparathyroidism (PHPT). Although PHPT is common, its differential diagnosis from familial hypocalciuric hypercalcaemia (FHH) poses practical problems. Proposed approaches to addressing this will be discussed. The definition and clinical course of normocalcemic PH...

Success following initial parathyroid surgery is high at approximately 95%. Developments in preoperative imaging techniques and subtle variations in parathyroid surgical approach have marginally improved already high success rates. However, failed initial neck exploration or true later recurrence of primary hyperparathyroidism (PHPT) can be difficult to manage. The initial consideration is always to ensure that the diagnosis of PHPT is secure and it is prudent to re-evaluate t...

Hypercalcaemia is common and can represent a broad spectrum of underlying diseases that range from common to extremely rare. Furthermore, causes of hypercalcaemia can be mild and indolent or may be rapidly progressive and represent serious underlying diseases such as cancers. It is thus important to have a clear understanding of hypercalcaemia, particularly its early assessment and management that will lead to a diagnosis of the underlying cause. Hypercalcaemia can present as ...

The last couple of years have seen an advance in generating human β-cells from pluripotent stem cells. It is now clear that cells of greatly increased maturity can be obtained from robust protocols. In addition to improving the prospects of cell replacement therapy, these developments allied to greater understanding of how human β-cells are first generated in the body are allowing development of more complex model systems. These model systems are likely to be importa...

Paediatric diabetes is a common, chronic, largely self managed disease. The problems children and young people deal with are complex and wide-ranging in scope. The key to success lies in close, personalised support and education for families facing this condition by an MDT who knows them well and is familiar with the local environment.I will put the case that this is best delivered in the UK by properly trained, resourced and accountable local teams, sup...

The natural history of osteogenesis imperfecta (OI) during childhood is changing due to the availability and effectiveness of bisphosphonates in ameliorating fracture risk and promoting significant gains in bone mineral density in most children with OI. Not all children with OI require treatment with bisphosphonates, however. Fracture rates in patients with OI typically fall in the latter teenage years as the longitudinal growth of the skeleton ceases. Most adults with OI enjo...