Endocrine Abstracts

Introduction: Inpatient admission presents an opportunity to deintensify treatment in people with diabetes and frailty. The Joint British Diabetes Society recommends checking HbA1c in people with diabetes and frailty during admission if it had not been checked in the preceding six months. The audit aimed to identify the proportion of people who had their HbA1c checked upon admission and, if appropriate, what proportion had their treatment deintensified.<p ...

Introduction: National guidance states that people with diabetes and frailty require personalised targets and less aggressive treatments due to the limited evidence for benefits and the high risk of hypoglycaemia. Studies have shown a low rate of deintensification in this cohort of patients that may increase the risk of inpatient hypoglycaemia, contributing to morbidity and mortality. The audit aims to assess the frequency of inpatient hypoglycaemia and its as...

Introduction: unior doctors (JDs) are important part of the multidisciplinary team when managing people admitted with diabetes and frailty. Several guidelines have recommended a target HbA1c of between 7.0-8.5% for this group of people with diabetes. We aimed to assess junior doctors’ knowledge and awareness of management guidelines for people with diabetes and moderate/severe frailty.Methods: Survey was conducted a...

Introduction: Our previous study has shown low rates of inpatient deintensification and high rates of adverse outcomes in people with diabetes and frailty1. The diabetes in reach (DiR) team consists of diabetologists working together with diabetes specialist nurses, proactively supporting non-specialists in the inpatient management of diabetes. This could be done either virtually or by face-to-face review in the medical ward. This study assessed the role of the DiR ...

We report a 33 year old female who presented at 23 weeks gestation with rapid onset polyuria and polydipsia. Fluid input and output was approximately 12 litres per day. She denied any other symptoms. She did not have signs of hypopituitarism, Acromegaly or Cushing’s syndrome. Visual fields were normal to confrontation. Her standard glucose tolerance test, Hba1c, creatinine and calcium were normal. Gestational Diabetes Insipidus was (GDI) suspected. Given her pregnancy, a ...

We report a 45-year-old man who developed acquired primary hypoparathyroidism based on a low serum adjusted calcium level and low parathyroid hormone level. His past medical history included recurrent chronic anaemia requiring multiple transfusions since 2011. He was an ex- intravenous drug user, and suffered from chronic bilateral venous leg ulcers, and liver cirrhosis following Hepatitis C infection. Despite using doses of up to 8 mcg Calcitriol daily, his calcium levels fel...

Background: Graves’ disease is widely treated with anti-thyroid medication. After an initial course of treatment, remission is achieved in around 50% of patients. Definitive treatment is generally offered in relapsed cases, based on the assumption that remission rates following a second course of anti-thyroid medication are significantly lower.Method: A database of patients with Graves’ disease has been kept from 2004. 150 patients were suitabl...

A 19 year old girl presented at 39 weeks gestation with headache and blurring of vision. MRI showed an enhancing pituitary mass measuring 1.2 cm maximum height, extending suprasellarly and distorting the optic chiasm. Visual field testing showed bilateral constriction. 0900 h cortisol was 502 nmol/l, thought to be relatively low for the stage of pregnancy and FT4 was 9.3 pmol/l suggesting TSH deficiency. Prolactin was appropriately raised for the gestational age at 4951 mU/l.<...

A 51-year-old asymptomatic man presented in 1998 with elevated thyroid stimulating hormone (TSH) 6.34 mIU/l (0.34–5.6 mIU/l), FT4 54.1 pmol/l (7.5–21.1 pmol/l), FT3 20.1 pmol/l (3.0–5.0 pmol/l) and TSH-α subunits 3.6 mcg/l (<2.0 mcg/l). After the first visit, he was lost to follow-up.He presented 10 years later in 2008 with 1-week history of symptoms of heart failure and hyperthyroidism. Clinically he was thy...

Background: Thionamides are a safe and effective treatment for Graves’ thyrotoxicosis and tend to be favoured over radioiodine in the UK. Risk of recurrence following cessation of thionamides is high although most studies tend to have short duration of follow up. We have previously published follow-up data to 4 years in this cohort and now present follow-up out to 7 years.Methods: Retrospective review of first presentation Graves’...