Endocrine Abstracts

Introduction: A 59-year-old gentleman with longstanding poorly controlled type 2 diabetes mellitus, obesity, hypertension, obstructive sleep apnoea, depression and type 2 respiratory failure was seen in diabetes review clinic and noted to have truncal obesity, moon facies and wasting of the proximal muscles.Investigations: Urinary free cortisol was 782 nmol/24 h (NR <200). Midnight cortisol was 595 and 532 nmol/l on consecutive days. After low dose d...

Type 1 Diabetes is typically a disease of the young but can present at any age. It is important to ensure correct categorisation as the acute complications related to insulin deficiency can occur and can be life threatening. It is important for physicians to maintain a high index of suspicion while dealing with newly diagnosed diabetes in an older patient. The following case report illustrates the fact that Type 1 Diabetes can present in the elderly.CAS...

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.Aim: To assess c...

A 64-year-old man presented with mild biochemical hyperthyroidism – TSH <0.01 mU/l (NR 0.35–4.90), FT4 19.4 pmol/l (NR 9–19) in 2005. He was treated by his general practitioner with a 9 months course of carbimazole. Six months later, TSH became suppressed (0.05 mU/l) but with a normal fT4 (17 pmol/l). He was referred to a ‘One-Stop’ Thyroid Clinic and was seen there 3 months later. Thyroid isotope scan showed a toxic multinodular goitre. He was tre...

Thyroid dysfunction is not uncommon in pregnancy and is associated with various maternal, foetal and neonatal complications. We report the occurrence of neonatal hyperthyroidism in two successive pregnancies in a post radio-ablation mother with Graves’ disease who is on thyroxine replacement.Mother: A 30-year-old lady, treated for Graves’ thyrotoxicosis with radioiodine 10 years ago, was on thyroxine 100 mcg replacement for hypothyroidism. She ...

Type 2 diabetes mellitus (T2DM) is associated with insulin resistance/ hyperinsulinaemia and chronic sub-clinical inflammation that is considered important in the pathogenesis of macrovascular disease. We propose activation of the innate immune system, a biologically conserved first line immune response, within adipose tissue by endotoxaemia secondary to hyperinsulinaemia as one of the causes of this phenomenon. Hyperinsulinaemia may lead to altered gut permeability and result...

Aim: To assess usage of newly available rapid-acting insulin analogues in the antenatal diabetes clinic, and to determine whether introduction of these agents has influenced glycaemic control.Methods: We analysed our diabetes antenatal clinic attendances from April 2002 to June 2003 using the DIABETA 3 database. 290 pregnant women were seen over this period which was divided into three groups: Group I (April to September 2002), Group II (October 2002 to ...

Aim: To assess usage of newly available rapid-acting insulin analogues in the antenatal diabetes clinic, and to determine whether introduction of these agents has influenced glycaemic control.Methods: We analysed our diabetes antenatal clinic attendances from April 2002 to June 2003 using the DIABETA 3 database. 290 pregnant women were seen over this period which was divided into three groups: Group I (April to September 2002), Group II (October 2002 to ...

Background: CSF rhinorrhoea is a rare but recognised complication of dopamine agonist therapy for macroprolactinoma. In the majority of cases, onset of CSF rhinorrhoea is within 4 months of commencing therapy.Case report: A 23-year-old man presented to the Emergency Department in April 2010 with acute weakness in his left arm and leg associated with intermittent headaches. Examination revealed mild right-sided ptosis and inadequate androgenisation. Visua...