Endocrine Abstracts

Context: Testosterone replacement therapy (TRT) has shown benefit on insulin resistance, glycaemic control and cardiovascular risk markers in hypogonadal men with diabetes. Arterial stiffness and intima-media thickness (IMT) are vessel wall properties associated with future cardovascular risk which allow the progress of atherosclerosis to be assessed non-invasively. Low testosterone has been associated with the presence and progression of carotid atherosclerosis as assessed by...

Objectives: Pituitary Apoplexy, either as a result of haemorrhage or infarction, remains a rare but serious Endocrine Disorder, requiring urgent clinical assessment and management. The British Endocrine Society (BES) has set out recommendations regarding the diagnosis and management of pituitary apoplexy, but there remains little published literature depicting this. The aim of this study was to compare our current Management practise of Pituitary Apoplexy with the recommendati...

Introduction: Patients with diabetes mellitus require insulin with disease progression to attain or maintain glycaemic targets. Patients and physicians work together to balance the advantages of improved glycaemic control with the risk of hypoglycaemia and increasing regimen complexity. Insulin Degludec (Tresiba) is an ultra-long-acting insulin analogue launched in the UK in March 2013 and is available in two strengths, 100 and 200 units/ml.Method: Retro...

Background: Adrenocortical carcinoma (ACC) is a rare malignant tumour of the adrenal cortex with an incidence of 0.7-2.0 per million per year. The majority are steroid-producing with non-ACTH dependent hypercortisolism the most frequent biochemical abnormality. Around 10-15% of cases are picked up incidentally on abdominal imaging. Management of ACC during the covid-19 pandemic poses specific challenges. We present the case of a 69-year-old man who was found to have a massive ...

Introduction: In 2003, the UK National Institute for Clinical Excellence (NICE) established guidelines on the use of GH in adults. These guidelines state that recombinant GH should be used only for adults with a severe GH deficiency that severely affects their quality of life. To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to assess if adults with GH deficiency met NICE criteria for GH therap...

Hypogonadism is more prevalent in populations with type 2 diabetes (T2D) and/or cardiovascular disease (CVD) and is associated with increase in all-cause and CVD mortality. Testosterone replacement therapy (TRT) improves visceral adiposity, insulin resistance, glycemia, lipids inflammatory cytokines and cardiac ischaemia. The long-term safety of TRT in men with CVD and/or T2D is not known and the British National formulary advises use with caution these groups.<p class="ab...

Context: Obesity, diabetes and cardiovascular disease in men are associated with low testosterone levels. Leptin is produced in adipose tissue in proportion to obesity and is known to be negatively associated with testosterone in men. The shared association of testosterone and leptin with obesity is in line with the proposed adipocytokine–hypogonadal–obesity cycle which aims to explain the relationships between these variables.Methods: We inves...

Low testosterone levels are a common in men with coronary artery disease and Type 2 diabetes (DM2). Testosterone replacement therapy improves insulin sensitivity and glycaemic control in men with diabetes and improves numerous other cardiovascular risk factors. Interest in testosterone as a potential treatment for cardiovascular disease continues to grow. Low HDL cholesterol (HDL-C) levels are recognised as an independent cardiovascular risk factor and comprise part of the met...

Men with Type 2 diabetes have a high prevalence of low testosterone levels. Testosterone replacement therapy (TRT) has been shown to improve insulin sensitivity and glycaemic control in men with Type 2 diabetes. TRT also reduces fat mass and central obesity. The androgen receptor CAG repeat polymorphism length (AR CAG) correlates positively with transcriptional activity of the receptor as well as body fat, and insulin levels in healthy men. Most studies have not found an assoc...

A 37 year old lady with relapsing Graves’ thyrotoxicosis initially managed on a ‘block and replace regime’ with propylthiouracil and levothyroxine for 7 years had her medication changed to carbimazole after a relapse from non-compliance but developed agranulocytosis. She was then restarted on an increased dose of propylthiouracil alone. Two weeks later, she developed tender purpuric lesions and was admitted after developing painful bullous lesions to her lower l...