Endocrine Abstracts

Introduction: The paediatric diabetes team in Leicester identified an unmet need for educating children about carbohydrate counting, following the initiation of most diagnosed patients on multiple dose insulin therapy (MDI). The team therefore started a new structured group education programme (SGEP) for children with type 1 diabetes (T1DM) called flexible adjustment of basal bolus (FABB) that has run since January 2007.Aims: To determine the effectivene...

A 28-year old Lithuanian woman presented with a 6-week history of firm anterior neck swelling. There were no symptoms of local obstruction, invasion, or thyroid dysfunction, and no past medical history, medication use or relevant family history. On initial assessment, she was euthyroid, with a 6 cm hard mass replacing the right lobe of the thyroid, a 2 cm lymph node lateral to it, but no other lymphadenopathy. No cellular material could be obtained on initial clinical and ultr...

After adrenal insufficiency is confirmed by synacthen testing, lifelong steroid replacement is expected. We report a case of apparent reversal of adrenal insufficiency. Case details: a 66-year-old man was referred for oral pigmentation, and a random cortisol level of 184 nmol/l. He reported a 2-year history of tiredness, nocturia, dry mouth and reduced libido. There was no dizziness, salt-craving, or weight loss. He denied taking any form of steroid or over-the-counter drugs. ...

CYP17A1 is a key enzyme of human steroidogenesis, which is unique in that it catalyses two reactions, 17-hydroxylase activity and 17,20 lyase activity. 17-hydroxylase deficiency, a variant of congenital adrenal hyperplasia, results in hypertension and mild glucocorticoid deficiency. Loss of 17,20 lyase activity results in sex steroid deficiency, presenting with undervirilisation in boys (46, XY DSD) and lack of pubertal development in girls. Here we present the cases of two si...

Background: Carcinoid tumours of colon and rectum (CTCR) are a rare entity. A review of a tertiary referral units experience is presented.Aim: Reviewing our experience of CTCR with emphasis on tumour site, disease stage, treatment and long term outcome.Method: Retrospective analysis of our endocrine tumour database was performed. All patients diagnosed with CTCR between 2000 and 2009 were included.Findings: T...

Successful surgery for pancreatic neuro-endocrine tumours (NET) requires accurate tumour localisation. Interpretation of cross-sectional imaging is often difficult, particularly after pancreatic surgery. Imaging by somatostatin-receptor-scintigraphy with indium-labelled octreotide may be useful in identifying recurrent disease; however, octreotide scans may be negative in some pancreatic NET, due to a low level of expression of somatostatin receptors. The GLP-1 receptor is abu...

The hypothalamo-pituitary–thyroid (HPT) axis serves to maintain appropriate systemic levels of thyroid hormone (TH) through a negative feedback pathway via the hypothalamic arcuate and paraventricular nuclei. However, the effects of TH in other hypothalamic regions are poorly understood. Triiodothyronine (T3) administration to the hypothalamic ventromedial nucleus (VMN) induces a potent hyperphagic response, although it is unclear whether this is part of a nove...

Stressors engage a neural stress response network that is mediated in large part through the immediate actions of the stimuli on corticotropin-releasing factor (CRF) neurons in the amygdala (CeA) and in the long-term by the actions of glucocorticoids (GC) on increased synthesis of CRF in CeA and secretion of CRF on the monoaminergic cell groups as well as forebrain. The consequences of this bias behavioral, autonomic and endocrine outputs in the stressed organism. However, the...

Saxagliptin (SAXA) is a potent, selective dipeptidyl peptidase-4 (DPP-4) inhibitor, specifically designed for extended inhibition of the DPP-4 enzyme. The efficacy and safety of SAXA 5 mg add-on therapy to a thiazolidinedione (TZD), metformin (MET), or an intermediate dose of glibenclamide (GLY), was investigated in patients with inadequately controlled (HbA1c>7.0%) type 2 diabetes mellitus (T2DM) in three randomised, double-blind trials (CV181-013, CV181-014 an...

Introduction: The majority of dedicated endocrine surgery centres in the UK and abroad routinely perform pre-operative vocal cord checks prior to cervicotomy. Ultrasound scanning is increasingly used as routine imaging in the work up of patients being assessed with thyroid and parathyroid disease. We report on the additional use of USS as a method of performing pre-operative vocal cord checks.Method: We report the early results on 32 patients undergoing ...