Endocrine Abstracts

Section 1: Case history: A 46-year-old woman was referred to the Endocrinology clinic for evaluation of persistently elevated parathyroid hormone levels despite correction of previous vitamin D deficiency. She had a history of calcific tendinitis of the left shoulder and iris pigment dispersion syndrome. Notably, her mother had undergone two parathyroid surgeries for primary hyperparathyroidism with removal of three parathyroid glands, revealing multiple parathyroid adenomas a...

Both genetic and environmental factors determine whether individuals who have a predisposition to the development of type 1 diabetes actually develop the disease. Although we now know a considerable amount about the genetics through genome wide scans, and diabetes risk scores have been developed, the actual environmental triggers or perpetuating factors are not clearly defined. There has been considerable interest in recent years in investigation of these possible environmenta...

Introduction: Ketotic hypoglycaemia is not an unusual presentation in preschool children particularly following gastroenteritis. Non-ketotic hypoglycaemia in a child is uncommon and could be due to endocrine or metabolic disorders.Case report: Presentation: 4-year-old presented with fainting episode and hypoglycaemia as first episode. She was managed by the ambulance crew with oral glucose. Weeks later present to emergency department with non ketotic hyp...

As endocrinologists, we consider a patient with a pituitary disease is controlled if hormone parameters are normalized and tumour growth is stabilized. However, the patients’ perception of health is related to whether they can continue performing their daily life, both personal and professional; this is often not the case due to pain, physical or psychological limitations or social/family issues related to their disease. This is more relevant nowadays that pituitary dysfu...

Pancreatic beta-cells maintain the body’s glucose levels within a very narrow range. In the face of insulin resistance and obesity, most people do not become diabetic due to the ability of the endocrine pancreas to have compensatory growth. Any limitation on replacement or shortening of lifespan could have dire consequences for glucose homeostasis. Type 2 diabetes develops only when b-cells fail to compensate for increased demand from insulin resistance. While Type 2 diab...

Aims: Implementation of a protocol-driven, nurse-led clinic to see influence on cardiovascular risk and renal disease progression using a simple ‘ABC’ approach – target HbA1c <7%, BP <125/75 mm Hg and Cholesterol <4 mmol.Method: Weekly Diabetes Specialist Nurse (DSN) clinic with emphasis on ABC approach and guided FLORENCE Telehealth free texting technology for medication reminders and self-monitoring of BP (machines provided)....

Background: Social deprivation is high within our large ethnic and diabetes prevalent population. Compliance is a major stumbling block in the achievement of Blood Pressure (BP) targets. Given the above, we took the opportunity to enrol with West Midlands Academic Health Science Network (WMAHSN) Florence (Flo) Exemplar project mobile phone texting service. Flo sends advice and collects patient information which clinicians can access through any device connected to the internet...

Aim: To investigate the trend of HbA1c levels of newly diagnosed type 1 diabetes paediatric patients in Gloucestershire Hospitals NHS Foundation Trust.Methodology: The Infoflex diabetes database was used to collate information on the type 1 diabetes paediatric patients, diagnosed in Gloucester NHS Trust between September 2015 and December 2017. The cohort totalled 74. Their HbA1c levels at diagnosis, 4–7 weeks, 3–4 months, 6–8 months and 1...

Cushing’s syndrome (CS) is associated with systemic complications, which despite successful treatment are not always totally reversible. Morbidity like venous thromboembolism, myocardial infarction, stroke, peptic ulcers, fractures and infections are higher in patients diagnosed with CS, both of adrenal and pituitary origin, and remain elevated during long-term follow-up. In fact, this increased multimorbidity risk is even present in the 3 years before diagnosis, as demon...

A 55-year-old female presented to her General Practitioner with hirsutism, male pattern baldness, weight gain and a deepening of voice. Her past medical history included well controlled type 2 diabetes on gliclazide, and hysterectomy for menorrhagia. She had an elevated serum testosterone after solvent extraction (18 nmol/l) and free androgen index (17.6). The patient was referred for further investigation.17-Hydroxyprogesterone and dehydroepiandrosteron...