Endocrine Abstracts

Introduction: In 2014 the diabetes multidisciplinary team at Gloucestershire Royal Hospital Foundation Trust introduced dedicated annual review clinics for children with type I diabetes over the age of 8 years. Children receive their Consultant appointment, foot check, annual review bloods and structured education sessions in a single afternoon clinic visit. We present the results of two annual service evaluation projects, which have helped us improve the clinics and allowed u...

Section 1: Case history: A 30-year-old Romanian male presented to A&E with symptomatic hypoglycaemia (point-of-care venous glucose 1.8 mmol/l, laboratory value 2.0). He reported 2 days of intermittent left-sided abdominal pain and frequent food craving. Despite eating, he developed dysarthria, hyperhidrosis, somnolence and asthenia, associated with epigastric pain and vomiting. He was recently diagnosed with hepatitis C, discovered incidentally during investigations for ch...

Background: Adrenal incidentalomas (AI) are common, with approximately 40% of these demonstrating evidence of mild autonomous cortisol secretion (MACS). MACS has been associated with increased morbidity and mortality, and some patients with MACS may benefit from medical therapy or adrenalectomy, so all require further evaluation. Given the large numbers of patients involved, this has potentially significant resource implications for outpatient endocrinology se...

Introduction: Testosterone(T) is converted to dihydrotestosterone(DHT), the most potent androgen, by the enzyme 5alpha-reductase type 2(SRD5A2). During foetal development, the masculinisation of male external genitalia crucially depends on DHT. Pathogenic variants in SRD5A2 cause 46,XY differences in sex differentiation(DSD). Early and accurate diagnosis is paramount to facilitate gender assignment since most reared as females may profoundly virilize at pubert...

Chemerin is a newly discovered chemoattractant adipokine and is a natural ligand for the G protein coupled receptor CMKLR1. Its role in the regulation of energy metabolism and inflammation makes it a promising candidate for urgently needed pharmacological treatment strategies for obesity. To demonstrate a central role of chemerin, we manipulated chemerin signalling in the arcuate nucleus, a specific hypothalamic region associated with appetite regulation. We designed a short-h...

The usual management at our centre for patients awaiting phaeochromocytoma surgery involves pre-operative titration of alpha blockade with frequent clinic visits for blood pressure (BP) and heart rate (HR) monitoring. The COVID-19 pandemic restricted our ability to consult with patients frequently. To reduce infection risk, we incorporated virtual BP monitoring using a Microsoft Excel template coupled with regular remote consultations. We present a clinical case highlighting o...

Introduction: Hybrid closed-loop (HCL) systems are characterised by integrating continuous glucose monitoring (CGM) with insulin pumps which automate insulin delivery via specific algorithms and user-initiated insulin delivery.Objectives: The aim of the study was to evaluate effectiveness of HCLs on HbA1c, time-in-range (TIR), hypoglycaemia frequency and quality of life measures in children and young people (CYP) with T1D, and their carers.<p class="...

Background: Cystic Fibrosis related diabetes affects 40-50% of adults with cystic fibrosis (CF). This can significantly affect pulmonary function and life expectancy. Kaftrio (Ivakaftor, tezacaftor and elexacaftor) has recently been licensed for use in CF. Previous data highlight that glucose regulation may be altered on commencing this treatment.Methods: Eight children and young people (CYP), aged 14 (12-15) years, who were diagnosed with CFRD aged 12.8...

Background: NICE recommendation is to use multiple daily insulin injections and to offer level 3 carbohydrate-counting education at diagnosis of Type 1 diabetes (T1DM), and at least at annual intervals thereafter. Best Practice Tariff states that every young person with diabetes should be offered at least one additional appointment per year with a paediatric dietitian with training in diabetes. Our aim was to identify details of all the patients in the current cohort who were ...

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Clinical guidelines recommend overnight dexamethasone suppression tests (ONDST) to assess for cortisol hypersecretion with cortisol levels of 50-138 nmol/l termed “mild autonomous cortisol secretion” (MACS). MACS may be associated with both cardiovascular and metabolic morbidity. We assessed cardiovascular risk in patients with MACS us...