Endocrine Abstracts

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Aim: To determine the association between recorded inpatient glycaemic variability and long-term mortality in patients with diabetes mellitus.Methods: Inpatient capillary blood glucose (CBG) readings from eight acute hospitals were included. Data was analysed from first admission within the dataset with >4 measured CBGs. 28 353 admissions were identified (24 181 type 2 DM, 4,172 type 1 DM). Matching parameters were: age, diabetes duration, admission ...

Introduction: The World Health Organisation (WHO) states that in an iodine sufficient population <3% of neonatal TSH values will exceed 5 mU/l. In Belgium and Wales 2.6 and 1.5% of values were above 5 mU/l respectively.Methods: Neonatal TSH (neoTSH) levels (AutoDELFIA fluoroimmunoassay, 2006–2013, Scotland) were analysed for prevalence of high value according to cut-off, season and feeding mode (IBM SPSS 22).Results: Out o...

Background: Insulin dose requirements are higher during puberty and in overweight/obese individuals with type 1 diabetes mellitus (T1DM) due to insulin resistance. Through meta-analysis metformin has been shown to be beneficial as adjunctive therapy in T1DM adults independent of BMI. The large volumes of insulin required to administer higher insulin doses in insulin-resistant individuals have adverse effects on insulin absorption. Insulin degludec (Tresiba) U200 preparation al...

A 85-year-old man presented with a 2-week history of malaise, confusion and agitation and 4 weeks of polydipsia and polyuria, with water intake of 6 l/day. His past medical history included hypertension, congestive cardiac failure, and chronic kidney disease. On examination he was hypervolaemic. Initial investigations were as follows: serum sodium 115 mmol/l, potassium 4.6 mmol/l, urea 8.1 mmol/l (2.5–7.8), creatinine 138 μmol/l (66–112), serum osmolality 245 mO...

Background: Turner syndrome (TS) is associated with significant morbidity and a reduction in life expectancy. National guidelines have been developed to support the management of adult patients with TS but little is known about their implementation. We therefore sought to compare the management of patients with TS seen within a single tertiary referral centre by endocrinology, either general-purpose or Turner-specific clinics (TSC), or by other specialties.<p class="abstex...

Background: Treating life-threatening diabetic ketoacidosis (DKA) with a pH of <6.9 is extremely challenging and often refractory to treatment using standard fixed dose insulin DKA management protocols which may not work effectively at this low pH because of increased insulin resistance. I.v. bicarbonate (HCO3) use in this situation can be considered but remains controversial due to the risk of significant side effects as well as limited evidence in literature. ...

Background: Dapagliflozin was the first SGLT2 inhibitor licensed in UK to improve glycaemic control in type 2 diabetes. Whilst it has not been studied for use in combination with GLP1 agonists the modes of action of the two therapies suggest they would be a logical therapeutic combination. We aimed to evaluate clinical experience with this regimen.Methods: Observational retrospective data was collected from electronic patient records (SCI–diabetes) ...

Opiate use is a well-recognised cause of hypogonadotrophic hypogonadism. Adrenocorticotrophic hormone and growth hormone deficiencies are much rarer.A 56-year-old female presented with weight loss, lethargy, and nausea of ~3 years duration. She had received treatment with morphine sulphate 100 mg twice daily for ~15 years for back pain due to disc prolapse and osteoarthritis. A 0900 h cortisol of 110 nmol/l requested by her general practitioner had resul...

Background: Pre-pituitary surgery, patients attend a ‘Pre-Pituitary Surgery Clinic’ (PPSC), to discuss management options and risks. Clinicians in attendance are; pituitary surgeon (1) registrar (1) endocrine team consultants (1–3), registrars (1–2) nurses (1) senior house officer (1) visiting doctors/medical students (4–6). Patients are informed a number of clinicians attend the clinic due to the multidisciplinary nature (MDT) and unit teaching respon...