Endocrine Abstracts

Background: Elevated morning plasma cortisol is associated with multiple cardiovascular risk factors in metabolic syndrome. Epidemiological studies have also reported a positive association between plasma cortisol and coronary heart disease (CHD), although not all estimates are statistically significant (OR 1.10 (95% CI 0.97 to 1.25)) (Davey Smith et al. Circulation 2005). Importantly, observational studies are unable to infer causality and results may be confounded.<...

Introduction: Microparticles (MP) are circulating submicron particles released from cell membranes. They have an important role in intercellular endocrine signalling and may be increased in numerous conditions including cardiovascular disease. However, the influences of gender on MP characteristics are not fully understood.Aim: To compare MP characteristics (size, concentration, cellular origin and inflammatory profile) in healthy males and females acros...

Background: Studies have shown that interruptions in sedentary time in non-pregnant adults is positively associated with metabolic parameters, including abdominal obesity and glucose tolerance. However, there are no specific guidelines in the UK about recommended physical activity for pregnant women nor any validated tools to measure it. Our aim was to determine how much physical activity is carried out by pregnant women and how it relates to body anthropometry, glucose tolera...

Islet transplantation, an effective treatment for Type I Diabetes, is compromised by transient ischemia. Ischemia reduces the viability and function of transplanted islets and may also promote signals that lower islet efficacy. In order to characterize the response of human islets to transient ischemia, high-throughput sequencing was employed to determine global gene expression. Islets isolated from healthy donors (n=4) were either pelleted in microcentrifuge tubes (i...

The modulation of pancreatic islet mass represents a novel therapeutic approach for the management of diabetes mellitus. G-protein coupled receptors (GPCRs) regulate beta-cell expansion and proliferation, and the objective of this study was to assess whether the calcium-sensing receptor (CaSR), which is an abundantly expressed beta-cell GPCR, may influence islet mass and systemic glucose homeostasis, and thus represent an exploitable drug target in some forms of diabetes. We c...

Introduction: The vitamin D hormone system has been implicated in the pathogenesis of several autoimmune diseases, including Type 1 Diabetes Mellitus, as an adaptive immune system modulator.Objectives: The objective of this study is to examine the role of cholecalciferol in modulating the altered immune response in T1DM, thereby improving glycemic control and residual pancreatic Beta-cell function, measured objectively by Haemoglobin A1c levels, GAD65 an...

Background: We aimed to determine and compare the prevalence and associated factors of metabolic syndrome (MS) among HAART exposed versus HAART naïve HIV infected patients at the Aminu Kano Teaching Hospital, Kano (AKTH).Method: In this cross-sectional comparative study we evaluated 300 HIV infected persons who were divided into two age and sex matched groups – HAART-exposed and HAART-naïve – attending AKTH. MS was diagnosed using ATP...

High protein diets suppress appetite and facilitate weight loss, but are difficult to adhere to in the long-term. Understanding the mechanisms by which protein suppresses appetite may establish targets for more acceptable interventions to treat or prevent obesity. Of particular interest is the concept of functional foods or novel products which aim to potentiate satiety. However, the specific mechanisms regulating protein-induced satiety are unknown. Protein has a satiating ef...

Rationale: Over the last 20 years, granulocyte colony-stimulating factor (GCSF) has become a recognised therapy in the treatment of patients suffering from neutropenia. Current therapies require daily injections of GCSF to stimulate stem cell production and response to treatment is often unpredictable as GCSF is rapidly cleared. A number of approaches to reducing GCSF clearance have been tried mainly through conjugation with another moiety. The technologies already being emplo...

Hypercortisolaemia (Cushing’s Syndrome) is characterised by abdominal fat accumulation and gluteofemoral fat loss. The mechanisms underpinning this fat mass redistribution are unknown. Adipose tissue blood flow (ATBF) and net fatty acid release rate (lipolysis) are important determinants of depot-specific fat mass. We hypothesized that hypercortisolaemia may result in increased femoral ATBF and lipolysis promoting gluteofemoral fat mass loss. We recruited nine healthy mal...

Obesity and the metabolic syndrome are chronic inflammatory states that are now understood to be involved in the development type 2 Diabetes. Hypothalamic cytokine signalling is thought to influence neuroendocrine networks critical to the dynamic maintenance of glucose homeostasis. Interleukin 6 (IL6) is a cytokine that displays tissue-specificity and is instrumental in the mounting of the acute phase response, as well as in the subsequent resolving and adaptive phase. IL6 is ...

Context: Idiopathic intracranial hypertension (IIH) is characterised by elevated intracranial pressure and occurs predominantly in obese premenopausal women. Signs and symptoms of polycystic ovary syndrome (PCOS) often coexist in IIH. Here we compared the androgenic and metabolic phenotypes in IIH, PCOS and simple obesity.Patients and methods: We studied 25 patients with IIH (mean age 34.4±9.2 years; mean BMI 37.8±5.2 kg/m2), in comp...

Men have a higher prevalence and risk of non-alcoholic fatty liver disease (NAFLD) than age-matched women and this may, in part, be related to differences in fatty acid oxidation. Fasting and postprandial fatty acid oxidation was investigated in 11 healthy men and 11 healthy women matched for age (46±2 years vs 46±2 years (mean±S.E.M.)), BMI (28.0±1 vs 27.0±1 kg/m2) and liver fat content (3.4±0.9 vs 3.9±0.7%) measure...

Hepatic steatosis, accumulation of intracellular triglyceride (TG) (>5% of hepatic tissue), is the prerequisite for the development of non-alcoholic fatty liver disease (NAFLD). NAFLD represents a spectrum of liver diseases and is associated with obesity and obesity-related metabolic diseases such as type 2 diabetes and cardiovascular disease. Steatosis occurs due to an imbalance between fatty acid input and removal (fatty acid partitioning) which can be affected by geneti...

Background: Chronically elevated brain glucocorticoid (GC) levels impair cognition. In rodents, raised GC levels prior to lipopolyaccharide (LPS) administration potentiate neuroinflammation although GC suppresses neuroinflammation if administered after LPS. 11β-hydroxysteroid dehydrogenase-1 (11β-HSD1) activity can increase intracellular GC levels, including in the brain, without alteration in circulating levels. 11β-HSD1 deficiency/inhibition protects against a...

Introduction: Islet transplantation (ITx) is a therapeutic option for patients with Type 1 diabetes. However there is attrition of graft function and the majority of patients require exogenous insulin injections and/or further transplants, within five years. Mouse models help elucidate mechanisms of islet graft failure and the NOD/Lt-scid IL2rγnull (NSG) mouse is useful to study human islet engraftment but few published studies exist. As diffe...

Background: Vascular impairment, most commonly due to endothelial dysfunction, is associated with cardiovascular risk in humans with obesity, insulin resistance or Cushing’s syndrome. Similar endocrine disorders in horses, resulting in insulin resistance, are associated with laminitis, a dysfunction of the vasculature supplying the hooves, the mechanism of which is unclear. We hypothesised that horses with insulin resistance have both local and systemic evidence of vascul...

Aims/hypothesis: Genetic and functional defects in mitochondria are linked with phenotypes of obesity, hypercholesterolemia, and type 2 diabetes (T2DM). However, the impact on mitochondria during surgery-induced metabolic recovery is unknown. We therefore studied the effect of restrictive versus malabsorptive bariatric procedures on indicators of mitochondrial efficiency and control of biogenesis/function.Methods: Forty-three morbidly obese, T2DM consent...

Adipose tissue inflammation may be an important mechanism in the development of systemic insulin resistance, such that modulation of this system may be a therapeutic target for type 2 diabetes and obesity-related disorders. AMPK has anti-inflammatory properties, yet the anti-inflammatory actions of AMPK in adipocytes remain poorly characterised. We questioned whether AMPK activation influences pro-inflammatory responses in cultured adipocytes in basal and stimulated conditions...

Extra-cellular nicotinamide phosphoribosyltransferase (eNAMPT; also referred to as visfatin/PBEF) concentrations are elevated in serum of patients with type 2 diabetes (T2D). However, the relationship between abnormally elevated serum eNAMPT and the pathophysiology of T2D is unclear. eNAMPT circulates in functionally and structurally distinct monomer and dimer forms. eNAMPT-dimer exerts NAD-biosynthetic activity. The role of eNAMPT-monomer is unclear but may exert NAD-independ...

Background: Dapagliflozin was the first SGLT2 inhibitor licensed in UK to improve glycaemic control in type 2 diabetes. The study aimed to assess impact of dapagliflozin on glucose, weight and BP and identify factors predictive of glycaemic response in a large cohort.Methods: Observational retrospective data collected on all patients prescribed dapagliflozin across primary and secondary care in two Scottish health board areas. HbA1c, weight, BP and conco...

Aim: Obstructive sleep apnoea (OSA) is widely prevalent in patients with obesity, referred for bariatric surgery. Various clinical tools are clinically used for screening pre-operatively before referring for formal sleep studies. The aim of our observational analysis was to assess the usefulness of various screening methods for OSA used in clinical practice.Methods: Records of all patients who had been referred to bariatric services in 2014 were reviewed...

Background: Evidence suggests associations between vitamin D deficiency and cardiovascular risk factors, including hypertension and excessive cortisol levels. Also, vitamin D levels may be associated with exercise performance. Thus, we aimed to investigate the effects of vitamin D intake on cardiovascular risk factors, free urinary cortisol and exercise performance.Methods: A randomised placebo controlled single-blinded parallel trial was conducted in he...

Background: Life expectancy of cancer survivors has doubled in the past four decades; however, death due to cardiovascular disease is more prevalent in survivors than the general population.Objective, design and methods: We evaluated novel and traditional cardiometabolic risk factors in young male cancer survivors in a cross-sectional study of male cancer survivors aged 25–45 years compared with age-matched non-cancer controls. Demographic and anthr...

Aims: Vitamin B12 insufficiency has been linked with adiposity and insulin resistance. A clinical study from India showed that B12 insufficiency in pregnancy was associated with higher risk of gestational diabetes (GDM), mediated by maternal BMI. It is not known whether the same association exists among pregnant women in the UK.Methods: A retrospective study was done on women attending our antenatal clinic from 2010–2013. Information including mater...

Pancreatic islets are susceptible to hypoxia during isolation, culture, and transplantation. An intervention that protects against hypoxia while preserving β-cell function will improve islet quality. Adrenaline suppresses insulin secretion and oxygen consumption in pancreatic islets. These findings suggest that adrenergic action creates metabolic quiescence in β-cells. Our objective was to determine whether adrenaline is protective during hypoxic culture in an insuli...

Background: Glucagon-like peptide 1 (GLP-1) is an incretin hormone released from enteroendocrine L-cells in the gut. GLP-1 analogues and dipeptidyl-peptidase-4 inhibitors are currently used to treat type-2 diabetes. A greater understanding of the mechanisms underlying the release of GLP-1 may facilitate the development of therapeutics to stimulate the release of endogenous GLP-1. Bile acids have been shown to induce GLP-1 release via the G protein-coupled bile acid receptor 1 ...

Background: Human cohorts and animal models provide compelling evidence suggesting the role of vitamin B12 in modulating the risk of diabetes and adiposity via developmental programming. We recently demonstrated that neonates born to mothers with low B12 levels in pregnancy have adverse cord blood lipid profile and in vitro studies in human adipocytes with low B12 showed increased cholesterol biosynthesis. Therefore, we hypothesized that vitamin B12 deficiency may pla...

Increased deposition of extracellular matrix (ECM) components such as collagens and hyaluronan is associated with diet-induced insulin resistance (IR) in skeletal muscle. Studies of the role of specific ECM components in muscle IR have been pivotal but incomplete. Here we used an approach (i.e. ECM-specific mass spectrometry-based proteomics) that gives a more complete view of ECM protein abundance with muscle IR. Male C57BL/6 mice were fed with either a chow or high fat (HF) ...

Increased adiposity is associated with insulin resistance, type 2 diabetes and metabolic dysfunction. Altered adipokine secretion, changes in local and systemic glucocorticoid metabolism and increased inflammation have all been postulated as contributory mechanisms. We have previously described changes in subcutaneous adipose tissue (SAT) gene expression that are associated with obesity and glucose intolerance in cross-sectional studies. However, the effects of longitudinal ch...

Background: Primary aldosteronism (PA) is now recognised to account for 5–10% of all cases of hypertension (and 20–25% of refractory hypertension). For patients with a demonstrable unilateral cause, adrenalectomy offers the potential for cure of PA, although resolution of hypertension occurs in only ~50% of patients. We have examined histological appearances and radiological features in patients with APAs undergoing adrenalectomy in an attempt to further our understa...

Introduction: Bariatric surgery is now a common surgical procedure for weight management recommended by NICE. Complications such as dumping syndrome, micronutrient deficiencies and cholelithiasis are well documented in the literature. Here we discuss the lesser reported complication of adrenal insufficiency seen in three patients following roux-en-y gastric bypass surgery for morbid obesity.Case reports: Three patients were seen in the outpatient clinic ...

Calcitonin and corticotropin-releasing hormone (CRH) are members of a family of neuropeptides that exert effects by activating secretin-type G-protein coupled receptors. Calcitonin lowers blood calcium levels and acts to protect against calcium loss from the skeleton during periods of calcium mobilisation. CRH is a key player in the stress response mediated by the hypothalamic-pituitary-adrenal axis. Analysis of the phylogenetic distribution of calcitonin-type and CRH-type pep...

The anti-diabetic drug, metformin, is associated with progressive decrease in serum vitamin B12 levels whereas vitamin B12 deficiency is related to increased insulin resistance and dyslipidaemia by altered methylation. As the risk of vitamin B12 deficiency is increased among metformin users, it is of utmost importance to examine how metformin response in vitamin B12 deficient population.We investigated the cellular mechanism of metformin in vitamin B12 i...

Introduction: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, which may relate to enhanced sympathetic nervous system (SNS) activation. The cerebral pathways involved in this process are not known.Aims: i) To compare SNS activation in response to isometric forearm contraction (IFC) in patients with PCOS and controls. ii) To identify and compare the neuronal signatures of this response.Methods: 15 ...

Intrauterine growth restriction (IUGR) is associated with postnatal metabolic complications, which include glucose intolerance in adulthood. However, information is limited on the progression of insulin secretion and its action in young IUGR infants. The objective of this study was to determine glucose stimulated insulin secretion and insulin action in young lambs with placenta insufficiency-induced IUGR.Placental insufficiency-induced IUGR was created b...

Glucocorticoids (Gcs) are widely prescribed to treat a number of conditions, such as arthritis and asthma. However, patients receiving Gcs often develop metabolic complications such as obesity and hyperglycaemia. The aim of this study was to investigate the molecular mechanisms in the hypothalamus which drive these adverse effects. Male C57BL/6J mice were given ad libitum access to either corticosterone (CORT; 75 μg/ml) or vehicle (V; 1% ethanol) in their drinkin...

Brown adipose tissue (BAT) is present in small quantities in human adults (~100 g) and can have a significant influence on metabolism. This effect is mediated by rapid activation of the BAT specific uncoupling protein 1 (UCP1), following stimulation of β-adrenergic receptor (AR) by the sympathetic nervous system. AR agonists stimulate rodent BAT, but have so far provided inconsistent findings in humans when administered orally (Vosselman et al. 2012). Rapid activ...

The shortage of donor material has driven research towards finding a replenishable supply of islets for transplantation. We have previously shown that the exocrine material that results as a by-product of the islet isolation procedure can be transdifferentiated towards functional islet-like structures by overexpression of the pancreatic transcription factors (TFs) Pdx1, MafA, Ngn3 and Pax4 followed by culture in the presence of betacellulin, nicotinamide and exendin-4. These c...

Women with Polycystic Ovary Syndrome (PCOS) are at increased risk of developing insulin resistance, obesity and dyslipidemia, however obesity per se does not explain the higher incidence of insulin resistance in PCOS women when compared to the general population. Altered adipose tissue morphology and function may be a central factor contributing to metabolic disturbances in PCOS. Using a clinically realistic ovine model of PCOS we reported hyperinsulinaemia and early ...

Prolonged increases in foetal plasma noradrenaline occur in pathologies, including intrauterine growth restriction (IUGR). Infusion of noradrenaline into healthy sheep foetuses showed continuous suppression of insulin secretion but produced a compensatory beta-cell response after noradrenaline infusion was terminated, similar to findings with adrenergic antagonists in IUGR foetuses. Hyper-insulin secretion responsiveness was confirmed in isolated foetal islets. To identify mol...

De novo lipogenesis (DNL) is recognised as potentially contributory to pathogenesis of non-alcoholic fatty liver disease (NAFLD), and could be a factor in the progression of simple steatosis to steatohepatitis, although it contributes a relatively minor amount of whole body fat compared to dietary lipid. Consequently understanding the lipidome during induced DNL may provide insight into potential biomarkers of DNL that could be clinically relevant in those at risk of ...

The wide range of phytochemicals in medicinal plants serves as sources of bioactive compounds for treatment diabetic complications. We investigated whether Syzygium aromaticum-isolated oleanolic acid (OA) has beneficial effects on some diabetic complications in STZ-induced diabetic rats. We used experimental models of hypertension [spontaneously hypertensive (SHR) and Dahl salt-sensitive (DSS)] rats to explore the effects of OA on mean arterial blood pressure (MAP) and renal f...

A growing number of studies have reported beneficial health effects of cocoa and turmeric, including atherosclerosis, hypertension and insulin resistance. Relatively few studies have investigated the preventive or therapeutic effects of cocoa and turmeric against obesity-related metabolic disorders and co-pathologies. The study was undertaken to determine the effects of cocoa and turmeric powder supplementation on glucose tolerance, insulin sensitivity and lipid profile in rat...

We examined the effect of dietary niacin supplementation on fat mass, glucose control, insulin sensitivity, lipid profile, and adiponectin level in diet-induced obese rats. Twenty-one male Sprague-Dawley rats (n=21) were initially divided into two (2) groups of seven and fourteen rats; the group of 14 rats was fed with a high-fat-diet (HFD) and the other group of 7 rats consumed the control diet. Eight weeks after the diet regimen started, half of the rats from the HFD group w...

Background & aim: Night shift work is associated with a disruption of circadian rhythms, where a person’s internal body clock is in conflict with the rotating shift schedule. The circadian rhythm of the human body is characterized with an alternating sleep-wake cycle. Shift work has been associated with increased risk of hypertension, cardiovascular diseases and hormonal disturbances. The Present study was aimed to investigate the effects of rotating night shift on 24...

Introduction: Idiopathic intracranial hypertension (IIH) occurs in young obese women (>90%) but little is known about the metabolic characteristics in these patients. We aimed to characterise IIH fat distribution, metabolic phenotype and evaluate alterations following weight loss.Methods: IIH and matched (BMI/sex) healthy obese controls were recruited. Metabolic indices (fasting lipid, glucose, insulin), anthropological measures and body composition ...

Improvements in circulating cytokine levels have occurred in patients with endometriosis and chronic heart disease when prescribed the type 2 diabetes (T2D) drug metformin. However it is unclear how metformin exerts these effects and whether or not they are related to antihyperglycaemic effects in T2D. The purpose of this study is to investigate the relationship between anti-inflammatory and anti-hyperglycaemic effects of metformin in the liver, the main target tissue of the d...

Background and objective: The prevalence of obesity is increasing worldwide and it is known that intra-uterine experience can program metabolic disorders. The hypothalamic appetite regulatory system is a key target of developmental programming by maternal nutrition. Therefore, the aim of this study was to investigate the effects of maternal overnutrition on the expression of hypothalamic genes controlling energy homeostasis.Research design: Eight week ol...

Research question: What are the differences in foetal size in early pregnancy between GDM and control.Methods: Serial foetal biometry was performed for GDM women and controls at 18–20 weeks and 28–32 weeks. At each visit, abdominal and head circumference (AC) & (HC), femur length (FL) and abdominal wall thickness (AWT) was measured along with collection of maternal data.Results: women with GDM and 184 controls had com...

Renal functions in a mouse model of Cushing’s Syndrome have been characterised by analysing RNA expression complemented by immunohistochemistry studies. A microarray of kidneys from mice infused with ACTH for two weeks identified gene transcripts that were up-regulated (70) and down-regulated (49) more than two-fold. Four separate clusters of closely correlated genes (r> 0.97; P< 0.001) were investigated in more detail. One down-regulated cluster included histocom...

Pregnancy is associated with increased maternal plasma lipid levels, an important physiological response to support the nutritional demand of the developing fetus and mother. The homeostatic controls of metabolically active organs are known to change in response to pregnancy signals. We hypothesised that pregnancy affects brown adipose tissue (BAT) phenotype and function and as a consequence plays a role in the regulation of fetal development and growth....

The aim of this study was to investigate seasonal variation in haemoglobin A1c (HbA1c) using a retrospective population analysis linking HbA1c values to the time of year. The study cohort included 171 442 NHS patients from Scotland, UK. Patients were divided into three groups. The ‘stable group’ were defined as having a HbA1c that varied less than the tertile either side of the mean HbA1c. The ‘high summer’ was comprised of ...

Background: Obesity contributes to the occurrence of many metabolic and cardiovascular complications including Type 2 diabetes, hypertension etc. Body adiposity is not just an energy store, but also an endocrine organ with elaboration of hormones and cytokines. Some of these cytokines have been implicated in the initiation and propagation of inflammation, and hence atherosclerosis.Aim: This study examined the relationship between high-sensitivity C-react...

Introduction: The aim of the present study was to evaluate the glycaemic control, antioxidant, pancreas and liver protective effect of 2β-hydroxybetulinic acid 3β-caprylate (HBAC) from Euryale ferox Salisb. seeds on streptozotocin induced diabetic rats.Materials & methods: The active principle was isolated from Euryale ferox Salisb. seeds extract by utilizing chromatographic techniques. The rats were divided into seven exp...

Background: Hyperglycaemic emergencies (HEs) continues to be important causes of morbidity and mortality among persons with diabetes mellitus. Hyperglycaemic hyperosmolar state (HHS) and diabetic ketoacidosis (DKA) are the two most common acute metabolic complications seen in persons with diabetes mellitus.Objective: To describe the clinical presentation and outcome of patients with hyperglycaemic emergencies.Materials and methods:...

Background & objectives: Vibration perception threshold (VPT) is the gold standard for diagnosis of diabetic peripheral neuropathy. The relationship between symptom severity and VPT remains to be determined. This study evaluated the diagnostic utility of symptoms using the NTSS-6 symptom score vis a vis Bio-thesiometry.Methods: diabetic patients with symptoms suggestive of peripheral neuropathy and 40 apparently healthy controls were studied. Detaile...

Glucocorticoid (Gc) excess, either endogenously produced (Cushing’s syndrome) or as a result of exogenous steroid treatment, can cause metabolic disorders such as obesity and hyperglycaemia. The contribution of centrally acting corticosterone in the development of these metabolic disorders is unknown. Gcs regulate the anorexigenic and orexigenic neuropeptides (POMC and AgRP) within the arcuate nucleus of the hypothalamus to modulate energy balance. This study investigated...

Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is associated with an adverse metabolic profile including insulin resistance and dyslipidaemia. Hyperandrogenism is the hallmark of PCOS and obesity increases androgen synthesis, partly due to accompanying hyperinsulinemia but also as a result of adipokines affecting ovarian steroidogenesis (Comim et al., 2013, PLoS ONE 8(11). Adipokines are factors secreted by adipose tissue and while a clear link betwe...

A 53 year old man, without any previous medical history, presented acutely to the Accident and Emergency Department with a 5 day history of vomiting and abdominal pain on a background of weight loss, fatigue, polyuria and polydipsia for 4 weeks. On examination he was obviously tanned and thin. He was clinically dehydrated and had palpable hepatomegaly. Immediate biochemical testing revealed hyperglycaemia with a venous blood glucose of 20.7 mmol/l, a metabolic acidosis with a ...

Background: In diabetes, exposure to frequent episodes of hypoglycaemia diminishes a persons awareness of hypoglycaemia, by poorly defined mechanisms. Evidence suggests that, at least in part, changes in cell behaviour within the ventromedial hypothalamus may contribute to this defect and that changes in AMP-activated protein kinase (AMPK), a key glucose-sensing enzyme are involved. Evidence suggests there are (mal)adaptations within neurons, however, little is known about cha...

Adipose tissue (AT) dysfunction is thought to be a central component in the pathophysiology of obesity-associated metabolic disease. Low AT oxygenation (hypoxia) is suggested to be a driver of this dysfunction, yet studies in humans have resulted in conflicting data. Therefore, we aimed to investigate if markers of AT hypoxia were present in the subcutaneous AT of morbidly obese individuals who had hypoxia from obesity hypoventilation syndrome (OHS), with or without obstructiv...

Background: Highly active antiretroviral therapy (HAART) particularly protease inhibitors cause hyperglycaemia through insulin resistance. There is raising number of HIV patients on HAART attending the diabetic clinic in Nigeria and very few studies were done to determine their risk of developing diabetes. We aimed to determine the prevalence and factors associated with diabetes mellitus (DM) among HIV patients.Methods: In a cross sectional study of 300 ...

Aim: Bariatric surgery can provide significant weight loss but a complete resolution obstructive sleep apnoea (OSA) cannot be predicted. The aim of our audit was to assess the prevalence of OSA in bariatric clinics and outcomes after malabsorptive bariatric surgery.Methods: Retrospective observational analysis was performed on patients who had undergone bariatric surgery (laparoscopic gastric bypass and sleeve gastrectomy) and completed a minimum of 6 mo...

Isoflavones are a subgroup of phytoestrogens and have a chemical structure similar to oestrogen, leading to concerns regarding possible adverse effects of isoflavones in men. Testosterone levels in men with type 2 diabetes mellitus (T2DM) are lower.Materials and methods: A randomised double-blind, parallel study was undertaken with 200 men with T2DM, of median age of 50 years (25th/75th centiles; 50, 55) years with a total testosterone level ≤12 nm...

A retrospective single centre audit was conducted on the effects of polycythaemia in trans-male and native male.Polycythaemia is a recognised side effect of testosterone treatment. It could be viewed as a maker of excess testosterone action. We examined whether lipid profiles as a marker of cardiovascular risk differed in a population of polycythaemic transmen (TM) and native males (NM).Forty-six NM and 12 TM were identified to hav...

Background: In Nigeria, the economic burden of diabetes foot ulcer is enormous for several reasons and there are very few studies that look at the economic cost of diabetes foot care. This study estimated the cost of illness among patients with diabetes foot ulcer in secondary and tertiary health facilities in Kano.Methods: The study was a cross-sectional evaluation involving ninety patients with diabetes having various degrees of foot ulcerations. A str...

Background: Dose adjustment for normal eating (DAFNE) structured education programme is an effective tool in improving glycaemic control in patients with type 1 diabetes while reducing the frequency of hypoglycemic episodes. DAFNE however, does not solve all glucose related problems and patients often request or are recommended continuous subcutaneous insulin infusion (CSII) therapy post DAFNE.Objective: Out of our 370 DAFNE graduates, 46 have subsequent...

Introduction: A complex cocktail of endocrine-disrupting and other chemicals is ubiquitous in the modern environment. Exposure to such chemicals contributes to diseases including metabolic syndrome and infertility. The liver is the primary defence organ against xenotoxicants, but also the source of major of plasma proteins, and growth factors/hormones.Aim: To understand how chronic exposure to complex mixtures of chemicals at human and environmentally re...

Background and aims: GLP1 agonists are used in UAE for diabetes and obesity management (prevalence of 19 and 74% respectively). Few outcome data on GLP1 agonist therapy in this population is available. We investigated the effects of two commonly used GLP1 agonists on weight and HbA1c among UAE patients with diabetes.Materials and methods: Data was retrieved from a computerized database of patients attending a large diabetes center in UAE. Patients on exe...

There are a limited range of drugs available to treat type 2 diabetes (T2D) and insulin resistance (IR) that are efficacious and inexpensive. In West Africa, extracts of Hymenocardia acida are frequently used. However, few objective studies have yet attested to their efficacy. Here we evaluated the potential for extracts of H. acida to overcome IR in muscle in vitro.Crude extracts of H. acida were prepared in methanol ...

Background: Most studies of the metabolic syndrome (MS) among HIV patients focus on those receiving HAART. This study determined the prevalence and factors associated with MS among HAART naïve HIV patients in Kano, Nigeria.Methods: In this descriptive study, we evaluated 150 consecutive HAART naive HIV patients attending the HIV clinic of Aminu Kano Teaching Hospital. Data on socio-demography, relevant clinical history, anthropometric indices, and b...

Introduction: Central obesity has been linked more to adverse cardiovascular risks than general obesity. The cut-off values for BMI, waist circumference (WC), waist:hip ratio (WHR), and waist:height ratio (WHtR) have been shown to vary with ethnicity. This study sets out to determine the optimal cut-off values for obesity in adult Nigerians using four anthropometric indices.Method: In a cross-sectional study of adults in Delta State, Nigeria, data on wei...

Background: Gender specific differences appear particularly relevant in the overall management and outcome of type 2 diabetes mellitus (T2DM). We determined gender specific differences in cardio-metabolic risk, microvascular, and macrovascular complications in patients with T2DM.Method: Four hundred T2DM patients matched for age and disease duration were studied. Relevant clinical information, physical examination and laboratory data were analysed.<p...

Background: We assessed the effects of hydrochlorothiazide given alone and in combination with an ACEI on β-cell function in a negroid population to further explore possible ethnic differences in the effect of antihypertensive drugs on HOMA-IR.Materials and methods: Eighty newly diagnosed Nigerian essential hypertensive patients were assigned to receive either hydrochlorothiazide 25 mg daily or both hydrochlorothiazide and lisinopril (25/10 mg daily...

Background: Quantifying the body fat percentage (%BF), its scientific and clinical implications is critical to timely intervention as it has been proven to be a better measure of patient’s risk of cardiovascular diseases than the BMI. Several techniques have been developed to assess BF including imaging, DEXA, bioelectric impedance analysis (BIA), and underwater weighing. The use of anthropometric indices to derive %BF provides an inexpensive surrogate. There are very few...

Research question: Are there ethnic differences in foetal growth patterns in GDM?Methods: Retrospective data collection was undertaken for all women with GDM between 2008 and 2012 at University Hospital Coventry. Foetal biometric data was obtained at 28, 32, and 36 weeks gestation for 125 South-Asian (SA) and 142 WC.Results: Compared to WC, SA had had lower BMI (28.5±6.1 kg/m2 vs 32.2±7.4 kg/m2), hei...

Objective: In this study we analysed the prediabetes incidence in women with polycystic ovary syndrome (PCOS), as well as prediabetes and cardiovascular disease (CVD) risk factors in women with PCOS.Methods: This study included 148 women with PCOS, with no type 2 diabetes mellitus (T2DM) and CVD present at the baseline. We determined a comprehensive panel of biochemical parameters, including lipid profile, glucose and insulin levels during oral glucose t...

Background: The 2013 Scottish Diabetes Survey demonstrated that only 22% of individuals with type 1 diabetes have optimal glycaemic control, defined as a HbA1c <58 mmol/mol. The 2014 Diabetes Improvement Plan in Scotland prioritised, ‘improving the care and outcomes of all people living with type 1 diabetes’. Scotland’s Diabetes Education Advisory Group has now been established. Accordingly, the Fife Insulin and Food Education for Diabetes (FIFE Diabetes) st...

Background: Endothelial damage is one of the early signs of cardiovascular disorders. Assessing endothelial function in women with polycystic ovary syndrome (PCOS) has shown evidence of cardiovascular disease in the absence of clinically evident disorder. Flow mediated dilation (FMD) and reactive hyperaemia peripheral arterial tonometry (RH-PAT) are the frequently used non-invasive techniques for assessing endothelial function. Both the techniques have been used to assess endo...

Background: Intensive glycemic control forms the benchmark of management of type 1 diabetes mellitus (T1DM) and is limited by the risk of hypoglycaemia. Repeated episodes of hypoglycaemia can lead to development of hypoglycaemia unawareness and a sixfold increase in deaths in those experiencing severe hypoglycaemia. Severe hypoglycaemia occurs in 35–42% patients with T1DM. However, there is lack of data from our population and hence we aimed to objectively estimate the pr...

Introduction: Approximately 700 000 women give birth in England and Wales each year with up to 5% of these women having either pre-existing diabetes or gestational diabetes (GDM). Women who have diabetes during pregnancy, it is estimated that approximately 87% have GDM. It is well recognised that early diagnosis of diabetes aids in timely intervention to reduce long-term complications.Objectives: To assess the screening for diabetes mellitus in post-deli...

Introduction: Sri Lanka has been experiencing rapid urbanization, with ~30% of the population residing in urban areas. We report the age and sex-specific prevalence of dysglycaemia and vitamin D (VitD) status, along with the association between the two in an urban community in Sri Lanka.Methodology: Using a stratified random sampling method, 369 subjects (116 men and 253 women) aged 18 years and above, were tested for 25OH VitD3, 75 g OGTT, and HbA1c. De...

Introduction: The mouth is said to be the body’s mirror. Diabetes can be associated with the development of various types of disorders within the oral cavity of which periodontal disease is about the commonest and may indeed be the first manifestation of diabetes.Aim: To evaluate the oral health of individuals with diabetes at Federal Medical Centre, Abeokuta, Nigeria.Methodology: Descriptive study carried out between January ...

Background: Obesity is significant risk factor for cardiovascular diseases and type 2 diabetes mellitus. Many anthropometric indexes are now being used in clinical practice to identify and determine the prevalence of obesity.Aim: This study determined the relationship between common anthropometric indexes and percentage body fat (%BF).Methodology: Ninety-four volunteer subjects participated in this cross sectional hospital based st...

Background: The lipid profile of healthy adults in northern Nigeria is scarcely reported in literature. Yet, hospital records show increasing frequency of dyslipidemia-related illnesses like CVA, MI, and peripheral vascular diseases in practice. We aim to report the pattern of lipid abnormalities in a rural population in Kano, Nigeria.Methods: A population screening of apparently healthy adults resident in sub urban community in Kano was undertaken over ...

Objective: To determine the prevalence of overweight and obesity and it’s associated risk factors in a rural population in Kano, northwestern Nigeria.Materials and methods: Thousand and twenty four men and women aged 18 years and above, who reside in Kumbotso ward in Kano, northwestern Nigeria were enrolled into the study using a multistage random sampling technique over a 5 months period (November 2014–April 2015). Anthropometric indices, heig...

Background: There are very few studies comparing glycaemic control in patients with different basal rates on Continuous Subcutaneous Insulin Infusion therapy (CSII), so the ideal number of basal rates for a patient is not clear.Objective: To compare the glycaemic control between patients with different basal rates.Methods: Data were collected from hospital’s database and by contacting patients via phone....

Diabetes Mellitus is a chronic disease characterised by hyperglycaemia due to peripheral insulin resistance and/or insulin deficiency. This may be due to a decline in viable pancreatic β-cells number or β-cell dysfunction leading to impaired nutrient-induced insulin secretion. The most probable causes of these β-cell effects are exposure to elevated levels of inflammatory cytokines, glucose and free fatty acids. There are many synthetic and herbal drugs availabl...

Nutrient sensors mediating the stimulatory effects of food-derived carbohydrates and lipids on incretin and insulin secretion have been widely studied. However, mechanisms underlying amino acid regulation of those processes remain poorly understood. GPR142 was recently reported to be highly expressed in pancreatic beta cells and selectively activated by L-Tryptophan (L-Trp). Moreover, synthetic GPR142 agonists were demonstrated to stimulate glucose-dependent insulin secretion ...

Introduction: Patients with life-threatening inborn errors of metabolism are usually managed at specialist care centres. These patients are living longer and some of them have migrated to areas far from their specialist care centres. We present two such cases.Case 1: A 37 year old female with Ornithine Transcarbamylase Deficiency (OTCD), well-managed at a specialist care centre since childhood, relocated a few times before settling down in our area. OTCD...

Introduction: Trimethylaminuria or Fish Odour syndrome is a rare genetic metabolic disorder. It can cause significant suffering to affected individuals due to social isolation and stigma. It is under recognised and ignored.The case: A 60 years old lady was referred by her GP. The referral – ‘She feels she has a problem with personal hygiene and is aware of an odour from her skin, her breath and urine.’ This lady has been suffering from thi...

Introduction: Diabetic nephropathy remains a major cause of morbidity and mortality for persons with diabetes mellitus. Globally, most patients with diabetes are in developing countries that do not have the resources or health infrastructure to provide universal renal replacement therapy. The ADA recommends that estimated glomerular filtration rate (eGFR) be calculated using serum creatinine for diabetics at least once a year.Objectives: To determine the...

Background: Besides differences in the overall prevalence between IGT and IFG, there is now clear evidence of differences in phenotype between the two categories. The most consistent and statistically significant difference is that IFG is commoner in men than women in virtually all age groups, typically being 1.5–3 times higher, but up to seven or eight times higher in Europeans aged 50–70 years. Conversely, the prevalence of IGT is higher in women than men in all ag...

Background: Weight gain is a recognised effect of HAART which occur through restoration of the body’s immune function and lipodystrophy. Weight gain could have a negative impact on the medical and social wellbeing of the persons affected. Most HIV studies in Nigeria tend to concentrate on the effect of HAART on viral suppression and improvement in quality of life neglecting other consequences of the disease and treatment. We aimed to determine the prevalence of obesity am...

Objectives: Obesity is a risk factor for Type 2 diabetes mellitus. This study evaluated the relationship between central obesity and fasting plasma glucose (FPG).Materials and methods: A cross-sectional study involving five hundred and twenty one (521) adult participants (134 males and 387 females) of a community health survey in Sagamu, Isara and Ode-Remo, Nigeria. The waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) o...

The in-hospital pharmacological management of patients with diabetes has recently been identified by the National Diabetes Inpatient Audit as a key safety issue. Over 30% of inpatient drug charts surveyed in the 2013 audit had at least 1 diabetes medication error in the preceding week. Patients with a diabetes medication error on their drug chart were also twice as likely to have one or more hypoglycaemic episodes during their hospital stay.A paper by Br...

Background: Self-monitoring of blood glucose (SMBG), an important tool in diabetes management help patients achieve and maintain target glycaemic levels hence reducing complications. SMBG is usually done with glucose meters which are affordable, portable and easy to use. Significant variations sometimes observed in glucose meter readings necessitated this study. We evaluated the accuracy of glucose meters used routinely in our unit using ISO 15197 guideline.<p class="abste...

Introduction: The prevalence of type 2 Diabetes is increasing worldwide. It is associated with significant morbidity and mortality, hence the need for early identification of risk factors. This study therefore aimed to determine the overall knowledge of the participants about Diabetes Mellitus and to assess its risk factors.Method: A cross sectional survey of 118 staff of three secondary schools in Owo was conducted using a structured self-administered q...

Studying the effect of deuterium depleted water (DDW) on isotope (D/H) composition and condition of an antioxidant-prooxidant plasma and lyophilized tissues of internal organs (liver, kidney) balance appropriate indicators in rats were compared: in group 1 (n=15) consumed mineralized water (150 ppm), which by a single intraperitoneal injection of alloxan (at a dose of 17 mg/100 g body weight) was established experimental model of diabetes; group 2 (n=15) cons...

Introduction: The prevalence of type 2 diabetes is increasing worldwide. It is associated with significant morbidity and mortality, with majority of the patients presenting for the first time with complications. We set out to determine the renal function of type 2 DM patients presenting in our facility.Method: A cross sectional study involving 50 type 2 diabetes patients. At presentation to the DM clinic, these were interviewed using a structured questio...

Background: Hypoglycaemia is considered a medical emergency and is treated as such. However, our experience as junior doctors has shown us that hyperglycaemia, despite being equally damaging to patients’ long term prognosis, can often be left to ‘run high’. This could be due to a number of factors, surrounding how often blood sugars (BM) are checked and how they are managed. We audited three standards set out in local guidelines for BM monitoring in diabetic pat...

A 54 year-old businesswoman who has been diabetic for 6 years and had a history of PUD. She was referred following complaints of increasing hyperpigmentation of her palms, feet and old scars. She also had a boil on her back, significant weight loss, poor appetite and a slight non-productive cough.She was transfused with two pints of blood a month earlier at a private hospital when her PCV was found low. She is not hypertensive. Her drug history included ...

Background/aims: Insulin resistance is predominant in type 2 diabetes mellitus (DM) patients. Obesity is a risk factor for insulin resistance. This study aims to determine the relationship between indices of nutriture and insulin resistance in type 2 DM patients.Methods: This is a cross-sectional study of type 2 DM patients attending the Diabetes Clinic, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and evaluated over a 6 wee...

Background: Both obesity and presence of certain patterns of lipid abnormalities has consistently been identified as a strong determinants of cardiovascular health. In resource limited populations, it is important to ascertain methods of reducing resources utilisation by identifying simple measures to cardiovascular risk. Considering the relative ease of measuring anthropometries (BMI, waist circumference-WC, and waist-hip ratio-WHR) data, we sought to determine if any measure...

Introduction: The objective of this Report is to evaluate for a possible association between serum uric acid levels and PAD in persons with diabetes mellitus.Methods: This was a cross sectional Study carried out in 232 DM patients, Anthropometric indices and ankle brachial pressure indices were documented. Biochemical analyses were carried out for lipid parameters, glycosylated haemoglobin and uric acid.Results: The mean age and ag...

Introduction: Reactive hypoglycaemia (RH) is a complex problem, with no definite treatment apart from lifestyle changes.Methods: We used Sitagliptin in two patients with RH, who had tried lifestyle changes for at least 2 years but without much effect. A gentleman with initial BMI of 31.4 kg/m2 and another lady of BMI 24.1 kg/m2 was treated with Sitagliptin 100 and 50 mg daily, in view of their weight and thereby volume of distributi...

Background: Diabetes mellitus (DM) is a leading cause of morbidity and mortality globally. Its prevalence is increasing worldwide due to the transition phase. The present prevalence of DM is projected to double in the year 2035.Materials and methods: This is an ongoing prospective observational study. Subjects were persons who had been diagnosed of DM using the World Health Organization (WHO) criteria, and had been on treatment for at least six months. S...