Endocrine Abstracts

Background: Diabetic ketoacidosis (DKA) is an acute endocrine emergency in people with diabetes. Paucity of information prevails over sex- and age-related variations in patients presenting with DKA.Objective: To assess the impact of age and sex in the clinical course, presentation, outcome and management of DKA in people with type 1 (T1DM) and type 2 diabetes (T2DM).Methods: We included all DKA from April 2014 to September 2020 in ...

Objectives: Limited evidence exists studying the impact of ethnicity on diabetic ketoacidosis (DKA). We aimed to study the impact of ethnicity on presentation, management and outcome of DKA in type 1 (T1DM) and type 2 (T2DM) diabetes.Methods: All DKA episodes from April 2014 to September 2020 in a UK tertiary care centre were identified. Data were collected on diabetes type, demographics, biochemical and clinical features on admission, and DKA management...

Introduction: Diagnostic markers to detect Diabetic Kidney Disease (DKD) at an early stage are important. Neutrophil to Lymphocyte ratio (NLR) is an easily available parameter to assess the inflammatory status of the subject and has shown its usefulness in prognostication of Cardiovascular diseases and Malignancy. Very few studies have explored the association between NLR and DKD in the North-Eastern Indian population with type 2 diabetes mellitus.Object...

Introduction: When diabetes mellitus is diagnosed, peripheral neuropathy is present in about 20 % of cases. Vibratory sense is perceived by mechanoreceptors, which have 2 types, Pacinian corpuscles and Meissner corpuscles. Pacinian corpuscles consist of large myelinated A-beta fibers detecting high frequency vibration and deep pressure. There are new methods to evaluate vibration sense and pressure sensation acting on Aβ, and C type fibres. TENS is considered as a non-inv...

Background: Insulin Autoimmune Syndrome is a rare condition characterized by hyperinsulinemic hypoglycemic episodes mediated by insulin autoantibodies (IAA). IAA form complexes with insulin leading to initial mild hyperglycemia and later hypoglycemia due to release of insulin. A comprehensive evaluation is necessary in all hyperinsulinemic hypoglycemia before a diagnosis of IAS is established. We present two cases of Hirata’s disease which presented with debilitating hypo...

Background: The presence of diabetes and the degree of hyperglycemia is considered an independent factor in the clinical severity of COVID-19 infection, impacting the duration of hospital stay and other related medical conditions.Objective: To identify the correlation between the insulin needs in COVID-19 patients and hospital stay and other related medical conditions. To identify the factors that would contribute to diabetes onset during COVID-19 infect...

Background: Cell membrane fluidity of erythrocytes in patients with type 2 diabetes can be influenced by glycosylation processes, changes in lipid homeostasis and oxidative stress.Objectives: We have measured red blood cell membrane fluidity looking for differences between healthy people and diabetic subjects and also between diabetic patients affected by macroangiopathy (vascular diabetic foot) and not.Methods: We have enrolled 32...

Background: Insulin like growth factor-2 (IGF-2) has structural similarity to insulin1. In excess, IGF-2 can activate glucose metabolism so precipitating hypoglycaemia1.Case Presentation: Six days following her second dose of Doxorubicin and Olaratumab therapy for a pelvic sarcoma, HS presented with two successive days of acute confusion secondary to documented hypoglycaemia (blood sugars 2.0-3.1 mmol/l, 36-55.8 mg/dl). Despite treatment, she had recurre...

Objectives: We explored the differences in severity and outcomes of diabetic ketoacidosis (DKA) in people with type 1 (T1DM) and type 2 diabetes (T2DM).Methods: All DKA episodes from April 2014 to September 2020 at a tertiary care centre in the United Kingdom were identified. People admitted with DKA were classified as having T1DM or T2DM based on previously established diagnosis, autoantibody status, and/or phenotypic features. We compared the differenc...

Introduction: Although the effect of pre-admission insulin usage (PAIU) in diabetic COVID-19 patients remains uncertain, early studies have reported worse results in this group. Studies generally report in-hospital mortality rates. However, mortality also increases after discharge in COVID-19 patients; the effect of PAIU on this issue is unknown. This study was conducted to examine the effect of PAIU on COVID-19 diabetics’ 90-day mortality data, including the post-dischar...

Background: The effect of maternal weight gain in obstetric and perinatal morbidity in pregnant with gestational diabetes (GD) is not established.Objectives: Evaluation of the impact of weight gain in obstetric and perinatal outcomes in women with GD.Methods: Retrospective study of women with GD between January/2020-March/2021. Weight gain in pregnancy was evaluated by 2009 IOM recommendations, women were divided in 3 groups: exces...

Background: Type 2 diabetes mellitus (T2DM) significantly impacts Health-Related Quality of Life (HRQoL) and sexual function. The aim of this study was to evaluate sex differences in HRQoL and sexual function in patients with T2DM.Methods: We performed an ancillary study of RECOGITO trial (REmodelling in Diabetic CardiOmyopathy: Gender Response to PDE5i InhibiTOrs - NCT01803828). All patients completed the 36-item-Short-Form Health Survey (SF-36), assess...

Background and Aims: Diabetes is often associated with an increased severity and mortality in COVID-19 patients. Possible mechanisms include hyperglycemia-induced impaired immune response, characterized by a state of chronic low-grade inflammation. Objectives: evaluate if diabetes and glycemic control were related to the severity of disease and mortality in hospitalized COVID-19 patients.Methods: We conducted a retrospective case control study that inclu...

Background: The COVID-19 pandemic has caused enormous damage to all countries of the world. Patients with diabetes mellitus are a separate risk group for the consequences of COVID-19, both in the acute and in the long-term period.Aim: To study change in the structure of mortality among patients with diabetes in the Republic of Uzbekistan during the COVID-19 pandemic.Materials and Methods: We analyzed the data of the report forms of...

Background: Nutritional interventions are required for effective management of diabetes Mellitus. Dietary recommendations act as amajor intervention for treatment of D Mand obesity. It is recommended that the diet should be individually adapted to personal choices and metabolic goals. With advent of technology newer monitoring tools like continuous glucose monitoring systems (CGM) are now finding their way into Diabetes management and nutrition therapy. The ambulatory glucose ...

HHS is a rare hyperglycaemic emergency, typically precipitated by infection in people with T2DM. There are few recorded cases of COVID induced pure HHS. We here by report 2 further cases, including the first known reported case in a person with T1DM.Case 1: 81yo male with T1DM (on glargine and aspart insulin, HbA1c 57 mmol/mol) presentedwith lethargy, general deterioration and a fall.Therewere no new symptoms offever/cough/breathlessness or change in tas...

Aim: To evaluate the efficiency of glucocorticosteroids (GCS) in combination with biological therapy in the treatment of COVID-19 in patients with type 2 diabetes mellitus (T2D).Materials and methods: A retrospective study of hospitalized patients with a PCR-confirmed diagnosis of COVID-19 with T2D was conducted (n=179). Patients received standard therapy, including biological preparations. The first group consisted of participants who received ...

Background: Screening for cognitive impairment (CI) that is strongly recommended in elderly with diabetes mellitus (DM) type 2 but in fact is not commonly fulfilled.Objectives: To evaluate cognitive state in elderly patients with type 2 diabetes mellitus.Methods: In this cross-sectional study all patients with DM type 2 in age 65 and older who were on a planned admission in endocrinology department University Hospital named after V...

A 69-year-old non-diabetic woman presented with 1 month of recurrent drowsiness and confusion secondary to hypoglycaemia, nocturnal and on fasting. On admission her CBG was 2.6 mmol/l, confirmed venously. Her history was of a large solitary fibrous tumour (SFT) of the chest wall first resected in 2011 with recurrent relapses requiring surgery in 2016 and 2017. Histology showed typical features of SFT. Despite palliative chemo-radiotherapy for a further relapses, there was prog...

Background: There is an increased burden on the healthcare system worldwide due to the ongoing pandemic of Covid-19. Moreover, there is a surge in the number of patients who are waiting for their routine follow up treatment for chronic disorders. Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, life expectancy and disease outcomes.Aim: To see the impact of the tele-consultation on drug compliance , patient follo...

Introduction: Effective management of diabetic ketoacidosis (DKA) improves clinical outcomes. We created an automated auditing system, Digital evaluation of ketosis and other diabetes emergencies (DEKODE), which identifies DKA episodes based on fixed-rate intravenous insulin infusion (FRIII) prescription.Aim: We validated DEKODE for its ability to audit DKA management against manually collected data.Methods: All episodes identified...

Background: The problem of eating disorders currently holds a special place in clinical practice. Bulimia nervosa is one of the main forms of eating disorders, characterized by difficulty in treatment, a long, recurrent course. Eating disorders are common in patients with type 1 diabetes mellitus (T1D), especially in adolescent girls.Case Presentation: In this article, we present a clinical case of a 29-year-old patient with T1D for 14 years and bulimia ...

Background: In March 2020, at the beginning of the first COVID-19 lockdown, Zagreb (Croatia) was hit by a strong earthquake aftermore than 100 years.Restrictive epidemiological measures affected people’s lifestyles, and the earthquakewas an additional traumatic event.Objectives: Determine whether the earthquakes and the lockdown affected glycaemic control in type 1 diabetes patients using flash glucose monitoring (FGM).Metho...

Background: Cyclic GMP-phosphodiesterase type 5(PDE5) inhibition was shown to counteract maladaptive cardiac changes triggered by diabetes in some, but not all studies.Objective: To assess sex differences in cardiac remodeling after PDE5 inhibition in patients with diabetic cardiomyopathy.Methods: 20-week, double-blind, randomized, placebo-controlled trial (NCT01803828). 220 men and women (45-80 years) with long-duration (>3 ye...

Background: Diabetic ketoacidosis (DKA) is the most common acute endocrine complication needing hospital admission. Morbidity and mortality resulting from DKA are largely preventable if we can identify and act on gaps in management in relation to current guidelines.Objectives: To establish a common DKA registry to identify gaps in management and share best practices across centres.Methods: All people admitted with DKA at four hospi...