Endocrine Abstracts

Metabolic dysfunction in skeletal muscle disturbs both the critical vascular network and fundamental muscle fibre architecture. However, the molecular drivers during metabolic stress responsible for transmitting these events remain poorly defined. To reveal these we mapped changes in the spatial proteome occurring as a result of impaired metabolic health. We exposed male and female mice (C57/BL6J) to high fat diets and conducted digital spatial profiling (NanoString GEOMX) on ...

Neurotensin is widely expressed in the brain and gastrointestinal tract. Centrally, neurotensin acts as a neuropeptide to suppress appetite, induce hypothermia and modulate analgesia. Peripherally, neurotensin inhibits gastric emptying and is reported to aid lipid absorption. There is also evidence that neurotensin can influence glucose homeostasis, though this role is contentious. We have found that neurotensin acutely improves insulin release and glucose tolerance in mice, a...

Obesity is a leading global health concern. The gut-brain axis is critical to appetite regulation. The vagus nerve represents the major neural pathway between the gastrointestinal tract and the central nervous system, capable of rapidly communicating information about the nutrient content from different regions of the gastrointestinal tract, directly via nutrient receptors expressed on vagal afferents and indirectly by responding to gut hormones and enteric nervous system sign...

The majority of the body’s 5-HT (serotonin) is produced from enterochromaffin cells (ECs) of the intestinal epithelium. 5-HT has important roles within the gastrointestinal tract in the modulation of motility, secretion and inflammation, while also signalling satiety and discomfort to the central nervous system. The factors regulating release of 5-HT from human small intestinal ECs have not been clearly elucidated: although circulating 5-HT levels typically increase after...

Intro/Aims: Maternal obesity is a major risk factor for the development of first onset of diabetes in pregnancy, also known as gestational diabetes mellitus (GDM). Recent studies also indicate that non-alcoholic fatty liver disease (NAFLD) is an independent predictor of GDM. Sulforaphane (SFN) is a well-known dietary activator of the redox-sensitive transcription factor Nrf2, with reported anti-adipogenic and NAFLD ameliorating effects in non-pregnant obese rodent models. In t...

Annona squamosa has been shown to have anti-diabetic properties, although the underlying mechanisms are not fully known. In the present study, ethanol extract A. squamosa (EEAS) leaf were investigated in vitro and in vivo, to elucidate the mechanism underlying anti-diabetic actions. EEAS significantly (P<0.05–0•001) increased insulin release 2.2-5.5-folds at 5.6 mM/16.7 mM glucose at concentrations between 8-5000µg/ml from BRIN-BD1...

Introduction: Central obesity is a significant risk factor for type 2 diabetes mellitus (T2DM), with omental adipose tissue (AT) particularly involved in such risk. Additionally, obesity can cause low-level gut-derived endotoxemia, which may drive metabolic dysfunction in AT through mitochondrial damage and reduced BRITE (brown-in-white) adipocytes. Bariatric surgery reduces obesity and may prevent such dysfunction. This study investigated whether endotoxin: 1) impairs mitocho...

The incidence of maternal obese and/or gestational diabetic (GDM) pregnancy are increasing globally, with ~10-20% of mothers classified as obese and/or GDM within the U.K. Both obese and GDM pregnancy are associated with increased risk of cardiometabolic disease, with mothers and their children at greater risk of developing later-life Type 2 diabetes, obesity and/or cardiovascular disease. Higher adiposity in pregnancy leads to increased inflammation, which may be countered by...

Background: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of progressive liver diseases driven in part by macrophages, occurring in the absence of excessive alcohol consumption that ranges from simple steatosis to non-alcoholic steato-hepatitis (NASH), ultimately progressing to fibrosis/cirrhosis and hepatocellular carcinoma. NAFLD is associated with insulin resistance and confers an increased risk of cardiovascular disease. Pre-menopausal women are protected against...

Obesity has been associated with a status of subclinical inflammation. Neutrophil to lymphocyte ratio (NRL) is a widely available and inexpensive inflammatory marker which can be reliable in evaluating the inflammatory status occurring in patients with severe obesity The aim of our study was to investigate the association between NLR and anthropometric and body-composition parameters, in a group of patients with obesityPatients and Methods: 737 patients ...

Introduction: When an individual predisposed to diabetes has excess weight, the cells in the body become less sensitive to the insulin which regulate blood sugar level. Ginger (Zingiber officinale) and Garlic (Allium sativum) are plants that have been acknowledged over years for their medicinal and therapeutic effects on mammals.Aim of The Study: Was to determine the effect of ethanolic and aqueous extract of Zingiber officinale and Allium sativum on wei...

Background: Chronic kidney disease aggravates loss of skeletal muscles mass and function, which is an independent risk factor for hospitalisation, morbidity and mortality. Glucocorticoid signalling has been implicated as a critical factor in the pathogenesis of muscle atrophy in kidney disease. This study tests whether genetic deletion of the glucocorticoid-activating enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11bHSD1) protects against muscle atrophy in the adenine-die...

Background: Adipose tissue exhibits an altered adipokine secretion profile in obesity which is pro-inflammatory and relates to higher risk of cardio-metabolic diseases. Asprosin is a novel pleiotropic adipokine with orexigenic and glucogenic effects which is secreted in response to fasting. Elevated circulating asprosin levels have been shown in obesity and type 2 diabetes, as well as in other cardio-metabolic diseases. Furthermore, in vitro studies have reported pro-...

Increased mammary metabolism after child-birth supports the synthesis of milk components and is critical for initiating lactation during postpartum days 1-4. We utilised clinical and cellular approaches to investigate whether growth hormone (GH), which is reported to increase milk yield in breastfeeding women, may play a role in initiating lactation and promoting mammary metabolism. We recruited n=30 pregnant women (age range 24-41 years) following informed consent an...

Alzheimer’s disease (AD) development has a direct relationship with Brain-insulin resistance. Central in the pathology of AD are beta-amyloid and tau proteins associated with cognitive decline in the hippocampus. Allium sativum L. has been shown to have a neuroprotective effect. Thirty-two male Wistar rats (80-150 g) were assigned into A-D (n=8 each), and housed in standard plastic cages at 23&pm; 1°C. Group A received saline, groups B and C were ad...

Introduction: Simulation via Instant Messaging - Birmingham Advance (SIMBA) is a simulation learning modality designed to recreate real-life clinical scenarios, in a safe environment to help improve participants’ confidence in solving such cases.Objective: To study SIMBA’s effectiveness in improving confidence in managing obesity-related cases and whether the country of residence and modality of attendance influence change in confidence.<p ...

About one in six hospital admissions are for a primary diagnosis of gastrointestinal (GI) disease in the UK, according to the British Society of Gastroenterology, and there is a similar incidence of disease in other developed countries. Inflammatory disease of the gut, in particular, alters the release of cytokines and gut hormones. Medication is used to manage GI diseases and endoscopies help visually monitor its progression. However, this procedure is invasive and causes dis...

Background: Animal-derived protein consumption has been rising globally, driven by socioeconomic factors and shifts in dietary patterns to improve performance and support weight loss. In recent years an increasing trend has been observed for plant-based proteins due to sustainability concerns. Previous studies indicate that the metabolic effects of proteins may vary according to their origin. Thus, the aim of this single-blind, crossover study was to assess the acute effects o...

Background: Pathological accumulation of intrahepatocellular triglyceride (IHTG) is the first stage non-alcoholic fatty liver disease (NAFLD), which encompasses a spectrum of disease from simple steatosis through to cirrhosis. Dietary interventions have demonstrated alterations in dietary fat quantity and quality affect IHTG content; diets rich in saturated compared to unsaturated fat increase IHTG accumulation to a greater extent. Studying the underlying mechanisms in viv...

Background: Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of diseases starting with pathological accumulation of intrahepatocellular triglyceride (TG) (i.e. steatosis), which can progress to steatohepatitis (NASH) and cirrhosis. Insulin resistance is often associated with the development of steatosis and disease progression however, the underlying mechanisms for this are poorly defined. A major challenge in modelling human NAFLD disease progression is the la...

Background: Following the RECOVERY study, dexamethasone is prescribed for patients requiring inpatient treatment of Covid. Cases of new and atypical diabetes have been reported during this pandemic. The risk of steroid induced hyperglycaemia is well recognised but other metabolic sequelae less so. We present a patient who developed severe hypernatraemia following commencement of dexamethasone.Case Report: A 44-year-old man (unvaccinated) was diagnosed wi...

Background: Asprosin is a novel adipokine involved in appetite and glucose regulation. During obesity, circulating asprosin is increased, which leads to increased inflammation and can disrupt cellular functions such as mitochondrial respiration. Asthma is a comorbidity of obesity, with both diseases sharing an inflammatory profile and mitochondrial dysfunction. This study investigated the molecular links between asthma and obesity, by exploring whether asprosin causes mitochon...

Background: Islet transplant into the liver is a therapy for type 1 diabetes patients experiencing severe hypoglycaemia or impaired hypoglycaemic awareness. Widespread use is not currently considered due to the requirement for immunosuppression for the lifetime of the graft, and the attrition in graft function over the following 1-5 years. Following transplant into the liver, inflammation results in >60% islet loss, with few patients achieving insulin independence. The liv...

Introduction: Hypoglycaemia following bariatric surgery is a recognised complication, secondary to increased incretin secretion to nutrient intake due to altered gut anatomy. It is predominantly postprandial, and usually occurs >6 months postoperatively. We report a case of insulinoma unmasked during the early postoperative period after sleeve gastrectomy (SG).Case presentation: A 49-year old female with severe obesity without diabetes underwent SG. ...

Gitelman’s syndrome (GS) is an autosomal recessive renal tubular disorder caused by mutations of the SLC12A3 gene coding for the thiazide-sensitive sodium chloride co-transporter (NCCT). Hypokalaemia, hypomagnesaemia, hypocalciuria and metabolic alkalosis are consequent. Sjorgren’s syndrome (SS) is a connective tissue disorder primarily affecting lacrimal and salivary glands resulting in sicca complex. The coincidental presence of both syndromes is rare. A 28 year ol...

Appreciation of hormonal control over mitochondrial function has increased over recent decades. Mitochondria adapt to the cellular environment through a variety of mechanisms; mitochondrial dynamics (fusion, fission, transfer) or through the signalling of a variety of proteins to induce mitophagy, depending on the cell stressor. In parallel, nuclear receptors and the production of their steroid hormone ligands within mitochondria have been a reoccurring incidental measurement....

Parenteral iron is commonly used in management of iron deficiency especially due to gastrointestinal, obstetrics and gynaecological bleeding. There is a variety of intravenous iron formulations available nowadays and they are generally preferred over oral iron preparations in raising haemoglobin and ferritin, especially in cases of noncompliance and patients with gastrointestinal problems. However, one of the frequently missed complications of iron transfusions is hypophosphat...

Background: We previously showed that in first 6 months of the UK Covid-19(C19) pandemic >6.6million HbA1c tests were missed, including 1.4million in people with diabetes(DM). Furthermore, C19 more significantly impacts people with DM / socioeconomically disadvantaged individuals.Aim: To examine variability in recovery rate of HbA1c testing, and links to demographics, including deprivation status.Methods: We examined HbA1c test...

Background: Abdominal fat accumulation is a risk factor for type 2 diabetes and cardiovascular disease, whereas lower body fat is protective. Erythroferrone (ERFE) is a recently discovered protein that increases intestinal iron absorption by inhibiting hepcidin. ERFE has been shown to inhibit BMP2 signalling and work from our group has shown that BMP2 is a differentiation factor for subcutaneous abdominal, but not gluteal, adipocytes. Because of this, we hypothesised that ERFE...

Background: Endocrinopathic laminitis is a painful equine condition that may cause persistent lameness warranting euthanasia. Hypoadiponectinemia and insulin dysregulation (ID, manifesting as hyperinsulinemia, tissue insulin resistance (IR), and/or excessive insulin responses to non-structural carbohydrates) are independently associated with increased laminitis risk, although underlying mechanisms remain unclear.Methods: This study aimed to investigate t...

Traditional literature has dictated diabetes to be a chronic irreversible disease with progression of micro and macrovascular complications. Modern medicine has now started to include bariatric surgery, starch restriction as potential interventions which could control diabetes at initial stages. Our case report is unique as it illustrates patient directed reversal of diabetes with lifestyle intervention. 77 years old gentleman was diagnosed with Type 2 diabetes at the age of 5...

Patients with chronic schizophrenia and psychosis are prone to develop hyponatremia secondary to psychogenic polydipsia. Hyponatremia secondary to water intoxication and its rapid correction are linked with rhabdomyolysis, an under-recognized yet serious condition. We report a case of 31 year old male with schizophrenia on Risperidone, who was brought to the emergency due to an unwitnessed fall and confusion. Serum sodium was 111 mmol/l, urine osmolality 55 mosm/kg and urine s...

Background: Diabetic peripheral neuropathy (DPN) is one of the microvascular complications of diabetes mellitus (DM) that causes substantial morbidities including pain, foot ulcers, lower limb amputation, and depression. It is said to affect about 50% of adults with diabetes. Understanding the predictors of DPN will help to re-focus on early preventive strategies to reduce its enormous untold morbidities.Methods: This is a multi-center cross-sectional st...

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by progressive joint destruction and inflammatory activation and hyperproliferation of synoviocytes. We have previously reported a marked shift towards reduced local androgen metabolism in active RA, driven by changing expression of SRD5A1 and AKR1C3 within macrophages. In this study we examined the role of altered androgen metabolism and availability in the inflammatory function of both macr...

Diabetes type two and Vitamin D deficiency has stirred a great interest recently due to rising prevalence globally. Currently, diabetes is one of the largest and fast growing non- communicable disease of the 21st Century with a close to a half a billion people living with diabetes globally. Vitamin D is a fat- soluble vitamin that is also referred to as the “sunshine vitamin” is an essential vitamin for humans. It is found in two forms: ergocalciferol (vitamin D2) wh...

Background: 38% of teens use social media more than once an hour and 16% use it almost constantly (Rideout, 2018). Even so, the connection between smartphone use and nutrition and eating disorders is understudied and merits further study. Therefore, this study aims to examine the associations between smartphone use and eating disorders among adolescents.Methods: The study enrolled 325 participants aged 14-19 years in Florida, US, with 46% (n=150...

Introduction: Chronic heart failure (cHF) is an often and unrecognized cause of mortality among people with type 2 diabetes (T2D), more often in elderly. Assessment of cHF comprises of a combination of clinical symptoms, echocardiography and a biomarker N-terminal pro b-type natriuretic peptide. It is underestimated and not treated timely. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are treatment of choice for subjects with T2D and cHF, frequently not initiated in elderl...

Introduction: Non-diabetic hypoglycaemia (NDH) has many causes including insulinoma, non-insulin producing cancers and gastric bypass surgery but medications like fluoxetine are rarely reported.Case history: 55 years female, university lecturer, history of Roux-en-Y gastric bypass in 2015 and depression, referred for recurrent symptomatic hypoglycaemia 1 to 2 hours post-meal (reactive hypoglycaemia) with recorded capillary blood glucose up to 1.6 mmol/l ...

Introduction: Obesity is a global public health challenge. Semaglutide, a weekly GLP-1 agonist, was recently approved in Europe for weight loss. There is paucity of real-life data about the effectiveness and safety of semaglutide for weight management.Methods: Real-world data of semaglutide use in a weight management clinic in Athens, Greece, for individuals with BMI (body mass index) > 30 kg/square meter without diabetes, including all patients with...

Background: Type 1 diabetes mellitus is an autoimmune disorder caused by the destruction of the pancreatic beta cells which produce insulin. People with type 1 diabetes usually require at least 3-5 years to develop microvascular complications in comparison to those with type 2 diabetes, who may develop such complications even before the diagnosis of diabetes due to its insidious onset and the delay in diagnosis. We discuss a patient who initially presented with proliferative d...

Background: Gestational diabetes (GDM) leads to an increased risk of delivering large-for-gestational-age infants (LGA), which has been linked to altered placental vascular development. Women with GDM who deliver LGA infants have temporal periods of mild hyperglycaemia, detectable by continuous glucose monitoring (CGM), compared to women who deliver appropriate-for-gestational-age infants (AGA). This study aimed to assess the impact of physiological periods and levels of hyper...

Dysbiosis of the gut microbiome contributes to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Reduced diversity and composition of the microbiome are associated with increased intestinal barrier permeability, increased bacterial translocation and NAFLD progression. The ALIOS diet in rodents replicates many of the metabolic and histological features of NAFLD in humans and here we report the effect of the ALIOS diet on the gut microbiome. Male and female C57BL/6 ...

Neuropathic pain (NP) is a microvascular complication affecting between 30-50% of people living with diabetes. Current painkillers including non-steroidal pain killers and anti-convulsant are ineffective. At the level of the spinal cord (SC), capillary regression is associated with the onset of NP in diabetic rodent models. Our aim was to investigate angiotensin II mediated pericyte activation in relation to vascular degeneration and the onset of NP. Adult male C57Bl/6J mice w...

Background: The beneficial effects of high protein diets on glucose homeostasis are thought to be in part mediated by the modulation of gastroenteropancreatic hormones by protein-derived metabolites such as amino acids. However, the precise mechanisms by which amino acids drive these beneficial effects are not well understood. Protein intake stimulates both insulin and glucagon release; glucagon is now recognized to have other metabolic roles besides increasing blood glucose l...

During pregnancy progressive maternal insulin resistance occurs which is normal, ‘sparing’ glucose that can be transported across the placenta to be used by the fetus. In gestational diabetes mellitus (GDM) maternal glucose dysregulation is exacerbated, characterised by hyperglycaemia and associated with long-term adverse outcomes in mother and child, such as increased risk of diabetes and/or cardiovascular disease in later-life. Continuous glucose monitoring (CGM) i...

The onset of lactation during post-partum days 1-4 is hormonally-regulated and critical for successful breastfeeding. Insulin represents a key lactogenic hormone as evidenced by women with type 1 diabetes who have delayed lactation onset. However, the role of insulin in lactation and its influence on mammary cells are unclear. We utilised clinical and cellular approaches to investigate this, and recruited n=12 women following informed consent and measured serum insuli...

Introduction: Brown adipose tissue (BAT) increases energy expenditure and is a potential therapeutic target for obesity and associated cardiometabolic disease. It is unclear whether human BAT activity is reduced in obesity, as BAT 18F-fluorodeoxyglucose uptake is reduced but BAT metabolic activity measured using11C-acetate PET is preserved. BAT thermogenesis relies on the presence of uncoupling protein 1 (UCP1), which uncouples oxidative phosphorylation f...

Introduction: Palmitoleate, a proposed adipose tissue (AT)-derived lipokine, has been suggested to contribute to glucose homeostasis. However, data relating to the association between circulating palmitoleate and markers of insulin sensitivity in humans are equivocal. Recently, AT-derived fatty acid-hydroxy fatty acids (FAHFAs) have also been suggested to play a role in glucose homeostasis by increasing glucose uptake in AT. Again, data is conflicting for the association betwe...

Developmental programming of insulin resistance in the offspring of diabetic mothers have contributed significantly to the increased prevalence of type 2 diabetes mellitus and other metabolic disorders in the general population. Vitamin D has been reported to improve glucose metabolism, however its potential in reversing glucose intolerance programmed in the offspring of diabetic mothers has not been fully elucidated. The study therefore aimed to investigate the effect of vita...

Introduction: Bile acid (BA)-feeding and genetic manipulation of BA receptors affect glucose tolerance in rodent pregnancy. In non-pregnant individuals, serum BA profiles depend on BMI and ethnicity. The interaction between serum BAs, ethnicity, and BMI in gestational diabetes mellitus (GDM) remains poorly understood.Methods: Fasted serum samples were collected between 23-31 weeks’ gestation. Experimental groups: lean or obese women of European (EU)...

Background: Obesity-linked metabolic disorders are a worldwide health concern affecting about one third of women of reproductive age. The programming events in utero impact the risk of predisposition to obesity and metabolic diseases. Maternal B12 deficiency is associated with higher cord lipids. B12 has a potential epigenetic role and therefore may perpetuate an intergenerational cycle of obesity through its effects on placental function and fetal metabolism. Therefore, we hy...

Introduction: Overweight and obesity is a worldwide chronic disease affecting 2 billion adults and millions of children. In diet-induced obesity (DIO), current treatments are not always effective or suitable for all patients due to the complexity of obesity and its associated health complications. Recently, the potential of developing weight loss therapy by targeting the gut microbiota has been raised. Previously, we have shown that mice overexpressing insulin-like growth fact...

Background: Obesity exacerbates a number of chronic inflammatory diseases including asthma, with increasing adiposity observed to worsen asthma severity and disease control. This exacerbation may arise as gut-derived bacterial fragments (endotoxin) and associated markers of endotoxin (lipopolysaccharide binding protein (LPB)), enter the circulation through a damaged gut barrier, provoking systemic inflammation. This study investigated the role of body weight on gut permeabilit...

Aim: The current focus for the treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) is lifestyle intervention with the aim of significant weight loss. NAFLD is tightly associated with type 2 diabetes (T2D) and obesity. In patients with T2D, glucose lowering agents that promote weight loss have shown a beneficial impact on NAFLD. However, it remains unclear as to whether glucose lowering can improve NALFD in patients with T2D, independent of weight loss.<p class="abstext"...

Authors 1-4 contributed equally to this work.Background: Insulin resistance is the central defining feature of type 2 diabetes and increases with age. People with type 2 diabetes are at an increased risk of cardiovascular disease, non-alcoholic fatty liver disease (NAFLD), Alzheimer’s disease and arthritis. Macrophages are phagocytotic leukocytes which play a central role in the development of type 2 diabetes and the chronic inflammatory di...

Background: C-peptide is an amino-acid chain which is an equimolar marker of endogenous insulin. It is used to investigate the cause of non-diabetic hypoglycaemia and classification of diabetes. C-peptide can only be interpreted with a paired venous glucose <3 mmol/l for non-diabetic hypoglycaemia, and >4 mmol/l for diabetes classification.Aims and Objectives: To determine if: 1. C-peptide tests were requested for appropriate indication 2. Tests ...

Introduction: Although patients with inflammatory bowel disease (IBD) -Crohn’s disease (CD) and ulcerative colitis (UC)- are considered prone to malnutrition, studies have shown an increased risk for obesity, especially visceral obesity and metabolic syndrome (MetS). Possible mechanisms involved include dysbiosis, gut microbiome and chronic inflammation. The aim of the study was to assess the prevalence of MetS and obesity in a group of IBD patients.<p class="abstext"...

Statins are among the most widely prescribed medications worldwide, decreasing the risk of cardiovascular diseases by reducing cholesterol levels. However, statins also increase the risk of incident type 2 diabetes (T2D), disproportionately affecting women compared to men. Inflammation has emerged as a central factor underpinning T2D pathology, with macrophages playing a significant role. Statins have been found to influence macrophage inflammatory responses, and this has been...

Background and Aim: Type 2 diabetes mellitus (T2DM) disparately affects ethnic groups. Prevalence is higher in Asian and Black ethnicities, and these patients suffer increased rates of some diabetes-related complications. Bariatric surgery is an effective treatment for T2DM and can lead to complete diabetes remission. The aim of this study was to assess if T2DM remission rates at 1-year following bariatric surgery vary between different ethnicities.Metho...

Introduction: Gestational diabetes mellitus (GDM) is any degree of glucose intolerance developed during pregnancy1. Remote Blood Glucose Monitoring (BGM) may facilitate more effective communication between women with GDM and physicians.Objectives: To evaluate the effectiveness of remote BGM (using OneTouch Verio system) in the management of women with GDM during COVID-19 and assess the impact on delivery modality. Diabetes in pregnancy NICE gu...

Background: Mucormycosis is a serious but rare angio-invasive fungal infection in high-risk patients with diabetes, organ transplantation, neutropenia, and hemochromatosis. The COVID-19 pandemic has been associated with increased incidence of mucormycosis and the incidence has risen more rapidly during the second wave of pandemic in India. The clinical profiles and risk factors for severity and mortality are not very clear among patients with COVID-19 infected with mucormycosi...

Background: Dysfunctional adipose tissue in obesity is known to contribute to metabolic diseases, including type 2 diabetes mellitus (T2DM). This may be due to increased gut-derived endotoxemia (LPS) reducing brown adipose tissue (BAT) activity and altering mitochondrial function. However, the effect of LPS on BAT activity in 3D culture models has not been studied, despite giving a better representation of in-vivo tissue. Therefore, this study investigated the effects of LPS o...

A 33-year-old woman with type 1 diabetes and autoimmune Addison’s disease conceived in September 2021 following careful preconception counselling. The patient had a history of recurrent, severe hypoglycaemia requiring intensive care admission and had previously received two allogenic islet cell transplants (January 2020 and November 2020). The patient had no severe hypoglycaemia following transplantation, although she continued to experience overnight hypoglycaemia, while...

Introduction: In vitro skeletal muscle cell models are vitally important for investigating the molecular mechanisms of skeletal muscle in metabolic and endocrine diseases, such as obesity and type 2 diabetes. Culture media for skeletal muscle cells can often contain glucose concentrations (GC) five times higher than what’s considered normal in fasting human plasma, thus is not representative of the in vivo environment. Hyperglycaemia in culture media may...

Purpose: Obesity and/or bariatric surgery can be associated with micronutrient deficiencies. We studied whether there was a correlation between body mass index (BMI) and micronutrient levels pre- and post-bariatric surgery.Methods: We performed a retrospective cohort study of 745 patients who underwent bariatric surgery in a Northwest England teaching hospital. Patients were recommended standard postoperative supplements consistent with national guidelin...

Background: Hyponatraemia is known to be associated with significantly increased mortality in hospitalised patients. We identified the number of cases of hyponatraemia referred for an endocrine opinion in our hospital, examined the causes present, and assessed how the speed of referral to endocrinology could affect the management. Methods: Inpatient referrals were audited over a 6-month period from 1st October 2021 to 30th April 2022. Data regarding the ...

Background: It is widely believed that increased circulatory concentrations of long-chain saturated fatty acids (LC-SFA) significantly contribute to the death and dysfunction of pancreatic β-cells in the development of type 2 diabetes (T2D). The mechanism by which LC-SFA cross the β-cell plasma membrane has not been fully established. This work aims to characterise the mechanism underpinning this uptake. Ultimately, regulation of LC-SFA entry may maintain β-cell...

Introduction: Flash glucose monitoring has been widely used for people with T1DM over the last 10 years. In March 2022 NICE guidelines recommended extending use to people with T2DM on insulin, previously use was limited to people on dialysis and those self-funding.Aim: To examine the use and outcomes of flash glucose monitoring in people with T2DM.Methods: People with T2DM locally who have used flash glucose monitoring for more tha...

Background: The mortality from COVID-19 is higher in DM patients compared to the general population. Hence, it is highly desirable that diabetic patients are vaccinated against COVID-19 infection in order to reduce their risk of contracting the disease and having devasting consequences from the infection.Aim: The aim of this study is to determine the willingness of type 2 DM patients to accept COVID-19 vaccine and the factors that influence their decisio...

Background: Self-care practices in patient living with diabetes are important to effectively prevent, manage, and limit complications associated with diabetes as patients spend more time alone than they spent with health care providers in managing their health conditions.Aims: The aim of the study was to evaluate self-cate practices and their determinants in patients living with type 2 diabetes. Hence, this study aimed at assessing self-care practices an...

Flash glucose monitoring has increased dramatically in patients with diabetes since the introduction of the FreeStyle libre 2 (FSL) incorporating hypoglycaemia predictive features and an alarm system. A 31-year-old lady, gravida 2, para 1 presented at 26 weeks’ gestation following a car accident where she fractured clavicle and navicular. She reported blurred vision and subsequent collapse whilst driving (with her daughter as a passenger) prior to the accident. Paramedics...

Introduction: Impact of COVID -19 lockdown on care of patients with chronic disorders such as dyslipidaemia and diabetes still being realized. We examined if care was impacted by assessing biomarkers for diabetes and dyslipidaemia management as well as for vitamin D status, often monitored in general practice.Methods: Retrospective laboratory data for total cholesterol, glycated haemoglobin (A1c) and for vitamin D levels were obtained for late (October t...

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance resulting in hyperglycaemia of variable severity, with onset or first recognition during pregnancy. GDM is a risk factor for dysglycaemia in later life. The objective of the study was to determine the impact of GDM on glucose tolerance in the short term post-delivery in a cohort of women who attended the Lagos University Teaching Hospital (LUTH)Study Design: This was a pros...

Background: Covid 19 infection has previously been reported to be associated with worsening of pre-existing and new onset diabetes mellitus1. However, the association of new onset autoimmune diabetes mellitus after Covid vaccination is not fully recognised in the literature.History: We report the case of a 58-year-old healthy woman who received a Covid 19 vaccination on 14th of Nov 2021. 2 weeks subsequently she was admitted with headache, blurred vision...

Introduction: Hyperglycemia is common in acute ischemic stroke and is associated with worse neurological outcomes. This study aims explore the association between hyperglycemia and short-term stroke outcomes.Methods: We retrospectively reviewed the records of 97 consecutive patients with acute ischemic stroke managed in a cardiovascular hospital. Hyperglycemia was defined as RBG > 7.8 mmol/l on admission, and was considered sustained if it persisted ...

Hyperglycaemia is common in patients (~65%) when they are admitted to hospital with ACS. It is recognised to be one of the important prognostic indicators for all-cause mortality in patients who present with ACS, regardless of pre-existing diabetes1. NICE guidelines recommend to keep blood glucose (BG) levels below 11 mmol/l2 and offer all people with hyperglycaemia after ACS (without known diabetes) for HbA1c 3 check before discharge. We were interested to see whether we foll...

Introduction: DKA is often seen in people with Diabetes Mellitus I and seldom in Diabetes Mellitus II but rarely seen in Maturity Onset Diabetes of Young (MODY) and even more rare in association with SGLT2i.Case history: 44 years female, genetically confirmed Hepatocyte Nuclear Factor 1 alpha (HNF1A) MODY since 2004 initially treated with maximum doses of metformin and gliclazide and then lost to follow-up. GP initiated Empagliflozin a year before presen...

Background: The COVID19 pandemic greatly affected the delivery of outpatient clinics. Tier 3 specialist weight management services (SWMS) aim to help obese patients lose weight through holistic lifestyle modification delivered by a multidisciplinary team consisting of specialist physicians, dieticians, physiotherapists, psychologists, and support workers. Prior to the pandemic, the service was delivered mainly through in person consultations. The nature of the pandemic necessi...

Introduction: Non-alcoholic fatty-liver disease and T2DM remain a global burden. Metformin is the first-line drug for T2DM that decreases glucose and lipid levels. However, prolonged metformin treatment decreases vitamin B12(B12), whereas low B12 is associated with obesity and dyslipidaemia. Clinical studies showed that metformin treatment increases circulating adiponectin and adiponectin improves NAFLD. Others suggested that metformin has no effect on intrahepatic triglycerid...

Background: Obesity is a global health concern and a recognised risk factor for several prevalent diseases. Genetic variation can influence susceptibility to the development of obesity. Existing work in humans explains a limited proportion of the heritability of obesity-related traits and prioritisation of variants on which to focus mechanistic studies is challenging. Novel insights can be obtained from species such as the domestic dog and the pig in which obesity occurs spont...

Objective: To determine if the impact of pre-pregnancy body mass index (BMI), fasting glucose levels and post load glucose levels on large for gestational age neonates varies with ethnicity.Data sources: Electronic health records of all eligible pregnant women in an inner city service. Study designRetrospective analysis of pregnant women at risk of developing gestational diabetes mellitus (2016-2019) of. Population or sampleEligible pregnant women. Synth...

Background: The aetiology of hyponatraemia in SARS-CoV-2 (COVID-19) is complex. Early studies have suggested a syndrome of inappropriate anti-diuretic hormone picture. We undertook a real-world retrospective analysis of patients with hyponatraemia and COVID-19 hospitalised over a 12-month period and evaluated practice against European hyponatraemia guidelines to see if initial investigations and management were appropriate. Additionally, we evaluated whether hyponatraemia in C...

Cognitive impairment and neurodegeneration are a few hallmarks of brain insulin resistance, a core feature of Type 2 diabetes mellitus (T2DM). Using a Wistar rat model of a high-fat diet and streptozotocin-induced T2DM, we aimed to determine the potential of Vernonia amygdalina (VA) as a possible treatment for the accompanied neurodegenerative effects of this condition on hippocampal structure and function. T2DM adult rats were prepared by a combination of a high-fat diet and ...

Background: A mutation in POMC in retriever dogs prevents production of the POMC-derived peptides β-MSH and β-endorphin but not α-MSH and is associated with weight, adiposity and owner-reported food motivation (Raffan et al, 2016). Melanocortin signalling is central to the control of energy homeostasis but the relative contribution of the POMC derived neuropeptides is not well understood because rodents produce only α-MSH whereas humans, like dogs,...

Background: Liraglutide is a long-acting glucagon-like peptide-1(GLP-1) receptor agonist that promotes weight loss. The minimum adequate/good response to liraglutide (≥5% weight loss at 3 months) is not achievable in all patients. Currently there are no biomarkers to predict good response. Enhanced postprandial glicentin concentration was recently considered as superior to GLP-1 in predicting weight loss following bariatric surgeries.Objective 1) T...

Ageing is associated with decline in mitochondrial function whereby dysregulation in carnitine metabolism is highly correlated to poor ageing phenotypes. L-Carnitine transports activated long-chain fatty-acids (FAs) across mitochondrial membranes for β-oxidation and energy production. It is hypothesised that accumulation of long-chain FAs within cells is related to disordered transportation and reflects lower cellular energy upon ageing. Our global aim is to determine the...

Introduction: Self-management of chronic disease is increasingly being recognised as an essential tool in chronic disease management. During the pandemic, face-to-face diabetes clinics were suspended, and resources were focussed on delivery of urgent care. A free NHS app was created to virtually deliver information on all aspects of type 1 diabetes management and to support patients in their self-management during an increasingly difficult period. The App included an ‘Ale...

Introduction: Simulation via Instant Messaging – Birmingham Advance (SIMBA) for Students is an online education model used to teach endocrine topics to pre-clinical medical and pharmacy students using simulated clinical cases delivered over WhatsApp. This study investigated the efficacy and acceptability of SIMBA for students compared with traditional small group teaching (SGT).Methods: The SIMBA sessions focussed on curriculum learning objectives a...

Background and aims: We aimed to explore the epidemiology of Diabetes Mellitus (DM) Type 1 and 2 in children aged 0-18 in Kazakhstan based on the aggregated large-scale healthcare data from the Unified National Electronic Healthcare System (UNEHS) in 2014-2019.Methods: 10,134 incident Type 1 and Type 2 DM pediatric patients were identified through UNEHS. Incidence, period prevalence, and mortality rates per 100,000 population at risk were calculated. The...

This study assesses adherence to the NICE guidance of GLP-1 agonist and DPP-IV inhibitor prescribing from 2021-2022, during the COVID-19 pandemic, in primary care. We took a group of 86 patients with type 2 diabetes mellitus (T2DM) and monitored HbA1c, BMI, frequency of diabetic reviews, medication changes and symptoms throughout the pandemic. Evaluation of adherence to the NICE guidance during COVID-19 and the effects on these patients was made. The intervention was an MDT me...

Introduction: Simulation via Instant Messaging -Birmingham Advance (SIMBA) is a virtual platform which simulates anonymised, real-life clinical cases to train healthcare professionals. Participants’ competence is assessed using an adapted version of the global rating scale (GRS) commonly used in medical schools.Aims: To compare GRS scores of participants according to country of residence and domains assessed as part of simulation.<p class="abste...

Background: Increased endogenous post-prandial GLP-1 release is a key mediator of improved glycaemic control following Roux-en-Y gastric bypass (RYGB) surgery. GLP-1 receptor agonists (GLP-1 RA) augment glucose-stimulated-insulin-release and suppress glucagon release, and do not usually cause hypoglycaemia. The use of GLP-1 RA have been shown to be safe for patients requiring additional glycaemic control following RYGB. We present a case of severe recurrent fasting nocturnal h...

Background: Maturity-onset diabetes of the young (MODY) is a group of 13 monogenic forms of diabetes transmitted in an autosomal dominant pattern and is characterized by a primary defect in pancreatic β-cell function. This disease has an early onset, usually before 25 years of age. It may present with mild asymptomatic hyperglycemia with progressive development to clinical diabetes mellitus. First-line treatment relies on sulphonylureas or insulin according to MODY subtyp...

Introduction: Diabetes striatopathy (DS) is an extremely rare hyperglycaemic complication of diabetes with a prevalence reported as 1 in 100,0001. Though DS is commonly associated with a non-ketotic hyperglycaemic hyperosmolar state (HHS), it is occasionally reported in diabetic ketoacidosis (DKA). DS is known as non-ketotic hemichorea-hemiballismus due to its presentation with hyperkinetic movements but rarely presents as stroke-mimic2. Here we present a...

Introduction: Commonest causes of pancreatitis are alcohol and gallstones but less common causes like hypertriglyceridemia should also be considered as management may differ.Case history: 47 years old gentleman with history of pancreatitis and hyperlipidaemia type1 taking atorvastatin and bezafibrate, admitted with severe abdominal pain and vomiting. He was non-smoker and non-drinker. No history of cholelithiasis or medications causing pancreatitis. He w...

Introduction: Growth hormone secretogogues (GHS) are popular among body building communities as muscle bulking agents. We present an interesting case of new onset diabetes induced by a combination of GHS and selective androgen receptor modulators (SARMs).Case report: A 34-years body builder was referred by his GP due to a 3-week history of polyuria, polydipsia and fatigue. He had recently used one cycle of a combination tablet which contained Ibutamoren ...