Endocrine Abstracts

Introduction: Hypoglycaemia is one of the most important acute complications of diabetes. The fear of hypoglycaemia has a significant effect on the quality of life of patients and their families. It also remains a major barrier to achieve optimal glycaemic control. The GluCare Health care model is centered on the use of Continuous Metabolic Monitoring (CMM) and behavioural change to address metabolic diseases in a continuous manner. The Glucare program aims to provide continuo...

Background: Approximately one-third of pituitary adenomas are identified as nonfunctioning pituitary adenomas (NFPA) which have a heterogenous profile and an increased potential for relapse one to five years after pituitary surgery. In a retrospective analysis by Almeida et al, multiple surgical resections, elevated ki-67 and cavernous sinus invasion were predictive of recurrence. They typically present with symptoms of mass effect and most are macroadenomas at time of diagnos...

Background: Diabetes is a chronic disease with significant negative impact on quality of life. Hypoglycemia and weight gain are two important variables that can impact HRQoL negatively in patients with diabetes under treatment with medication.Objective: The objective of this study was to evaluate HRQoL tools and questionnaires and to explore if the HRQoL instruments address issues related to hypoglycemia and weight gain, which impact HRQoL along other do...

Introduction: The National Paediatric Diabetes Audit (NPDA) in 2012 reported a twofold increase in the incidence of diabetes ketoacidosis (DKA) admissions from 2005/6 to 2010/11 in children and young people with type 1 diabetes mellitus (T1DM). The paediatric diabetes best practice tariff (BPT) was introduced in 2012 to incentivise provision of high quality care to those under the age of 19.Aims: We examined DKA admission rates in children and young adul...

When investigating patients for possible Cushing’s, repeat testing should be considered despite initial negative results if there is a high index of suspicion. We report a case of a patient whose initial tests for Cushing’s yielded conflicting results; cyclical Cushing’s Disease was diagnosed following persistent testing. A 40 year-old lady (BMI 38.0 kg/m2) was seen in the obesity clinic with a 12-month history of weight gain. She had clinical feature...

A 57-year-old man presented with a 6-month history of worsening headaches and bitemporal hemianopia on visual field examination. MRI of the brain revealed a 3 cm pituitary lesion impinging the optic chiasm and indenting the pons. Appearances of the lesion on imaging and the patient’s normal anterior pituitary hormonal profile were highly suggestive of a non-functioning pituitary adenoma and this was the presumed diagnosis. The patient underwent trans-sphenoidal resection ...

Introduction: Guidelines for the use of GH in GH deficient adults were issued by the UK National Institute for Clinical Excellence (NICE). To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to i) assess if adults with GH deficiency met NICE criteria for GH therapy and ii) identify reasons for initiating or continuing GH treatment if NICE criteria were not met.Methods: Retro...

Synthetic glucocorticoids (GCs) including dexamethasone (Dex) are potent anti-inflammatory drugs. However, long-term use of GCs results in deleterious side effects such as hyperglycemia, hepatosteatosis, and insulin resistance. The nuclear hormone receptors LXRα and LXRβ are known for their important roles in modulating whole-body cholesterol homeostasis. Recently, we have shown that liver X receptor β (LXRβ) knockout mice are protected against Dex-induced ...

Aim: To compare the BMI z-score of children with type 1 diabetes (T1DM) in Nottingham with that of national and local background populations and to identify factors associated with increased BMI.Methods: A retrospective observational cohort study of patients with T1DM aged 2–15 years under the care of the paediatric diabetes team at Nottingham Children’s Hospital, between April 2013 and March 2014. Mean BMI-z-score for the year was com...

Background: Metformin is widely used for treatment of gestational diabetes mellitus. Metformin is considered safe in pregnancy but crosses the placenta. The limited available data of follow-up of children exposed to metformin in utero suggests potential for increased adiposity but mechanisms are unknown. As placental DNA methylation has been linked to later obesity and metformin causes global DNA methylation changes in cancer cell lines we hypothesised that this may be a candi...