Endocrine Abstracts

Biochemists have defined a probably complete catalogue of proteins involved in insulin secretion. Similarly, over the last two decades, biochemists and physiologists have defined the physical characteristics of different types of ion channels that underlie normal pancreatic beta cell physiology. What is missing is information describing the ‘wheres and whens’: where are these proteins (i.e. not just for example on the surface of a cell, but how are the single protein...

The discovery of insulin and its subsequent mass manufacture transformed the lives of people with type 1 diabetes. Insulin replacement is not, however, without risk and it soon emerged that many individuals with type 1 diabetes experienced iatrogenic hypoglycaemia. Hypoglycaemia in type 1 diabetes has both immediate (cognitive impairment) and longer-term consequences. In this presentation I will focus on the longer-term consequences of recurrent hypoglycaemia and in particular...

The fundamental importance of insulin to glucose homeostasis is well recognized and most evident in type 1 diabetes where β-cell destruction and loss of endogenous insulin secretion lead to marked hyperglycaemia and ketosis. The pancreatic α-cell product, glucagon, has garnered less scientific attention. However, the demonstration that glucagon receptor null mice did not develop diabetes following near-complete chemical destruction of the pancreatic β-cell renew...

PCOS is associated with increased androgens, elevated insulin and obesity. As obesity and androgens promote insulin resistance and hyperinsulinemia increases ovarian androgen production, and the likelihood of obesity, the interaction between these factors is complex. We investigated the development of insulin resistance, hyperandrogenism and obesity using a clinically realistic ovine model of PCOS. Exposure of the pregnant ewe to increased testosterone from d62 to d102 of gest...

Introduction: Patients with Addison’s disease are burdened by substantial comorbidity and likely require a large package of care. There is a proportion of South African patients who can afford private health-care, comparable to health-care offered in a developed country. We hypothesised that comprehensive package of care costs for Addison’s disease is relatively high.Methods: We identifed 131 patients with Addison’s disease within a privat...

Background: Hypoglycaemia in Type 1 diabetes (T1D) and type 2 diabetes is associated with long-term cognitive dysfunction. We have previously demonstrated that recurrent hypoglycaemia (RH) in a rodent model of T1D induces oxidative stress and inflammation in the hippocampus, associated with impaired cognitive function. This study sought to investigate whether pre-treatment with a potent inducer of the antioxidant response would ameliorate these cognitive deficits.<p class=...

Background: Growth hormone stimulation testing (GHST) is used to diagnose growth hormone deficiency (GHD) in children. Given that sex steroids impact on anterior pituitary function, there is concern around the efficacy of GH stimulation testing in pre/peripubertal children, where sex steroid levels are low. Sex steroid priming prior to GH stimulation testing is thought to improve test efficacy in these children, however evidence to support its use in clinical practice is limit...

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...

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...

In recent years, the increasing availability of massive computational capacity has reached what may be seen as a ‘tipping point’, bringing once unimaginable computational power into the lab. This is enabling models to be built, fit and refined during experiments, making predictive models that are powerful tools for hypothesis generation and testing. Neuroendocrine systems are at the forefront of these advances. Because of the exceptional opportunities that they offer...