Endocrine Abstracts

Introduction: Hyperosmolar hyperglycaemic state (HHS) is an acute complication of diabetes which requires prompt recognition to prevent morbidity and death. Owing to its low prevalence, clinicians report a lack of confidence in management, which may result in delayed diagnosis and worsened outcomes. The limited literature on HHS management means most guidelines are based solely on expert opinion, resulting in significant discrepancies between care in centres.<p class="abst...

Background: Joint British Diabetes Societies (JBDS) have developed guidelines for the treatment and management of diabetic ketoacidosis (DKA) in adults in the United Kingdom (UK). Multiple single center audits are known to assess compliance to guidelines. However, unified data on DKA management across multiple centers is unknown.Aims: To study the precipitating factors and assess for differences in DKA management across UK hospitals.<p class="abstext...

Background: The appropriate and timely management of diabetes-related ketoacidosis (DKA) has important implications for patient outcomes. Despite the availability of national management guidelines to promote standardised care, we do not know if there are differences in DKA outcomes and complications between hospitals.Aim: To assess for differences in DKA outcomes and treatment complications between hospitals.Methods: This retrospec...

A 59-year-old lady presented with 2 days of increasing confusion, hallucinations and drowsiness. Her family reported lethargy, weight gain and changing appearance over several months.On examination she was profoundly hypothyroid with typical coarsened facial features and dry skin. She had pulsus paradoxus, BP 120/70mmHg and Glasgow coma scale was 11/15. She was transferred to our care.Free thyroxine was <3.0pmol/L and TSH 30.8mu...

Background: Cardiac failure is an infrequently reported complication of Addison’s disease which is unique in its reversibility. We report a rare case of heart failure as the initial presentation of Addison’s disease.Case Summary: A 39-year-old gentleman presented with classical features of heart failure and hypotension. His Echocardiogram showed moderately impaired left ventricular function. Addison’s disease was suspected due to hyponatre...

The molecular mechanism of circadian clocks in mammals is generated by a set of genes forming a transcriptional autoregulatory feedback loop. The ‘core clock genes’ include: Clock, Bmal1, Per1, Per2, Cry1 and Cry2. The discovery of ‘clock genes’ led to the realization that circadian gene expression is widespread throughout the body and that the clock is cell autonomous. The cellular autonomy of circadian clocks has raised a number of quest...

In 2013, a panel of international experts in hyponatremia published our recommendations for clinicians caring for patients with hyponatremia (‘Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations’). In 2014, a similar working group of experts from EU countries published their recommendations (‘Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia’). Despite reviewing the same evidence databases, these two grou...

Growth hormone (GH) is the primary regulator of insulin-like growth factor-I (IGF-I) production in a wide variety of tissues. After secretion by the pituitary GH, GH is transported to the liver and stimulates IGF-I production in the liver. The IGF-I produced in the liver accounts for most of the IGF-I in the circulation. The circulating IGF-I will have effects on extra hepatic tissues as the heart, lung, muscles and kidney. Circulating IGF-I feeds back at the level of the pitu...

Aim: To assess the utility of early detection of diabetic peripheral neuropathy using Vibration perception threshold (VPT) via digital Biothesiometer and correlation with patient reported symptoms. Type of study: Audit of peripheral neuropathy assessment in all diabetes patients Standard: NICE guideline on Diabetic foot problems (NG 19- Updated October 2019)Methods: The NICE guidelines recommend neuropathy assessment on all patients with Type 2 Diabetes....

One of the major risk factors for type 2 diabetes is Obesity (accounts for 80-85% of overall risk of developing type 2 diabetes). The UK is currently amid an obesity epidemic and it is recommended that the UK population reduce their daily calorie intake. As people are surrounded by food, it was acknowledged that this can be challenging to achieve on a long-term basis. This pilot study aimed to identify common social cues that encourage people to in...