Endocrine Abstracts

Introduction: The short synacthen test (SST) is commonly used to assess the hypothalamic pituitary adrenal (HPA) axis in clinical practice. We evaluated the underlying clinical conditions pre-empting the request for a SST in a general medical ward and the adequacy of clinical follow up of patients with suboptimal responses to the test.Methods: All patients with suboptimal SST results (30 min cortisol level 450–540 nmol/l) performed in the Acute Asse...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The short synacthen test (SST) has been advocated as an alternative to the IST. Fatigue can be a common presenting symptom of patients suffering from abnormalities in the HPA axis.Methods: We audited the results of ISTs following failed SSTs for the assessment of patients who present with symptoms of fatigue. We ...

A 73 years old female presented in 2005 with 8 year history of face and body hirsutism. Examination confirmed hirsutism but there were no other masculinization features. Her initial investigations revealed a high testosterone of 13 nmol/l, normal androstenedione, DHEA-S and 17 hydroxy progesterone. CT and U/S of pelvis and abdomen, showed normal adrenals, ovaries and a large calcified uterine fibroid. Urinary steroid metabolites ruled out adrenal testosterone source and exogen...

Introduction: Prevalence of diabetes mellitus (DM) in the UAE is around 20% amongst adults. Lifestyle including meal timings are different from the West and may necessitate different treatment schedules. We have used continuous glucose monitoring (CGMS) to look at glycemic patterns in patients with type 1 and type 2 diabetes in the UAE.Methods: Available CGMS data (using methods previously described) on forty-four patients (thirty-one with type 2 DM and ...

Background and aims: Combination of drugs, affecting early insulin secretion and peripheral insulin resistance are a good therapeutic option for patients (pts) with type 2 diabetes mellitus (T2DM). The aim of the present work was to compare efficacy of Repaglinide+Metformin and Sulphonilurea+Metformine in obese T2DM pts.Materials and methods: A total of 107 pts with T2DM not well-controlled on monotherapy. Repaglinide - naïve were allocated into 2 g...

Acromegalic patients have increased morbidity and mortality, which correlate with post-treatment growth hormone (GH) level. Target post-treatment plasma GH level should be less than 2.5 nanograms per millilitre, which predicts normal life expectancy.We evaluated the prevalence of complications and treatment outcome in 76 acromegalic subjects who attended our unit for surgery between 1978-2002. 60 patients are followed up in a specialised pituitary clinic in Beaumont Hospit...

The cellular and molecular mechanisms underlying the actions of BMP-2 to induce gonadotroph-specific gene expression during pituitary development are poorly understood. We have characterised BMP receptor (BMP-R) expression in two gonadotroph models, the alphaT3-1 and LbetaT2 cells, which represent different stages of gonadotroph development. Signal transduction via BMP-R requires a heterodimeric complex between type I (A or B) and type II receptors. RT-PCR for BMP-R, using sub...

Background: Maternally inherited diabetes and deafness (MIDD) is a rare disease affecting approximately 1% of all diabetics. The most common mutation involved is a single base mutation (A-G) at position 3243 within the tRNALEU(UUR) gene. The clinical characteristics normally associated with this disease include sensorineural hearing loss, macular pattern dystrophy, cardiomyopathy, and diabetes. This study aims to identify clinical phenotype and insulin secretory res...

Aim To describe the early outcomes of carcinoid patients undergoing surgical heart valve replacement.Methods In a retrospective study, records of patients with symptomatic carcinoid heart disease referred for valve surgery between 2012 and 2021 were reviewed. The perioperative and early postoperative outcomes were analyzed.Results Thirteen patients, with a mean age of 64 years (range 55-79 years) underwent cardiac surgery for carci...

Objectives: The use of new diabetes technologies, such as insulin pumps, continuous glucose monitoring systems (CGMs) and hybrid closed-loop systems (HCL), is rapidly increasing among people with type 1 diabetes (T1DM). As these technologies are becoming an integral part of T1DM management, we expect an increase in the number of patients who present in the Accident and Emergency department (A&E) using them. The aim of this study was to assess and compare A...