Endocrine Abstracts

Insulin allergy has become uncommon (<1%) with the wider use of human and analogue insulin in recent decades. We report a case of multiple analogue insulin allergy. A 71 year old woman with an eleven year history of Type 2 diabetes was referred to our Diabetes service. She had a BMI of 37.5 kg/m2. She was in tolerate of metformin. HbA1c was 12.4% on gliclazide and sitagliptine. She was commenced on Novomix 30. Within four days of therapy, she developed generalis...

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=...

Hypoglycaemia is an almost unavoidable consequence of iatrogenic insulin therapy in type 1 diabetes. Recurrent hypoglycaemia (RH) results in suppression of normal counter-regulatory hormonal and physiological responses (CRR) to future episodes increasing the risk of severe hypoglycaemia. The mechanisms responsible for this phenomenon remain unclear but may reflect changes in critical hypothalamic glucose sensing neurons (GSN). We set out to indirectly test the hypothesis that ...

Introduction: Older age and diabetes are both risk factors for frailty. Functional decline and disability in older, frail adults with diabetes results in an increased susceptibility to falls and hospital admission. Hypoglycaemia is common and more likely to result in hospital admission in older adults with diabetes and frailty. An HbA1c of below 7% (53 mmol/mol) is likely to represent overtreatment of hyperglycaemia. JBDS has recommended a review of HbA1c...

Introduction: Inpatient admission presents an opportunity to deintensify treatment in people with diabetes and frailty. The Joint British Diabetes Society recommends checking HbA1c in people with diabetes and frailty during admission if it had not been checked in the preceding six months. The audit aimed to identify the proportion of people who had their HbA1c checked upon admission and, if appropriate, what proportion had their treatment deintensified.<p ...

Introduction: National guidance states that people with diabetes and frailty require personalised targets and less aggressive treatments due to the limited evidence for benefits and the high risk of hypoglycaemia. Studies have shown a low rate of deintensification in this cohort of patients that may increase the risk of inpatient hypoglycaemia, contributing to morbidity and mortality. The audit aims to assess the frequency of inpatient hypoglycaemia and its as...

Introduction: unior doctors (JDs) are important part of the multidisciplinary team when managing people admitted with diabetes and frailty. Several guidelines have recommended a target HbA1c of between 7.0-8.5% for this group of people with diabetes. We aimed to assess junior doctors’ knowledge and awareness of management guidelines for people with diabetes and moderate/severe frailty.Methods: Survey was conducted a...