Endocrine Abstracts

Background and aims: The ISO guideline 15197 lays out the system accuracy (SA) and user performance (UP) evaluation requirements for BGMS for self-testing in managing diabetes mellitus. They require the measurement of blood glucose to be tested across a spectrum of glucose ranges to demonstrate accuracy, including within the hypoglycemic range. Fulfilling the requirements for accuracy evaluations at the hypoglycaemic range can be challenging. The aim of the study was to show t...

APS I is a rare condition with autosomal recessive inheritance. We report a series of three sisters (Table 1), affected by APS I, who all had a mutation of the autoimmune regulator (AIRE) gene. An index case (A) died at 26 years old due to vascular complications.The management of primary hypoparathyroidism in case A, who also had type I diabetes was also complicated by nephrocalcinosis, renal calculi, chronic renal failure and vascular calcification. In ...

The incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) constitute the enteroinsular axis which promotes postprandial insulin secretion. The therapeutic potential of these hormones in diabetes is limited by their rapid inactivation by the enzyme dipeptidylpeptidase-IV (DPP-IV). Here we investigated the acute effects of metformin in the presence and absence of food on DPP-IV activity in type 2 diabetes....

An adrenal incidentaloma is defined as an adrenal mass >1 cm diameter, discovered serendipitously on radiological imaging done for another reason. They are important because a percentage will turn out to be malignant or secrete excess hormones. The aim of the current study was to ascertain if these lesions were being investigated and followed appropriately compared to American Association of Clinical Endocrinologists guidelines. All imaging reports for the calendar year 20...

Recent Endocrine Society guidelines advocate IGF-1, random GH and nadir GH after oral glucose tolerance test (OGTT) for assessment in acromegaly. In our regional centre the 24 h GH profile has also been used partly because of changing IGF-1 assay methodology but also because of concerns that IGF-1 may not adequately reflect partial therapeutic success. We evaluated 58 GH profiles in 35 patients from April 2008 to November 2012 when both GH and IGF-1 assays remained unchanged. ...

Primary aldosteronism is an important cause of secondary hypertension though its diagnosis can prove challenging. In normal individuals aldosterone release follows a diurnal pattern, with a morning peak and low levels in the evening. Aldosterone is present in saliva and due to its lipophilic nature it passes into saliva along a concentration gradient. Salivary steroid testing is well established for cortisol and testosterone, but not yet for aldosterone....

Observational studies suggest reduced vitamin D levels are associated with an increased incidence of type 2 diabetes mellitus. We examined the relationship with insulin resistance (assessed using a two-step euglycaemic hyperinsulinaemic clamp technique) in 92 overweight, non-diabetic individuals with no history of cardiovascular disease - mean age 56 years (range 40–77 years), 64% males, 36% females, BMI 30.9 kg/m2 (range 26.4–36.9 kg/m2), fasti...

Introduction: Recently low circulating levels of sex hormone binding globulin (SHBG) have been shown to be a strong predictor of the risk of developing type 2 diabetes. Genetic studies suggest that this may be a primary causal abnormality and the mechanism may relate to effects on insulin resistance.Methods: Insulin resistance was assessed using a two-step euglycaemic hyperinsulinaemic clamp (EHC) in 87 (59 male and 28 post-menopausal female) overweight ...

Hypopituitary patients are at increased vascular risk. This may be partly attributable to changes in insulin action. It has been suggested that the addition of dehydroepiandrosterone sulphate (DHEAS), which is low in patients with secondary hypoadrenalism, to routine replacement may have beneficial effects on glucose metabolism. Previously, patient populations and techniques used to assess insulin action varied and overall results have been conflicting.W...