Endocrine Abstracts

Behcet’s disease (BD) is a chronic disease characterised by systemic involvement of blood vessels of all sizes on both arterial and venous circulation resulting in recurrent ulcers. The posterior infundibulo-hypophysitis, causing DI, has been commonly reported in association with systemic inflammatory/autoimmune disorders, however there are a handful of cases presenting with DI and Behcet’s disease.A 26-year-old African-American woman diagnosed...

Prompt, effective and safe management of Diabetic Ketoacidosis (DKA) is key to reducing mortality rate and length of stay. An Integrated care pathway (ICP) Pro-forma for DKA management during the first 24 hrs, based on a modified JBDS guideline was introduced in the trust. DKA management based on the pro-forma between Nov 17 to Feb 18 was audited; focussing on fluid management in terms of timing and electrolyte replacement, CBG monitoring, faster senior reviews, HDU admissions...

Introduction: Inpatient hypoglycaemia management remains a significant challenge. An audit in 2009 revealed poor understanding (“recognition” by frontline staff) of the need to treat and manage hypoglycaemia. Consequently a management protocol, documentation sheet and hypoboxes with standardized quantities (15 g) of dextrose in various forms were introduced throughout the hospital.Aims: We re-audited inpatient hypoglycaemia management and the i...

Introduction: Inappropriate meal to insulin timing, poor appetite, tight glycaemic control, cardiac, renal or hepatic impairment and sepsis are seen in association with hypoglycaemia. Poor understanding of these risks and management of hypoglycaemia(hypo) remain challenging. Hypo management guidelines and hypoboxes with standardized 15 g of dextrose in various forms were introduced throughout the hospital in November 2010 after an audit in 2009 revealed poor understanding of t...

Hypoglycaemia is defined as capillary blood glucose (CBG) of ≤4 mmol/l irrespective of symptoms. We audited the recognition and management of inpatient hypoglycaemia with a view to identify potential areas for improvement.Methods: A total of 120 inpatients with diabetes were identified in the hospital on a single day, of whom n=32 had ≥1 episode(s) of hypoglycaemia, as evidenced by their CBG. Data relating to recognition and management...

Introduction: Thyroid Storm is a rarely occurring severe form of hyperthyroidism, almost always brought about by precipitating event. It occurs more frequently with Grave’s disease. The mortality varies from 20 to 50%. The diagnosis of thyroid storm is mainly clinical along with abnormal thyroid hormone levels. We report a case of thyroid storm with chorea as one of its manifestation.Case report: A fifty year old lady was referred to us for recent o...

Background: Glucocorticoid replacement is life saving in adrenal insufficiency. There are established guidelines for management of adrenal insufficiency. This audit was under taken to evaluate whether we are implementing these guidelines in our day to day management of patients with adrenal insufficiency.Method: A retrospective study was performed on 18 patients. Data was collected from clinical records on the proforma and were evaluated against the reco...

The objective of the study was to assess the effect of intra-muscular testosterone on constitutional symptoms, sexual symptoms, memory and in men with hypogonadism and poorly-controlled type-2 diabetes. This is a randomised double-blinded placebo-controlled add-on trial of intramuscular testosterone undecanoate(Nebido®) administered every 12 weeks in 65 hypogonadal men with poorly-controlled diabetes. Phase-1 patients were randomly assigned to either treatment ...

Introduction: Regional Migratory Osteoporosis (RMO) is a rare condition, characterised by a self-limiting migratory arthralgia, which generally tends to involve the lower limbs. The arthralgia is usually, not associated with any history of trauma. Radiologically, Magnetic Resonance Imaging (MRI) is the investigation of choice. Bone Marrow Oedema (BMO) with subchondral sparing are the usual findings in patients with RMO. This condition is usually under diagnosed due to the comp...

A 48 years old male presented with an acute episode of dizziness, weakness, diaphoresis, palpitations, and shakiness. Hypoglycaemia was confirmed with a CBG of 1.6 mmol/L. His symptoms resolved on treatment with Hypostop gel and 10% dextrose. He had an otherwise unremarkable physical examination. In view of his history of consumption of a bottle of vodka daily a diagnosis of alcohol induced hypoglycaemia was made on discharge. A year later he was found being agitated and aggre...