Endocrine Abstracts

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...

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...

Introduction: We undertook an audit evaluating the glycaemic management of patients on steroids. This audit is based on the Joint British Diabetes Societies guideline on Management of Hyperglycaemia and Steroid (Glucocorticoid) Therapy, 2014.Method: The audit was conducted prospectively over a period of 5 days. All patients on steroids greater than 5 mg of Prednisolone, or an equivalent dose of alternative synthetic gluc...

Introduction: We undertook an audit evaluating the glycaemic management of patients on steroids. This audit is based on the Joint British Diabetes Societies guideline on Management of Hyperglycaemia and Steroid (Glucocorticoid) Therapy, 2014.Method: The audit was conducted prospectively over a period of 5 days. All patients on steroids greater than 5 mg of Prednisolone, or an equivalent dose of alternative synthetic gluc...

Introduction: We undertook a service development audit within our trust to review the Medical team’s knowledge on DKA and the management involved in treating these patients. The aim was to identify where there was a lack of knowledge in this area so we could provide teaching sessions on DKA and aim at the specific areas highlighted from the audit. We went on to deliver education sessions on DKA management and pinpointed the areas lacking from the pre audit. The education ...

A 52 year old lady was admitted with collapse in May 2001 with h/o being nauseous, generally unwell, off her feet and food for several weeks. GP consultation five weeks before, for similar complaints, resulted in thyroid function tests confirming hypothyroidism. Thyroxine 25 mcg was commenced by the GP and uptitrated to 50 mcg. She however deteriorated despite this treatment becoming increasingly lethargic and sleepy. On admission she appeared tanned, BP was 93/50 she was dysa...

A 44-year-old gentleman known to have adult polycystic kidney disease with chronic renal failure was found to be profoundly hypothyroid in predialysis assessments in the renal clinic. He was symptomatic feeling tired and generally unwell with multiple problems, which were initially all attributed to his renal failure. Investigations of his thyroid by ultrasound revealed two nodules in the left lobe and one nodule in the right lobe of the thyroid. FNAC failed to differentiate b...

Road traffic accidents resulting in traumatic brain injuries are increasingly common. Patients are often males in their third decade. Many of these patients persist to have various symptoms even after recovery from the acute phase, which tend to be diagnosed as post concussion syndromes. Interest has increased of late in Post traumatic hypopituitarism. We report two patients with head injuries with endocrine insufficiencies.A 21 year male was hit by a ca...

Background: The Covid-19 pandemic has led to various unprecedented challenges and obstacles, especially in the field of Diabetes and Metabolism, many of which are as novel as the pandemic itself. Discovering efficacious therapeutic options resulting in positive outcomes has been a challenge. Dexamethasone has been shown to reduce mortality in patients with Covid-19 pneumonitis who require oxygen therapy and/or ventilation. Exogenous steroid therapy is renowned to cause adverse...