Endocrine Abstracts

Introduction: Hypoglycaemia remains the major barrier to tight glycaemic control in diabetes. Oral hypoglycaemic agents such as sulphonylureas (SU) remain one of the main options for managing type 2 diabetes mellitus (T2DM), but the glucose independent action is associated with an increased risk of hypoglycaemia. We present a retrospective audit of patients attending the A&E Department with severe hypoglycaemia at a large acute trust serving a population of 450 000.<p ...

Nebido (testosterone undecanoate, 1000 mg) is a new, long acting, intramuscular (IM) preparation of testosterone (T) that can be administered every 10–14 weeks. We conducted a study to evaluate the factors that influence serum T levels after commencing Nebido and may therefore help clinicians estimate dosing frequency for this therapy.Following the recommended loading regimen, 51 hypogonadal men (35, 68.6% secondary hypogonadism) had two injections ...

It is important when initiating intramuscular Nebido (testosterone undecanoate) to monitor the serum testosterone level to ensure physiological replacement is achieved. Following a loading regimen of Nebido the manufacturer recommends measuring testosterone levels to determine the frequency of subsequent injections.We conducted a retrospective study of 36 hypogonadal men [12 (33%) primary hypogonadism, 24 (67%) secondary hypogonadism] to establish what f...

There are a number of symptomatic patients with hypothyroidism who fail to normalise thyroid function (TFTs) despite large doses of thyroxine (LT4) replacement. Non-compliance is a common cause of treatment failure even in patients who strongly deny this. To avoid unnecessary and prolonged investigations for other causes we advocate a simple protocol to manage this problem. Patients are observed taking 1000 mcg of LT4 at 09.00 hrs, and have hourly Free T4 and TSH levels measur...

A 75-year-old man was admitted acutely with a 1 week history of headaches, reduced visual acuity, diplopia and ptosis of his left eye. Examination confirmed a left III and VI nerve palsies with decreased visual acuity in the left eye. A CT and subsequent MRI revealed pituitary mass lesion measuring 2.4×2.1×1.5 cm with extension into the left cavernous sinus. The pituitary stalk appeared thickened and was deviated to the right. The optic apparatus was uninvolved.<...

Hypopituitarism is associated with increased cardiovascular mortality. It has been suggested that hypogonadism, hypothyroidism, growth hormone deficiency (GHD), or indeed unphysiological hormone replacement regimens, might contribute to this excess cardiovascular risk. The adverse effect of hypercortisolaemia on insulin resistance, carbohydrate metabolism and hypertension is well recognised. It is also known that glucocorticoids adversely affect the coagulation-fibrinolytic sy...

It is unclear why GHD is associated with a reduced quality of life. Previous studies of GHD have shown impaired cardiovascular function and an increased cardiovascular mortality. We investigated whether the reduced quality of life is correlated with cardiac function and levels of cardiorespiratory fitness.Eighteen adults (9 male) with severe, untreated, GHD were studied. Cardiac power and cardiorespiratory fitness were investigated using a new, non-invas...

Background: Primary hyperparathyroidism (PHPT) is caused by a solitary benign adenoma in 80–85% of cases, but may also be due to multi-gland or ectopic disease, hyperplasia, and rarely parathyroid carcinoma. Preoperative localisation studies are important to identify patients suitable for minimally invasive parathyroid surgery. The aim of this study was to evaluate the accuracy of ultrasound (US), parathyroid scintigraphy (MIBI) and computed tomography (CT) utilised in th...