Endocrine Abstracts

Background: Diabetes is a metabolic disorder characterized by chronic hyperglycaemia as a result of defective insulin secretion, insulin action or a combination. Poor glycaemic control increases the risk of microvascular and macrovascular complications. For group two driving license holders with diabetes there are specific requirements set out by the Driver and Vehicle Licensing Agency. It is therefore hypothesised that this patient group is likely to aim for less tight glycae...

Introduction: The Short Synachten Test (SST) is the gold standard test for assessing adrenal insufficiency, however these can be time and resource consuming. Improved cortisol assays (Scottish consensus) currently advise a cut-off of 430 nmol/l at 30 minutes . However, there is no clarity about the optimum baseline cortisol level and recommendations range varies from 300–500 nmol/l.The aim of this study was to establish a single baseline cortisol c...

Background: Nivolumab is a programmed death receptor-1 blocking antibody and the first to gain regulatory approval for use in non-small cell lung cancer (NSCLC). Whilst well tolerated in clinical trials, 3% of patients in a phase Ib study displayed thyroid dysfunction. Diagnosis and referral to appropriate specialties is a challenge in complex cancer cases where symptoms are often multi-factorial. Improved knowledge of the potential complications of new and novel...

Background: Nivolumab is a programmed death receptor-1 blocking antibody and the first to gain regulatory approval for use in non-small cell lung cancer (NSCLC). Whilst well tolerated in clinical trials, 3% of patients in a phase Ib study displayed thyroid dysfunction. Diagnosis and referral to appropriate specialties is a challenge in complex cancer cases where symptoms are often multi-factorial. Improved knowledge of the potential complications of new and novel...

Somatostatin analogues (SA) represent the most effective medical treatment for the control of neuroendocrine tumour (NET) symptoms, like carcinoid syndrome. Recently there has been evidence of lengthened time to tumour progression in patients with midgut carcinoid treated with octreotide. Nevertheless, a number of new therapeutic indications and the clinical effectiveness of SA for other clinical conditions are appearing. A 69-year-old man was investigated for anaemia (haemogl...

We report a rare case of 37 years female of Greek and Irish extraction with a history of thalassemia trait, who presented with generalised weakness and severe loin and pelvic pain 9 days post vaginal hysterectomy and 3 days after hospital discharge. After readmission, she developed mild pyrexia (37.5°C), hypotension, mild hyponatraemia with plasma sodium which fell from 138 to 131 mM and early signs of acute respiratory distress syndrome. A Short Synacthen test was perfor...

Aim: Diagnosis of type 1 diabetes in older adults can be challenging, and management can be complicated by co-morbid conditions. In this study we aimed to compare glycaemic control, microvascular complications and diabetic emergencies (severe hypoglycaemia and diabetic ketoacidosis) in the early years following diagnosis between younger adults (<50) and older adults (≥50).Method: A retrospective cohort study was performed on people with newly d...

Background: SIADH is the most frequent underlying cause of hyponatraemia but is frequently ignored and suboptimally treated.Aim: To identify the treatment applied in clinical practice for hyponatraemia due to SIADH and to evaluate the effect of fluid deprivation.Method: A prospective, non-intervention observational study of a sequentially evaluated cohort of hyponatraemic patients during first 48 h after hospitalization from Januar...

Introduction: The natural history of adipsic diabetes insipidus (ADI) is not completely understood. Isolated case reports suggest occasional recovery of adipsia. We present the follow up of a cohort of 12 patients with ADI.Setting: National pituitary unit with interest in diabetes insipidus.Methods: ADI was identified by demonstrating absent thirst and AVP responses to hypertonic saline infusion. Results 12 patients with ADI were i...

Introduction: Excess mortality due to hyponatraemia is well documented but it is not clear whether the mortality associated with SIADH is different to that associated with non-SIADH hyponatraemia (NSH).Methods/design: Prospective evaluation of all patients admitted with or developing hyponatraemia in a tertiary hospital (pNa <130 mmol/l) in January 2015. Diagnosis of SIADH was based on standard clinical and biochemical criteria (pNa, spot urine sodiu...