Endocrine Abstracts

Very low calorie diets (VLCD) have been a time-honored means of losing weight for many decades. The DiRECT trial has put VLCD back in the limelight and now NHS England and Scotland have committed resources to piloting VLCD as an intervention for Type 2 diabetes. Is this premature, or is it the solution for the tsunami of Type 2 diabetes that we face? Prof Tricia Tan and Dr Abd Tahrani will debate the utility of VLCD in the treatment paradigm of Type 2 diabetes....

Objective: To test the hypothesis that poor adolescent diabetic control results in poor adult control.Methods: We conducted a retrospective case notes study involving 57 patients (M:F 30:27) in a teaching hospital. Patients who had diabetes atleast for a minimum period of 10 years were selected and their HbA1c when they were between 17 and 19 years of age were compared with the most recent HbA1c.The adolescent control was divided i...

Insulinoma is a tumour of the endocrine pancreas, usually benign, with an annual incidence of 1–2 new cases per million population. We describe a case of Insulinoma complicated by the simultaneous development of diabetes.A 72year old lady had episodes of funny turns and confusion following her meal. She had lost a stone in weight over 6–8 months. There was no history of sulphonylurea ingestion. Examination revealed low BMI and no evidence of ra...

Introduction: Phaeochromocytomas commonly present with episodes of sweating, palpitations, and hypertension. Urinary catecholamines measurement is the most common screening test for suspected phaeochromocytoma in the UK. We report a series of three cases in which the reason for hypertension and raised catecholamines was not a phaeochromocytoma and treating the underlying condition corrected the clinical and biochemical abnormality.Cases: Three patients w...

A 24-year-old Pakistani woman presented one day after returning from a 6-week holiday in Pakistan with a 3-day history of generalised weakness, difficulty in walking and left flank pain. She was known to have mixed connective tissue disease (MCTD). Clinically she was pyrexial and had generalised muscular weakness (power 3/5), and hypotonia. Biochemically, she was found to have hypokalaemia (1.8 mmol/l), raised serum urea (8.1 mmol/l), and creatinine (160 μmol/l), high ESR...

Background: Obesity levels and the demand for obesity services are increasing. Those with morbid obesity require specialist care and consideration for bariatric surgery. Based on recent figures and NICE guidelines, at least 35 000 individuals in Birmingham alone may be suitable for surgery. Numbers currently assessed are limited due to lack of resource and expertise. This audit reviewed baseline characteristics of patients referred for specialist obesity and bariatric services...

Aim: This study was aimed to assess the need for multiple cortisol samples in ruling out adrenal insufficiency by standard dose Short Synacthen Tests (SST) and Low Dose Short Synacthen Tests (LDSST).Method: We assessed the lab results of 767 patients who attended Metabolic Unit of a University Hospital in the UK from 1999 to 2006 for assessment of adrenal reserve. In LDSST, serum cortisol was measured at 0, 30 and 40 min after administration of 1 mcg of ...

Objectives: The Tier 3 Weight Management (WM) service is a comprehensive pathway for people with a Body Mass Index (BMI) >40 or >35 with complications. This study aimed to describe the clinical characteristics and outcomes in patients referred to the WM service in Birmingham and Solihull (BSol).Methods: This was a retrospective health service evaluation of adults consecutively referred to the BSol WM service from March 2017 to April 2018. Data wa...

Background: Hyperinsulinemic hypoglycaemia (HH) after Roux-en-Y gastric bypass (RYGB) is rare. Patients typically present with post-prandial hypoglycaemia >1 year after surgery and once weight loss has plateaued. Despite multiple treatment options, the management of these patients remains challenging.Clinical case: A 31-year-old female was referred for bariatric surgery with a BMI of 41.4 kg/m2. In the year preceding the r...

Background: People with Primary adrenal insufficiency (PAI) were identified as a vulnerable group by the UK government during the COVID-19 pandemic. Hence our aim was to evaluate the incidence of COVID-19, and associated adrenal crisis (AC) in people with PAI in the UK.Methods: A prospective observational study of patients with PAI was performed between January-June 2022. Participants were recruited via the Addison’s Disease Self Help Group. Diagnos...