Searchable abstracts of presentations at key conferences in endocrinology

ea0053ou2 | A year in review: what are the highlights? | OU2018

Novel therapies for obesity – an update

Tan Tricia

Obesity surgery is not a scalable solution for obesity and diabetes. Options for pharmacotherapy are sorely required because there will be patients who cannot and will not have surgery, or perhaps will require a ‘bridge’ to surgery. Although oral agents such as Orlistat and Bupropion/Naltrexone are marketed in Europe, these treatments suffer from considerable side effects that limit their appeal and efficacy. Gut hormone treatments, exemplified by high-dose Liragluti...

ea0061ou5 | Debate: Will metabolic surgery replace pharmacotherapy for the treatment of t2 diabetes? | OU2019

Very low calorie diets for the treatment of Type 2 diabetes and obesity are a waste of time -DEBATE

Tan Tricia , Tahrani Abd

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....

ea0061p009 | (1) | OU2019

The effect of high protein meal on Glycaemic Indices and Gut Hormones Profiles in patients with Post-Bariatric Hypoglycaemia

Ilesanmi Ibiyemi , Tan Tricia

Post–bariatric surgery hypoglycaemia (PBH) is a metabolic complication of bariatric surgery. Symptoms of post-bariatric hyperinsulinaemic hypoglycaemia may develop from 6 months to years after surgery, and typically present 1 to 3 hours after a meal. The incidence of post bariatric hypoglycaemia is estimated to be 0.2–11%,1,4 but the actual incidence is unknown due to the vague symptoms and lack of diagnostic criteria for the diagnosis of post-bariatric hy...

ea0048cb13 | Additional Cases | SFEEU2017

Primary aldosteronism – management can be challenging and complex

Naqvi Ali , Mills Edouard , Tan Tricia

Africo Caribbean gentleman was referred to our endocrine department for management of secondary hypertension. He initially presented to his doctor with headache and he was found to be hypertensive with systolic BP of 200 mmHg and hypokalaemia. A renal MRI showed a right adrenal mass, 2.9×2.4 cm, and echocardiogram showed moderate left ventricular hypertrophy and diastolic dysfunction. He had normal 24 h excretion of metanephrines and free cortisol. An aldosterone renin ra...

ea0044p16 | Adrenal and Steroids | SFEBES2016

Comparison of insulin tolerance test performance with other dynamic tests of cortisol reserve

Haria Payal , Tan Tricia , Hatfield Emma

Introduction: Misdiagnosis of secondary hypocortisolaemia can have profound consequences on a patient’s life. Due to contraindications the gold standard dynamic diagnostic test of cortisol reserve – the insulin tolerance test (ITT) – may not always be suitable. Here we examine the diagnostic accuracy of the second line dynamic tests: the overnight metyrapone test (OMT), short synacthen test (SST) and glucagon stimulation test (GST).Patient...

ea0044p143 | Neuroendocrinology and pituitary | SFEBES2016

Investigation of hyperprolactinaemia in patients with polycystic ovarian syndrome

Tokhy Omar El , Hatfield Emma , Tan Tricia

Background: Hyperprolactinaemia is common in patients presenting with polycystic ovary syndrome (PCOS). Recent studies suggest that each condition has an independent aetiology, hence appropriate investigation of hyperprolactinaemia in the context of PCOS is required, for which separate treatment may then be provided. Appropriate investigation includes a serum macroprolactin screen, a specific drug history for drug-induced hyperprolactinaemia (DIH), blood tests to exclude secon...

ea0025p143 | Diabetes, metabolism and cardiovascular | SFEBES2011

Insulin-mediated pseudoacromegaly

Sam Amir , Tan Tricia , Meeran Karim

Patients with acromegaly have characteristic clinical features of soft tissue overgrowth. Both somatic and metabolic features of acromegaly are secondary to excess GH secretion and high circulating levels of insulin-like growth factor 1 (IGF1). However, an acromegaloid phenotype associated with severe insulin resistance is occasionally seen in the absence of biochemical hallmarks of acromegaly (insulin-mediated pseudoacromegaly). Here we present a case of ‘insulin-mediate...

ea0077p3 | Adrenal and Cardiovascular | SFEBES2021

Improving outcomes from SSTS: Redefining Cortisol Cut-Offs

Choudhury Sirazum , Ramadoss Vijay , Lazarus Katharine , Tan Tricia , Meeran Karim

Background: Short Synacthen Tests (SSTs) are integral to the diagnosis of Adrenal Insufficiency (AI). A 30-minute stimulated cortisol value is assessed against local assay dependent thresholds to ascertain or exclude the diagnosis. A diagnosis of AI is a life changing event requiring the initiation of life long glucocorticoid replacement therapy for survival. Glucocorticoid replacement is associated with long term morbidity and mortality, including an increased risk of diabete...

ea0077p19 | Adrenal and Cardiovascular | SFEBES2021

Prednisolone versus Hydrocortisone in Adrenal Insufficiency: A positive and negative control cross-sectional study

Choudhury Sirazum , Lazarus Katharine , Thaventhiran Thilipan , Tan Tricia , Meeran Karim

Background: Management of adrenal insufficiency (AI) with glucocorticoid replacement is associated with increased mortality and morbidity. There is growing evidence that this is because of excess, non-physiological steroid exposure. Low dose prednisolone (2-4 mg) is a once-daily alternative to standard hydrocortisone regimens that more closely mimics the circadian rhythm and may translate to better outcomes. There is however a paucity of studies comparing the two treatments.</...

ea0081p530 | Adrenal and Cardiovascular Endocrinology | ECE2022

Objective markers and new indicators in adrenal insufficiency- findings from the omni-aid study comparing hydrocortisone and prednisolone replacement therapy

Choudhury Sirazum , Thaventhiran Thilipan , Lazarus Katharine , Tan Tricia , Meeran Karim

Background: Adrenal insufficiency (AI) is a life-threatening condition if left unmanaged. Despite treatment patients can expect a life expectancy that is shortened by 12 years secondary to probable inherent over-replacement associated with oral glucocorticoid regimens. Thrice-daily hydrocortisone is the most common regimen used. Very low-dose prednisolone (2-4 mg) is an alternative with lower uptake due to the absence of evidence for its use. This study fills this literature g...