Endocrine Abstracts

Management of type-2 diabetes (T2D) should be individualised given recent increase in treatment options. There is a spectrum of phenotype of T2D from thinner patients who may be more insulin deficient to those who are overweight/obese and insulin resistant. We hypothesized that, if we are personalising treatment, thinner patients would be more likely to be treated with insulin secretagogues. To compare the management between these phenotypes, we reviewed 1007 patients with T2D...

There is an increase in cardiovascular risk factors in polycystic ovarian syndrome (PCOS) compared with BMI matched controls. Almost all women with PCOS are insulin resistant and increased cardiovascular risk is commonly attributed to insulin resistance (IR). However, it is unclear if cardiovascular risk differs in women with PCOS compared to equally insulin resistant women. We performed a case–control study (n=56 pairs) of women with PCOS (NIH criteria) compared t...

Women with polycystic ovary syndrome (PCOS) have an increased prevalence of cardiovascular risk factors. Insulin resistance (IR) is believed to be an important factor in the pathogenesis of both PCOS and cardiovascular disease and thus provides a plausible link between these two conditions. An exaggerated post-prandial triglyceride (TG) response is thought to be one of the mechanisms through which IR is associated with atherosclerosis. The aim of this study was to compare fast...

A 44 year old woman presented with leg swelling. Past history included hypothyroidism and ulcerative colitis treated with eltroxin (100 mg/day) and azathioprine (100 mg/day) respectively. Clinical examination revealed pitting oedema to knees and a ’puffy face’. Free T4 was 5.8 pmol/l (12–22 pmol/l), TSH 84.61 mU/l (0.27–4.20), serum albumin 24 g/l (40–49 g/l). She reported good compliance with L-thyroxine and no recent gastrointestinal symptoms. L-thyr...

A 20-year-old woman, with type 1 diabetes, presented to Emergency Department complaining of abdominal pain and vomiting for 3 days. She reported intermittent non-compliance with insulin therapy. Physical examination revealed epigastric tenderness. Blood glucose was 34.6 mmol/l, blood ketones 7.8 mmol/l, creatinine 131 µmol/l and CRP 31.47 mg/l (< 10). Despite clinical and initial laboratory features suggesting diabetic ketoacidosis, pH was 7.52 (7.32–7.43), pCO<s...

Enhanced community care (ECC) for type 2 diabetes mellitus (T2DM) is a new initiative in Ireland. ECC involves episodic community-based consultant-led multidisciplinary care that supports general practitioner (GP)-delivered chronic disease management (CDM, available to patients with a medical or GP visit card). The Dublin North West (DNW) hub was the first fully operational hub. This study focuses on its inaugural year of activity. The study goals were to report on hub referra...

The neuropsychological mechanism underlying cognitive impairment in hypothyroidism is poorly understood. It is not known whether cognitive impairment resolves following L-Thyroxine (LT4) replacement. It is also unknown whether similar neuropsychological abnormalities occur in patients with sub-clinical hypothyroidism (SCH). To address these questions, we performed neuropsychological tests in 17 patients with hypothyroidism (age 45±3 years; mean±S.E.M.)...

Introduction: Fine needle aspiration cytology (FNAC) is a widely adopted pre-operative investigatory tool for thyroid nodules. The British Thyroid Association (BTA) recently updated guidelines recommending that an FNAC that initially yields benign cytology (Thy2) should be repeated if there is any clinical or ultrasound (US) suspicion (1). We postulate that there is a tendency for a more conservative approach in older age groups with smaller thyroid nodules on US studies.<...

Memory formation largely depends on normal function of the temporal lobes (particularly the hippocampal complex) and prefrontal cortex. Evidence from animal studies suggests abnormal hippocampal function in hypothyroidism1. We hypothesized that specific defects in hippocampal-dependent memory would be observed in hypothyroid patients. Patients with overt (n=17) and subclinical (n=17) hypothyroidism underwent neuropsychological testing at baseline, 3 an...

Chronic ulcers represent very common and serious complications of diabetes mellitus. Their persistence leads to repeated infections, often leading to amputation. The current state-of-the art treatment includes debridement which is aimed at preparing the wound bed and stimulating ulcer edges to trigger tissue regeneration. We aimed to test the hypothesis that features of the debrided tissue may be indicative of the natural evolution of the wound. As a first step for this charac...