Endocrine Abstracts

Background and aims: Diabetic neuropathy is a common complication in patients with type 1 diabetes mellitus (T1D). In this study, we explore the importance of circulating chemokines for the development of diabetic neuropathy (DN) in T1D.Materials and methods: This study was a cross-sectional analysis of patients with childhood onset T1D followed prospectively in a long-term longitudinal cohort study. Fifty-two patients (20 women/32 men; mean age 28 &#177...

Background and aims: Diabetic neuropathy is a common complication of type 1 diabetes. In this study we investigated the importance of long-term metabolic control for the development of diabetic neuropathy in patients with type 1 diabetes diagnosed in childhood.Materials and methods: Longitudinal cohort study. Twenty-five patients (9 women 16 men) were studied three times with neurophysiological measurements and clinical examinations. At baseline the pati...

Introduction: During recent years many authors have advocated lower hydrocortisone doses in patients with primary adrenal insufficiency (PAI) mainly due to worries for non-physiological effects like increased cardiovascular risk and bone resorption, but very little attention has been drawn to fludrocortisone dosing. Our main hypothesis was that that the higher hydrocortisone dose, the lower the fludrocortisone dose and vice versa.Design: The Eur...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...

Background: Neuropsychiatric symptoms and cognitive dysfunction are common in Cushing´s disease (CD), and seem only partly reversible after biochemical remission has been achieved.Aim: To investigate prescription of drugs associated with neuropsychiatric morbidity in a large national cohort of CD patients.Methods: Patients in the Swedish Pituitary Registry, diagnosed with CD between July 2006 and January 2018 were included, <e...

Introduction: Cushing’s syndrome is rare, but assessment of patients with clinical suspicion of Cushing’s and/or adrenal incidentaloma is frequently required. Thus, there is a need for biochemical screening methods that with high sensitivity and specificity identifies or rule out hypercortisolism. Analysis of late night salivary cortisol allows an easy sampling procedure performed at home and is independent of variations in plasma CBG levels. Analysis by liquid chrom...

Background & Objective: Late night salivary cortisol (LNSC) and 1 mg overnight dexamethasone suppression test (DST) are two of the three recommended screening tests for Cushing’s syndrome (CS). The classical DST uses serum cortisol, but analysis of salivary cortisol and cortisone has shown high diagnostic accuracy at DST (1). Salivary cortisol can be analysed with immunoassays, which suffer from variable degree of cross reactivity with other steroids, or with LC-MS/MS...

Introduction: Patients with acromegaly have an increased mortality, mainly due to cardiovascular and respiratory diseases. Sleep apnea is related to hypertension, stroke and cardiovascular diseases and is reported to occur in 11–30% of acromegaly patients, according to retrospective studies based on diagnostic ICD-codes. However, in smaller prospective studies sleep apnea is found in about 70% of patients with active acromegaly and 40% after biochemical control. This diff...

Introduction: Oral once-daily dual-release hydrocortisone (DR-HC) therapy provides a more physiological cortisol profile than conventional thrice-daily (TID) replacement therapy and has demonstrated improved metabolic profile among patients with adrenal insufficiency (AI). The mechanisms by which this metabolic improvement occurs may be due to less total exposure, changed cortisol time exposure profile, but also modified metabolism of cortisol.Objective:...

Introduction: Primary adrenal insufficiency (PAI) leads to a drastically reduced production of steroids from the adrenal cortex, but a few patients may keep some residual adrenal steroid secretion that may simplify replacement therapy and prevent adrenal crisis. Irrespectively, the conventional glucocorticoid (GC) replacement therapy, using thrice-daily oral hydrocortisone, does not restore the patients’ physiological cortisol profile.Objective: The...