Searchable abstracts of presentations at key conferences in endocrinology

ea0063s30.2 | Personalised medicine in diabetes and obesity (Endorsed by the European Journal of Endocrinology) | ECE2019

New avenues for novel drugs to treat obesity

Wilding John

Obesity is a chronic disease with significant adverse implications for health. Guidelines recommend first line treatment with lifestyle interventions that include restriction of energy intake, increased physical activity and behavioural modification, but these only reduce body weight by 3–5% initial over 12 months, and weight regain is common. Bariatric surgery is effective, but most suitable for people with more severe obesity or with significant complications such as di...

ea0061ou1 | A year in review: what are the highlights? | OU2019

Is obesity pharmacotherapy finally coming of age?

Wilding John

Obesity is a chronic relapsing disease with significant adverse implications for current and future health. Whilst guidelines recommend first line treatment with lifestyle interventions that include restriction of energy intake, increased physical activity and behavioural modification, these only demonstrate an average decrease of 3–5% initial body weight over 12 months, and weight regain is common. Bariatric surgery is effective, but is generally only offered to people w...

ea0034cmw1.2 | Workshop 1 (Supported by <emphasis role="italic">Clinical Endocrinology</emphasis>) Management of complex obesity | SFEBES2014

Medical management of severe obesity

Wilding John

Obesity poses a major threat to health, increasing the risk of degenerative diseases and the burden of health costs. Those with severe and complex obesity (often with a BMI > 40 kg/m2) have the greatest burden of co-morbidity and reduced life expectancy are now 2% of the UK population. These patients comprise the majority of referrals to tier 3 obesity services in primary and secondary care. Bariatric surgery is recognised as an effective intervention for approp...

ea0028cmw4.3 | How do I approach... | SFEBES2012

Neuroendocrine assessment in morbid obesity

Wilding John

Severe or morbid obesity is becoming more common and now affects about 2% of the UK population. Neuroendocrine disturbances are a common feature of morbid obesity and include male and female hypogonadism, deficiencies of the GH-IGF-1 axis and features suggestive of Cushing’s syndrome in some patients. Patients with neuroendocrine disturbance can broadly be considered in three main categories: 1. Those with genetic syndromes (eg Prader-Willi syndrome, leptin deficiency, MC...

ea0015s51 | Managing the obese | SFEBES2008

Obesity management: the role of drugs in the 21st Century

Wilding John

The use of drugs for weight loss dates back to the first half of the 20th century. These older agents were mostly amfetamine-derived, centrally acting sympathomimetics, and although effective, their side-effect profile would not be acceptable today. A new generation of drugs, acting on brain serotoninergic pathways was developed in the 1960’s, including fenfluramine and later dexfenfluramine. In the 1990’s, a combination of fenfluramine with an older agent – phe...

ea0061cd2.2 | Case Discussions: complex clinical cases 2.0 | OU2019

Simultaneous islet cell and kidney transplant in a patient with Type 1 Diabetes and End-Stage Renal Failure after Roux-en-Y gastric bypass

Lim Jonathan ZM , Rutter Martin K , Wilding John PH

Background: Severe obesity, BMI ≥40 kg/m2, confers a greater risk for graft loss and mortality among renal transplant patients. Transplantation provides a better survival and quality of life in overweight dialysis patients. Higher BMI is associated with progressively increased risk of CKD stages 4–5, hazard ratio of 3.10 (CI 2.95–3.25) for BMI ≥35 kg/m2. A recent meta-analysis found pre-transplant BMI <30 kg/m2 is asso...

ea0019p161 | Diabetes, Metabolism and Cardiovascular | SFEBES2009

MMIF but not MCP-1 is correlated with adipose-derived TNF alpha in human obesity

Kos Katarina , Wong Steve , Kerrigan David , Pinkney Jonathan , Wilding John

Background: Adipose-tissue (AT)-derived cytokines contribute to systemic inflammation and insulin resistance. The systemic inflammation observed in obesity is thought to be mainly derived from the stroma–vascular fraction of adipose tissue due to macrophage-infiltration of AT in obesity. Macrophages are thought to be recruited and trapped in AT by release of chemoattractant-molecules such as monocyte-chemoattractant-protein-1 (MCP-1) and macrophage-migration-inhibitory-fa...

ea0015p105 | Cytokines and growth factors | SFEBES2008

Unlike subcutaneous expression of IL-6 and IL-18, omental expression of IL-6, IL-18 and MCP-1 are not related to systemic cytokine levels in human obesity

Kos Katarina , Wong Steve , Kerrigan David , Wilding John , Pinkney Jonathan

Background and aims: Adipose tissue (AT) secretes cytokines which contribute to systemic inflammation in obesity. Cytokines like monocyte-chemoattractant-protein-1 (MCP-1) have also been associated with macrophage infiltration of AT in obese mice. However, it is unknown whether visceral-AT (VAT) or subcutaneous-AT (SCAT) expression is related to serum levels of these cytokines in humans.Methods: Morbidly-obese non-diabetic subjects undergoing bariatric s...

ea0077cc6 | (1) | SFEBES2021

Monozygotic twins with hypothyroidism responding to T3/T4 combination: a role for Nuclear Factor-kappa B (NF-κB)?

Al Jumaah Ali , Reddy Narendra , Levy Miles , Barwell Julian , Twiss Philip , Wilding John , Bhake Ragini

Introduction: There are patients who remain symptomatic with hypothyroidism despite apparent adequate replacement on levothyroxine (LT4) therapy. We present an observation where monozygotic twins responded only to combination therapy with liothyroinine (LT3), and were found to have a genetic variation which may have clinical significance in thyroid metabolism.Case report: A 47-year-old female with polyglandular auto-immune syndrome (APS1) presented with ...

ea0077p75 | Metabolism, Obesity and Diabetes | SFEBES2021

“The eyes have it”: a case of treatment-induced neuropathy of diabetes

Nicholson Martha , Morrison Emily , Page Oliver , Hammond Christopher , Lim Jonathan , Wilding John , Cuthbertson Daniel , Ooi Cheong , Malik Rayaz , Alam Uazman

A male in his 40’s diagnosed with type 2 diabetes in 2011 (BMI:20.7kg/m2) was admitted with DKA (Dec 2018) after a period of poor glycaemic control on oral hypoglycaemic agents (Feb 2017: HbA1c-105mmol/mol, Nov 2018: HbA1c-115mmol/mol). There was dramatic improvement in glycaemic control after commencing him on subcutaneous insulin (April 2019: HbA1c-56mmol/mol). GAD65 antibodies were positive (24u/mL; normal<5u/mL) and a diagnosis of latent autoimmune diab...