Endocrine Abstracts

Severe hypercalcaemia poses a real threat of end organ damage mainly to the kidney and the skeleton. While an accurate diagnosis of the cause of the severe hypercalcaemia is important for effective management, initial treatment often has to be instituted before all tests are completed. The kidney is pivotal in this respect since it is the only way in which the body can excrete an unwanted calcium load. Hypercalcaemia impairs renal function by reducing GFR and also by causing n...

Although abnormal glucose metabolism defines type 2 diabetes mellitus (T2DM), efforts to understand the pathogenesis of T2DM are increasingly focused on disordered lipid metabolism. Magnetic resonance spectroscopy (MRS) is a non-invasive technique which provides real time data. Its uses in metabolic studies include: 1) static measurements of energy stores e.g. intramyocellular and hepatic glycogen and triglyceride levels and, 2) dynamic measures of mitochondrial function (ATP ...

Spontaneous hyperadrenocorticism in dogs and cats is most commonly (∼90%) caused by a functional pituitary tumour. As pituitary surgery is still an uncommon practice in veterinary science, these animals are generally managed medically using either mitotane or trilostane.The traditional method of managing PDH in dogs has been long term mitotane (o, pDDD) administration. The essence of this regime is to destroy most of the hyperplastic adrenal cortex...

Some 50 years on from the originally published description of gestational diabetes mellitus, debates continues as to the significance of minor degrees of glucose intolerance for maternal/fetal outcome. Confusion has been compounded by different diagnostic practices and the likelihood that there is a continuum of risk. A fundamental lack of robust evidence is reflected in the lack of consensus among published guidelines. The picture has been further complicated by the current s...

Normal pubertal development is characterised by a decline in insulin sensitivity resulting from the effects of elevated growth hormone levels on peripheral glucose uptake in muscle. The increased glucose availability for other tissues leads to protein sparing, contributing to the anabolism of puberty. Insulin also has an important role in the regulation of the tempo of puberty through its actions on SHBG and IGFBP-1 which, in part, determine the bioavailability of sex steroids...

All forms of severe lipodystrophy are associated with features of the metabolic syndrome including insulin resistance, T2DM, NAFLD, dyslipidaemia and cardiovascular disease. The question I will address is if this means that what happens in patients with monogenic forms of lipodystrophy is at all relevant to common forms of insulin resistance and the metabolic syndrome....

Introduction: Type 2 diabetes mellitus (T2DM) is associated with urological and endocrine complications, including erectile dysfunction (ED) and hypogonadism.Aim: REVITALISE was conducted to assess men with/without T2DM at risk of ED and/or hypogonadism, and highlight gaps in current clinical management.Methods: Data were collected from 13 UK primary care practices on incidence of ED, hypogonadism (defined as serum total testostero...

Introduction: The super-super-obese category of patient (BMI >60) tend to respond poorly to conservative weight interventions. Bariatric surgery is therefore considered the best form of intervention. Only a few UK centres have expertise to manage patients with a BMI >100kg/m2 and careful counselling is essential as those standing to benefit the most from these procedures (through reduced risk of cardiovascular disease, diabetes and malignancy) also face the ...

Aims: The lowest licensed dose of tolvaptan for treatment of hyponatraemia is 15 mg. There is little data on lower doses. Our study aimed to evaluate the safety of an initial dose of 7.5 mg tolvaptan.Methods: We retrospectively reviewed data from a London teaching hospital over a 6-year period. All adults administered a first dose of 7.5 mg tolvaptan were included. Three different timeframes were reviewed: 4-12, 12-18 and 18-30 hours. We analysed respons...

Background: HSD-1 converts cortisone to cortisol in tissues in which cortisol excess is associated with morbidity including liver, adipose, bone, and brain. SPI-62 is a potent HSD-1 inhibitor in clinical development for treatment of Cushing’s syndrome and autonomous cortisol secretion, and as adjunctive therapy to prednisolone in polymyalgia rheumatica. In Phase 1 clinical trials SPI-62 was generally well tolerated and associated with maximal liver and brain HSD-1 inhibit...