Searchable abstracts of presentations at key conferences in endocrinology

ea0094oc7.2 | Thyroid | SFEBES2023

Examining latest costs and prescribing on Liothyronine (T3) by dose levels with respect to the 2017 Competition and Market Authority (CMA) investigation into liothyronine prices and the implementation of 2023 British Thyroid Association (BTA) guidance for appropriate patients suggesting Liothyronine daily dose levels of 5-10mg at possible split dose twice day

Stedman Michael , Taylor Peter , Premawardhana Lakdasa , Okosieme Onyebuchi , Dayan Colin , Heald Adrian

Background: CMA showed price paid for liothyronine tablets rose from £15.15 in 2009 to £258.19 in 2017; a £100 million fine against suppliers was made public December 2021. BTA published guidance on use of liothyronine for appropriate patients in May 2023 suggesting daily dose 5-10mg at possible split twice day. This report investigated link between amounts and costs of T3 prescribing for different dose levels over the last 6 years.<p class=...

ea0094p230 | Metabolism, Obesity and Diabetes | SFEBES2023

Case report - success story of GLP-1 agonist (liraglutide) treatment in someone with type 1 diabetes: A life transformed

Heald Adrian , Whyte Martin , Warner-Levy John , Belston Lleyton , Horne LInda , Gibson Martin

Introduction: Glucagon-like peptide-1(GLP-1) agonists are widely used for treatment of type 2 diabetes(T2D). To date a number of reports have described improvements in glucose control with the addition of a GLP-1 agonist to the insulin regime in treatment of type 1 diabetes(T1D). From a physiological perspective there is credence to the notion that a GLP-1 agonist will lower glucose levels in people with T1D as they do in T2D. GLP-1 is an endogenous hormone th...

ea0099p134 | Pituitary and Neuroendocrinology | ECE2024

Macroprolactin over time: Is there any point in rechecking it in people with a persistently elevated serum prolactin?

Heald Adrian , Hashimi Syeda , Warner-Levy John , Ramachadran Sudarshan , Laing Ian , Livingston Mark

Design: Macroprolactinemia may influence the interpretation of serum prolactin levels – a recognised phenomenon since 19781. The degree of macroprolactinaemia over time is less well described. We determined how macroprolactin status (based on polyethylene glycol (PEG) precipitation varied by analysing serial measurements in hyperprolactinaemic individuals over nine years.Patients and Measurements: Results from 1810 individuals were includ...

ea0099ep275 | Diabetes, Obesity, Metabolism and Nutrition | ECE2024

Endocrine disorders in adult patients with inherited metabolic diseases: their diagnosis and long-term management

Heald Adrian , Bassett John , Warner-Levy John , Puente-Ruiz Nuria , Clayton Peter , Stepien Karolina

Background: Inherited metabolic disorders (IMDs) are a group of heterogenous genetic disorders resulting in substrate accumulation, energy deficiency or complex molecular defects due to the failure of specific molecules to act as enzymes, cofactors, transporters, or receptors in specific metabolic pathways. The pathophysiological changes seen in IMDs sometimes impact on the endocrine system. We here describe our experience at one UK centre where patients are seen jointly by an...

ea0077p64 | Metabolism, Obesity and Diabetes | SFEBES2021

The Variability In Glycosylated Haemoglobin (HbA1c) Testing Interval In People With Diabetes Is Linked To Long-Term Diabetes Control, Independent of HbA1c Test Interval

Heald Adrian , Holland David , Stedman Michael , Duff Chirstopher J , Green Lewis , Scargill Jonathan , Hanna Fahmy WF , Wu Pensee , Fryer Anthony A

Introduction: Worldwide guidance advocates regular HbA1c testing for people with diabetes mellitus, usually 2-4/yr. We previously showed that HbA1c testing frequency is linked to outcome in terms of HbA1c control. Here we examine the effect of variability (standard deviation = SD) in test interval on change in HbA1c over 7 yrs (Jun 2012-Jul 2019) using laboratory data.Methods: We focused on people with HbA1c within the first 2 years who also had a HbA1c ...

ea0050oc3.5 | Obesity, Diabetes Thyroid | SFEBES2017

Increased global long interspersed nucleotide element 1 DNA methylation in type 2 diabetes mellitus individuals relates to lower blood pressure and BMI

Malipatil Nagaraj , Siddals Kirk , Moreno Gabriela , Narayanan Ram , Donn Rachelle , Lunt Mark , Heald Adrian H , Gibson J Martin

Introduction: T2DM is one of the main causes of morbidity and mortality in the UK. Epigenetic mechanisms impact gene expression and could predispose individuals to a particular metabolic phenotype. We investigated association of LINE-1 methylation (a surrogate of global DNA methylation) with cardiometabolic parameters in a longitudinal cohort of T2DM patients.Methods: Global LINE-1 DNA methylation in blood-derived DNA samples from 795 (men 60%, women 40%...

ea0050oc3.5 | Obesity, Diabetes Thyroid | SFEBES2017

Increased global long interspersed nucleotide element 1 DNA methylation in type 2 diabetes mellitus individuals relates to lower blood pressure and BMI

Malipatil Nagaraj , Siddals Kirk , Moreno Gabriela , Narayanan Ram , Donn Rachelle , Lunt Mark , Heald Adrian H , Gibson J Martin

Introduction: T2DM is one of the main causes of morbidity and mortality in the UK. Epigenetic mechanisms impact gene expression and could predispose individuals to a particular metabolic phenotype. We investigated association of LINE-1 methylation (a surrogate of global DNA methylation) with cardiometabolic parameters in a longitudinal cohort of T2DM patients.Methods: Global LINE-1 DNA methylation in blood-derived DNA samples from 795 (men 60%, women 40%...

ea0065p28 | Adrenal and Cardiovascular | SFEBES2019

Recalibration of thinking about adrenocortical function assessment: How the random cortisol relates to the short Synacthen test ‘Verdict’

Michaelidou Maria , Yadegarfar Ghasem , Robinson Adam , Naseem Asma , Khan Inamullah , Kochhar Rupinder , Scargill Jonathan , Trainer Peter , Heald Adrian

Background: The short synacthen test (SST) is the most commonly performed investigation to assess for suspected adrenocortical dysfunction. We investigated how random cortisol levels may relate to pass/fail on the STT.Methods: We analysed the relation between random cortisol measurements taken between 04.40 and 20.52 in the day and results of SST baseline and 30/60 min cortisol performed over a 12 month period (338 SSTs) at Salford Royal Hospital. Serum ...

ea0065p176 | Metabolism and Obesity | SFEBES2019

Brain derived neurotrophic factor (BDNF) methylation in patients with impaired glucose regulation: implications progression to type 2 diabetes mellitus (T2DM)

Fachim Helene , Siddals Kirk , Malipatil Nagaraj , Cortes Gabriela , Donn Rachelle , Dalton Caroline , Reynolds Gavin , Gibson Martin , Heald Adrian

Introduction: There is growing evidence of external factors modulating epigenetic modifications and their contribution to the development of obesity and T2DM. One of the epigenetic signatures is DNA methylation. We investigated whether a lifestyle intervention could influence DNA methylation of Brain derived neurotrophic factor (BDNF) in individuals with IGR, as BDNF is thought to play an important role in glucose metabolism.Methods: IGR participants (<e...

ea0065p189 | Metabolism and Obesity | SFEBES2019

The FreeStyle libre flash glucose monitoring system: how it has improved glycaemic control for people with type 1 diabetes (T1DM) in Eastern Cheshire, UK

Dwived Shivangi , Heald Adrian , Naseem Asma , Kochhar Rupinder , Khan Inamullah , Leivesley Kate , Metters Ann , Horne Linda , Steele Tom

Introduction: Many people with type 1 diabetes continue to experience suboptimal glycaemic control. We now also know that often HbA1c levels are an inaccurate reflection of glycaemic patterns and variability. We describe here how the systematic use of the FreeStyle Libre flash monitor helped improve the glycaemic control of many people with type 1 diabetes.Methods: We report the outcomes of 92 consecutive adults (18 years of age or more) with type 1 diab...