Endocrine Abstracts

Fetal growth restriction (FGR) defines a fetus which does not achieve its intrauterine growth potential. FGR is linked to placental dysfunction and hypoxia and is associated with a high risk of stillbirth, neonatal death and long-term complications; there are no treatments. Estrogen related receptor γ (ERRγ) is a nuclear receptor that is regulated by hypoxia in other systems; it is expressed in the placenta, thus we propose that it may be an important regulator of hy...

Introduction: The British Society of Paediatric Endocrinology (BSPED) DKA guidelines endorse the use of subcutaneous (SC) insulin in clinically well patients. In our institution, routine practice is to use SC insulin to manage DKA patients, without clinical evidence of shock. We present safety and efficacy data.Methods: A retrospective review of electronic records was performed to identify episodes of DKA (pH <7.30 or HC03<18 mmol/l and ketonaemi...

A 41-year-old woman presented with a puffy face since five months. She experienced alopecia, hirsutism, easy bruisability, amenorrhea and proximal muscle weakness. Clinical examination revealed a moonface, centripetal obesity, proximal muscle atrophy, thinned scalp hair, hyperpigmentation in sun-exposed neck region, ecchymosis and arterial hypertension grade 1. Blood analysis showed elevated morning cortisol, elevated morning ACTH of 66.1 pg/ml (normal 10–60), hypokalemic...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

A 41-year-old woman presented with a puffy face since five months. She experienced alopecia, hirsutism, easy bruisability, amenorrhea and proximal muscle weakness. Clinical examination revealed a moonface, centripetal obesity, proximal muscle atrophy, thinned scalp hair, hyperpigmentation in sun-exposed neck region, ecchymosis and arterial hypertension grade 1. Blood analysis showed elevated morning cortisol, elevated morning ACTH of 66.1 pg/ml (normal 10–60), hypokalemic...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Introduction: C-peptide is frequently used in clinical practice to estimate insulin secretion, and guide need for future insulin treatment. Present practice is based on studies with small patient numbers.Aim: To explore the association between non-stimulated c-peptide and progression to insulin therapy in patients with diabetes.Patients and Methods: 1971 patients with c-peptide measurements were identified (February 2007–Decem...

The incretin hormone glucagon-like peptide-1 (GLP-1) has been proposed to increase beta cell mass, via effects on proliferation, apoptosis and neogenesis. However, the role of GLP-1 during normal human development is unclear. We have addressed this in human fetuses by quantifying GLP-1 secretion during fetal development and determining how GLP-1 signalling impacts on early human fetal pancreas in explant culture.GLP-1 is first secreted by the stomach, du...

Background: A re-emergence of mild iodine deficiency in the United Kingdom (UK) has been reported. A recent UK study suggested a dose dependent relationship between mild maternal deficiency and a number of childhood cognitive scores. The World Health Organisation defines sufficiency in a population as a median urinary iodine concentration (UIC) of ≥100 μg/l in non-pregnant women and infants and ≥150 μg/l during pregnancy. It also recommends a daily intake...

Introduction: Pregnancy in women with pre-existing Type 1 diabetes (T1DM) is known to carry a 3–5 times increased frequency of severe hypoglycaemia (SH) in the first compared to the third trimester. The main predictors are: pre-gestational SH, HbA1C <6.5%/48 mmol/mol, duration of diabetes and higher total daily insulin doses. Freestyle Libre or flash monitoring utilizes a 14 day tiny glucose sensor which is applied to the back of the arm and scanned with a reader, to ...