Endocrine Abstracts

Background: We previously demonstrated that elderly patients with GHD have increased and young GHD patients have reduced cardiac sympathovagal balance. Therefore we decided to investigate whether the relationship between age and cardiac sympathovagal balance is altered in GHD compared to healthy controls.Method: HRV, which indirectly measures cardiac sympathovagal balance, was measured in 22 untreated GHD patients (13 F; mean age 47.4 yrs; range 19-73 y...

Little is known on the impact of acute COVID-19 infection on causation of diabetes. We report on a 36 years old man from Nigeria who presented with diabetic ketoacidosis (DKA) with typical osmotic symptoms of polyuria and polydipsia, fatigue and weight loss over 2 weeks. He tested positive for SARS-COV2 by PCR. The initial laboratory results: Random glucose 30.6 mmol/l, capillary blood ketones 7.4 mmol/l, pH 7.22, bicarbonate 7.5 mmol/l. Despite insulinopaenic state, at presen...

Background: Combination treatment with Levothyroxine (LT4) and Liothyronine (LT3) in primary hypothyroidism has been debated recently due to restrictions placed by local health boards. National guidance suggests that a short-term trial of combination LT4/LT3 treatment may be considered for individuals who report persistent symptoms despite adequate LT4 replacement.Method: We created a prescribing protocol for combined LT...

Background: A 73-year-old female presented to the hospital with a 3-day history of right upper quadrant abdominal pain and episodes of vomiting. Her past medical history included insulin treated Type 2 diabetes diabetes, deep venous thrombosis for which she was on rivaroxaban, COPD, right leg angioplasty and previous p-ANCA vasculitis. She also had flank tenderness and was noted to be hypertensive with a blood pressure of 225/93mmHg. A CT scan of the abdomen identified a new 4...

Background: The prevalence rate of Diabetes within Manchester is higher than the national average of England. Association of British Clinical Diabetologists (ABCD) guidance highlights an increased risk of typical and atypical presentations of diabetic emergencies in patients with Diabetes and COVID-19. In the absence of early recognition and treatment, this could lead to adverse outcomes and poor prognosis, thus leading to increased mortality rates.Aims:...

Post-prandial hypoglycaemia (PPH) can be associated with debilitating symptoms. Causes include altered physiology post-bariatric and upper gastrointestinal (GI) surgery and rarely noninsulinoma pancreatogenous hypoglycemia syndrome and insulin antibodies. We present a case of 49y female with no prior GI surgery presenting with debilitating hypoglycaemia with blood glucose falling to 2.8 mmol/l responding to glucose. Freestyle Libre monitoring confirmed hypoglycaemia 2-3 h post...

Background: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) which is widely used for the management of type 2 diabetes as well as for the obesity treatment. Evidence suggest that the level of HbA1c reduction and weight loss with oral semaglutide were similar to those of the subcutaneous formulation1. However, oral formulation not only improves the patient’s compliance to treatment but also makes it a favourable option for those who are relu...

Background: Appendiceal neuroendocrine tumours (aNETs) are usually diagnosed incidentally at appendicectomy, are indolent and rarely recur.Methods: We retrospectively analysed patients diagnosed with aNETs and entered prospectively into our tertiary referring centre’s NET database between 1990 and 2016.Results: 102 patients (F:M ratio of 1.04:1) presented with aNET at a median age of 39.4 (range 16.3–81.1) years. Average ...

Background: Current ENET guidelines inform our management of GCCs but we still have poor understanding of how these tumours behave in clinical practice.Methods: We retrospectively analysed patients diagnosed with GCCs and entered prospectively into our tertiary referring centre’s NET database between 1990 and 2016.Results: 41 patients (F:M ratio of 1.28:1) presented with GCC at a median age of 61 (range 27–79) years. Aver...

Objective: To define the prevalence of Diabetic Peripheral Neuropathy (DPN), painful diabetic neuropathy (PDN) and the at risk diabetic foot in 2 out of the 3 National Diabetes Centres in Qatar.Methods: 712 people with Type-1 & Type-2 diabetes recruited from Alwakra Hospital and Hamad General Hospital underwent assessment for DPN & PDN using the Neurothesiometer and the DN4 questionnaire, respectively.Results: The average a...