Endocrine Abstracts

Objective: To investigate the management of thyroid replacement during pregnancy in women who were prescribed thyroxine prior to pregnancy.Design: Record-linkage technology was used retrospectively to identify pregnant women who were prescribed thyroxine in the general population of Tayside, Scotland.Patients: All pregnant women who were 18 years and above and who delivered between 1st January 1993 and 31st March 2011 in Tayside we...

Introduction: Glucose homeostasis is central to the understanding of diabetes and is influenced by hormones and by substrate flux. This implies a non-linear system which has been confirmed by time series analysis. A dynamic systems approach is required for describing the inter-relationship of glucose and insulin and we describe a method that measures a mathematical domain of glucose homeostasis termed the observed variability and lability (OVAL).Methods:...

The incidence of type 1 diabetes in children under 5 years is increasing. The insulin requirements, eating regimens and reaction to invasive procedures make this group a challenging cohort to manage on multiple daily injections. NICE Guidance was amended in 2008 to include the option of using CSII at diagnosis in the under 5’s.Seven CSII starts at diagnosis have been done (from 2009 to current). CSII is initiated within 72 h from initial diagnosis, ...

A decrease in insulin sensitivity (IS) is associated with increasing visceral adiposity. An inverse correlation has been demonstrated between Intramyo-(IMTG) and intrahepatocellular triglyceride (HCTG) concentrations and IS. Patients with AA have reduced IS but IMTG and HCTG content has not been studied.Eight patients with AA (IGF-I >ULN, median 1.83×ULN (range1.16–4.38) ((6 M), median age 39.5 (range 23–66) years, median BMI 30.6(23.5...

The prevalence of primary hyperparathyroidism (PHPT) is increasing and the majority (over 85%) are now asymptomatic and remain untreated. In order to know whether or not they can be left safely without surgery, issues on disease progression need to be addressed. We aimed to update the natural history of PHPT, with a focus of serum calcium progression in mild untreated patients, selected from a large pre-defined cohort of PHPT in Tayside, Scotland. Possible predictors of progre...

Glucocorticoids (GCs) are used extensively in the treatment of inflammatory disease. Unfortunately, as GC act on virtually every organ system they also carry a broad range of serious side-effects which limits their clinical use.The structure of the bound GC strongly impacts the final conformation of the glucocorticoid receptor (GR) and thereby dictates downstream events. Designing drugs with different GR binding properties therefore offers a plausible ro...

Objective: To investigate the long term outcomes for patients with endogenous subclinical hyperthyroidism (SH).Design: Population record-linkage technology was used retrospectively to identify patients with SH and hospital admissions from January 1, 1993 to December 31, 2009.Patients: All residents over 18 years old with at least two serum TSH measurements below the reference range for at least 4 months apart and normal free T...

A 65-year-old female, with a 4 month history of left upper quadrant discomfort, was identified as having a multi-loculated para-renal ‘cyst’ on ultrasound scanning. CT identified a 13×11×10 cm heterogeneous mass arising from the left adrenal. An enlarged ill-defined left retro-crural ‘lymph node’ was also noted. There was no history of weight loss. Past medical history was unremarkable. She was no medication. Examination was unremarkable apart fro...

Continuous aerobic exercise improves glucose tolerance in type 2 diabetics (T2D), with greater improvements during exercise in hypoxia. Continuous exercise has been linked with poor adherence. Positive effects with intermittent exercise (IE) with reduced time commitments would have clear benefits. Exercise and hypoxia both increase pro-inflammatory cytokines, potentially reducing benefits of hypoxia. This study aimed to establish the effects of IE under hypoxic conditions in T...

Background: Obesity is associated with increased insulin resistance, type 2 diabetes and increased cardiovascular risk leading to atherosclerosis. Bariatric surgery has been shown to improve some of these factors in obese patients with glucose intolerance. A form of bariatric surgery is the Roux-en-Y procedure which can result in greater weight loss and restriction with less malabsorption than other procedures (such as the bilious-pancreatic diversion); but the effect of some ...