Endocrine Abstracts

Capillary blood glucose testing by patients with diabetes can be useful in the management of diabetes. Whilst the meters now available are small, fast and reliable finger-pricking remains painful and cumbersome. Most patients would prefer not to do this.There has thus been great interest in the development of alternative methods of measuring glucose employing invasive, minimally-invasive and non-invasive sensing technology. Currently three devices are av...

The identification and characterization of patients with morbid obesity due to mutations in single genes has shed light on the molecular mechanisms underlying the hypothalamic regulation of appetite, body weight and endocrine axes.Two severely obese cousins in a consanguineous family were found to have undetectable levels of serum leptin and were homozygous for a frameshift mutation in the ob gene. These children were severely hyperphagic, constantly dem...

It has previously been established that the hypothalamic arcuate nucleus receives appetite input signals from both the brain stem and the peripheral circulation. Two neuronal types control food intake, an inhibitory neurone secreting alpha MSH and CART and a stimulatory neurone secreting NPY and AGRP. It was established that leptin activated the inhibitory neurone and inhibited the appetite stimulating neurone. The intestinal hormone, PYY, released after food ingestion acted i...

The ovary may not be an obvious target tissue for insulin action but there is ample evidence to suggest that insulin affects glucose metabolism, steroidogenesis and cell growth/differentiation, and that these effects are relevant to both normal ovarian physiology and to disorders of ovarian function. Glucose uptake and glycolysis by granulosa cells - important for providing energy for the maturing oocyte are regulated by both insulin and gonadotrophins. In the human ovary, ins...

Autoimmune thyroid disease (AITD) clusters in families pointing, at least in part, to a genetic basis for disease. Subjects with AITD and other family members also have an increased risk for the development of other autoimmune diseases such as type 1 diabetes (TID) and rheumatoid arthritis suggesting the involvement of general autoimmunity genes. In common with other autoimmune diseases the HLA region was the first cluster of genes to be reported to be associated with AITD. Mo...

Within the United Kingdom continuous insulin infusion pumps have not been widely used. This is due to concerns over safety with the early models and fundamentally a lack of funding. With NICE guidance now recommending use in some patients there is likely to be increased demand for the provision of these instruments. The devices have considerably improved and offer an alternative to multiple dosing regimes in some patients.Whilst home glucose testing can ...

The diagnosis of Congenital Adrenal Hyperplasia can be immensely difficult to cope with, especially if the infant presents unwell with associated salt-losing crisis. The need for education verbally and in written format is paramount. This needs to be staged and ongoing, with regular updates.New parents often need advice on general baby care/bonding. Add to this instruction on how to manage the condition, and things can become overwhelming. Practical advi...

Nitric oxide (NO) is a ubiquitous gaseous signaling molecule, many of whose physiological roles are mediated through activation of the soluble guanylate cyclase. At physiological concentrations, NO also inhibits the mitochondrial enzyme cytochrome c oxidase (complex IV) in competition with oxygen. We have suggested that the interplay between these two gases allows complex IV to act as an oxygen sensor in cells and have shown that endogenous NO modulates oxygen consumption unde...

Malthus said human population was limited by starvation. We are the survivors of previous rounds of starvation. Obesity is a survival characteristic! Unsurprisingly, now food is plentiful we are dying of obesity, and ways of controlling appetite are needed. It is thus essential to understand how the brain controls energy expenditure and appetite. The hypothalamus is the key centre regulating energy balance. It integrates several inputs. Higher centres give psychological inform...

Steve Bloom, Division of Investigative Science, Imperial College, London, UK AbstractProfessor Bloom is currently Chairman and Chief of Service for the Directorate of Pathology, Therapy Services and Endocrinology for Hammersmith Hospitals Trust (Chelsea Westminster Hospital, Charing Cross Hospital and Hammersmith Hospital), and Head of Division of Investigative Science, Imperial College School of Medicine....