Endocrine Abstracts

Background: Due to practical limitations, the diagnosis of hypogonadism is predominantly based on a single measure of reproductive hormones, often with confirmation on a second occasion. Factors associated with reproductive hormone variation include: pulsatile secretion, diurnal rhythm, and food intake, which can affect the accuracy of diagnosis of reproductive disorders. There is limited data quantitatively estimating the variability of reproductive hormone levels over the da...

Background: Acanthosis nigricans (AN) is a cutaneous condition characterised by pigmented hyperkeratosis of the skin flexures and neck and occurs most commonly in association with hyperinsulinaemia and insulin resistance (IR). A high prevalence of hyperinsulinaemia and abnormal glucose intolerance has been reported in the Emirati population. Current knowledge of AN suggests that it is a strong visible cutaneous marker associated with IR and can precede the onset of hyperglycae...

Alkaline phosphatase (ALP) was discovered by Robert Robison, PhD in London in 1923. In New York in 1932, he added to his hypothesis that ALP functioned in skeletal calcification by liberating inorganic phosphate (Pi) for hydroxyapatite crystal formation, perhaps from a hexosephosphoric ester, some unknown factor also conditioning this process. In 1948 in Toronto, Canada, ‘hypophosphatasia’ (HPP) was coined by John C. Rathbun, MD to describe a unique rickets without r...

Background: Recent NICE guidelines1 suggest imaging the parathyroid with ultrasound as first line prior to parathyroidectomy, MIBI as an alternative and surgical exploration if discordant. Investigation should also include a renal ultrasound and DEXA. This audit compares a single surgeon practice in one hospital to the guidelines.Methods and Results: All patients with a parathyroidectomy performed by a single surgeon between July 2016 and July...

Introduction: Patients with the familial cancer syndrome von Hippel–Lindau disease (VHL) are enrolled in radiological screening programmes which aim to identify tumour development at an early stage. This facilitates timely intervention to lesions when the risk of metastatic spread is low and when they are conducive to less-invasive and parenchymal-sparing interventions, thereby minimising treatment-related morbidity. A number of international screening protocols exist, al...

Background: Type 2 diabetes (T2D) and obesity have been linked with sleeping disorders in general and obstructive sleep apnoea (OSA) in particular; both are highly prevalent amongst Emirati patients. However, little information is available in this population regarding the prevalence and symptomatology of OSA, its relationships with T2D and obesity, and its impact on health outcomes.Objectives: This study aims to investigate the risk of OSA based on the ...

Background: Over the past decade there has been increased recognition of the dangers associated with inpatient management of diabetes insipidus (DI) and omission of desmopressin leading to hypernatremia. In May 2009 a patient died from diabetes insipidus mismanagement in a London hospital. An NHS England patient safety alert was issued in 2016 highlighting this risk.Method: Inpatients with a serum sodium of 155 mmol/l or greater were prospectively identi...

Purpose: There are sporadic reports illustrating more severe TED and complications in those with diabetes mellitus (DM) and from local experience these patients have poorer outcomes as seen in other diseases, such as cardiovascular disease. However, the relationship between glycaemia and clinical activity/severity and disease course are not well described.Methods: A multi-centre retrospective patient-cohort study of 236 patients referred to three TED mul...

Introduction: Screening patients with type 1 diabetes (T1DM) for other autoimmune diseases such as thyroid disorders has been recommended by international guidelines. Data from the Middle East is currently limited. This study aims to identify the pattern and prevalence of thyroid disorders among the UAE population with T1DM.Method: A retrospective cohort study was conducted looking at all adult patients (age ≥16 years) attending Imperial College Lo...

Introduction: The FreeStyle Libre is increasingly employed in the management of T1DM. This audit examined if users are meeting the recommended competencies set out in the London prescribing guidelines, to ascertain if users are aware of and utilising inbuilt features of the Libre, to identify if user training can be enhanced, and to see if Libre use improves patients’ quality of life as a result of Libre use.Methods: The audit was conducted via a st...