Endocrine Abstracts

Very low calorie diets (VLCD) have been a time-honored means of losing weight for many decades. The DiRECT trial has put VLCD back in the limelight and now NHS England and Scotland have committed resources to piloting VLCD as an intervention for Type 2 diabetes. Is this premature, or is it the solution for the tsunami of Type 2 diabetes that we face? Prof Tricia Tan and Dr Abd Tahrani will debate the utility of VLCD in the treatment paradigm of Type 2 diabetes....

48 year-old woman was referred to the endocrine clinic by the respiratory team for management of an incidental 2cm right adrenal mass found on chest/upper abdomen computed tomography (CT) as part of investigations for recurrent chest infections. On review, she described attacks of ' doom and gloom', flushing and palpitations with a rate of 140 beats per minute. The attacks were sporadic and occurred for some years. Blood pressure in the endocrine clinic was 210/110. Urea and e...

A 37-year-old female was referred with recurrent episodes of altered consciousness and disorientation. She described a three-year history of recurrent “funny turns”. They started with a sensation of warmth accompanied with cold sweat followed by unfamiliarity with the surroundings and cognitive impairment. The attacks increased in frequency gradually over time. There was a tendency for the attacks to occur in the morning, before bed and 3–4 hours after food. The...

We report a 49 year-old female patient who was referred to the endocrine clinic with two months history of heat intolerance and weight loss. She denied any symptoms related to her eyes. Past medical history included hypertension, epilepsy and manic-depressive psychosis, and she was on lithium, atenolol, phenobarbitone, doxazosin and phenytoin. On examination, there was a 45 g firm symmetrical multi-nodular goitre (MNG) with normal examination of both eyes. Thyroid function tes...

A 32-year-old woman was referred, at 12 weeks in her second pregnancy, to the antenatal diabetic clinic for control of Type 1 diabetes. HbA1c was 6.5% (4.5-6.2%DCCT).At 32 weeks gestation she was admitted with premature labour. Treatment with betamethasone resulted in hyperglycaemia. Four days later she was admitted with a suspected subarachnoid haemorrhage. Brain CT was normal. She declined lumbar puncture. Over the next 2 days she developed recurrent h...

Background: Vitamin-D deficiency and type 2 diabetes (T2D) are common in South Asians (SA). The diagnosis of a vitamin-D deficiency in the setting of a chronic disease depends on a high index of suspicion and adequate investigation. This involves bone profile, occasionally in conjunction with serum 25-hydroxyvitamin-D. The ability of routine investigations to identify vitamin-D deficient patients have not been widely studied.Aims: To assess the ability o...

Objective: To test the hypothesis that poor adolescent diabetic control results in poor adult control.Methods: We conducted a retrospective case notes study involving 57 patients (M:F 30:27) in a teaching hospital. Patients who had diabetes atleast for a minimum period of 10 years were selected and their HbA1c when they were between 17 and 19 years of age were compared with the most recent HbA1c.The adolescent control was divided i...

Insulinoma is a tumour of the endocrine pancreas, usually benign, with an annual incidence of 1–2 new cases per million population. We describe a case of Insulinoma complicated by the simultaneous development of diabetes.A 72year old lady had episodes of funny turns and confusion following her meal. She had lost a stone in weight over 6–8 months. There was no history of sulphonylurea ingestion. Examination revealed low BMI and no evidence of ra...

Objective: To describe a novel mutation of the calcium sensing receptor gene (CaSR) in a family diagnosed with familial hypocalciuric hypercalcemia (FHH).Case history: A 62 year old man being investigated for short term memory loss was referred to us by GP for hypercalcemia found on routine blood tests. He was asymptomatic otherwise. Repeat blood tests revealed serum calcium high at 2.88 mmol/l, inorganic phosphate of 0.75 mmol/l, and normal serum PTH of...

Introduction: Phaeochromocytomas commonly present with episodes of sweating, palpitations, and hypertension. Urinary catecholamines measurement is the most common screening test for suspected phaeochromocytoma in the UK. We report a series of three cases in which the reason for hypertension and raised catecholamines was not a phaeochromocytoma and treating the underlying condition corrected the clinical and biochemical abnormality.Cases: Three patients w...