Endocrine Abstracts

Current guidelines recommend pre-meal blood glucose (BG) levels of <140 mg/dl in the hospital. The aim of this analysis was to compare two versions of a workflow-integrated algorithm for basal-bolus insulin therapy (REACTION algorithm) for glycemic management in patients with diabetes mellitus type 2 (T2D) hospitalized at the general ward.For both algorithms BG measurements were performed four times daily (pre-breakfast, pre-lunch, pre-dinner, and at...

National training surveys demonstrate that medical trainees feel under-prepared for practice and under-prepared for managing emergencies, such as diabetic ketoacidosis (DKA). It is challenging for traditional clinical training to guarantee first-hand exposure to all medical emergencies as they occur at random and often out-of-hours, resulting in only minority of students witnessing many emergencies first-hand. It is unfeasible for most universities to provide in-person simulat...

Delayed hyponatraemia(DH) is a well-known complication following trans-sphenoidal pituitary surgery (TSS), varying in incidence from 9–36% and occurs between post-operative days(POD) 4 to 14. Various studies have demonstrated that post-operative fluid restriction after TSS reduces the incidence of DH.Objective: to assess whether a fluid restriction protocol from POD5 to POD14 following TSS reduces the incidence of post-operative DH ...

Control mechanisms of adrenocorticotrophic hormone (ACTH) and cortisol (CORT) secretion and metabolism during acute systemic inflammation (e.g. major surgery) have never been clearly elucidated. We sampled blood every 10 minutes for 12 h during and after coronary artery bypass grafting (CABG) in 10 patients to create profiles of ACTH, CORT and inflammatory mediators and compared these to healthy controls. Patients’ ACTH and CORT responses were classified into one of three...

Case history: A 26-year-old lady presented with a two-week history of weakness associated with pins and needles affecting the lateral calf and dorsomedial aspect of her left foot. The patient denied any trauma or symptoms including weight loss. She had no drug allergies and was taking no regular medications. She had a vegan diet supplemented with multivitamins. Her past medical and family history was unremarkable. On examination, she had a narrow-based high-steppage-gait. Lowe...

Introduction: For the last 2 years we have been giving regular diabetes education sessions in conjunction with our hospital school, based around maths skills. These went well, but we wanted to develop these further, making them more patient centred. We gained a grant from the Diabetes Research and Wellness Foundation and designed a 4 day programme with ‘The Puppet Project’ and ‘WAC arts’. This was done very much in collabaration with our hospital school who...

Introduction: Use of degludec [tresiba] in children and adolescents with type 1 diabetes was approved by EC 2015 and FDA in December 2016. Degludec is a new ultra-long acting basal insulin with terminal half-life of approximately 25 hours and duration of action of more than 42 hours. Constant release of insulin throughout the day leads to better control of blood glucose for more than 24 hours with significant reduction in HbA1c.Aim: To compare and assess...

Background: Observational and genetic Mendelian randomisation (MR) data has demonstrated the association of adulthood overweight/obesity with development of polycystic ovary syndrome (PCOS). However, the contribution of early life (i.e. childhood/adolescence) body composition on incident PCOS is unclear. This study determines the influence of body composition on the likelihood of developing PCOS.Methods: We conducted a 2-sample Mendelian randomisation st...

Introduction: Pancreatic neuroendocrine neoplasms (PNEN) present with a fibrotic stroma which constitutes the tumor microenvironment (TME). The role played by stromal fibroblasts over the growth of PNEN and their sensitivity to the mTOR inhibitor, RAD001, are as yet unestablished.Methods: We investigated reciprocal interactions between 1) human PNEN cell lines (BON-1/QGP-1) or primary cultures of human ileal neuroendocrine neoplasm (iNEN) or PNEN, and 2)...

Introduction: Diabetes is a chronic condition causing morbidity and mortality globally, with a growing economic burden on healthcare systems. In the UK, 1 in 14 people have diabetes, with type 2 accounting for 90% of cases (1). Complications from poorly controlled diabetes are associated with increased socioeconomic costs and a reduced quality of life. Research has shown education and self-management are crucial in helping diabetic patients achieve metabolic control (1). Smart...