Endocrine Abstracts

Introduction: The National Paediatric Diabetes Audit (NPDA) provides a benchmark of performance for paediatric diabetic services across the UK. Whether intentional or not, a league table is created comparing units based on their mean HbA1c. Although the coordinators suggest submitting the patients’ most recent HbA1c, this may not necessarily be a universally adopted phenomenon. We examined the effect of selecting patient’s best, yearly average, and latest HbA1c on ou...

It is important to identify whether benign adrenal incidentalomas are hormonally active. Traditionally, investigations were arranged during the first medical consultation and relied heavily on the patient remembering a considerable number of instructions. The patient was required to collect urine bottles from pathology, a prescription from pharmacy and perform multiple tests including renin, which was often incorrectly performed in outpatients. Due to the cumbersome nature of ...

Exposure to maternal obesity or overfeeding during early development has lasting effects upon the young adult rat. Maternal cafeteria (CD) feeding during lactation programmes behaviour in the adult offspring, reducing anxiety in males and altering the behavioural satiety sequence in females. The aim of the present study was to examine the impact of early exposure to maternal over-nutrition upon bioactive amines in the brain. Lactating Wistar rats were fed either a control chow...

Testosterone in serum may be unbound (free), or bound to either sex hormone binding globulin (SHBG) or albumin. Consequently, ‘total’ serum testosterone analysis may be misleading in situations where binding protein concentrations are abnormal. Current methods for estimating the biologically active (bio-available) serum testosterone concentration involve physical separation of testosterone fractions and are not amenable to high-throughput analysis. The use of automat...

Background: Over the last two decades, supported by two metanalyses, the low-dose Synacthen Test (LDST) has gained in popularity, with many believing it to be more sensitive than the supra-physiological Standard (250 microgram) Short Synacthen Test (SSST). The literature reveals lack of consensus about its specific clinical applications, what is considered “low-dose” and how that dose is made up.Methods: To ascertain current UK practice,...

Background: Since the DCCT demonstrated that improved glycaemic control reduced complications the goal of diabetes management has been to maintain HbA1c as close to normal as possible. Recent changes by the laboratory to our HbA1c assay, combined with the debate about deanonymised publication of clinic’s HbA1c results, creating the potential for ‘league tables’, focussed our attention on the variation between HbA1c assays.Clinical data: Ou...

The liver performs essential functions including the control of blood nutrient levels; the synthesis of many blood proteins; the metabolism of bile components and the conversion of ammonia to urea for excretion by the kidney. Impaired urea synthesis is often the cause of coma and death in patients with liver failure. The only treatment for liver failure at present is transplantation.Stem cells may be a promising future resource for the treatment of acute...

A 72 year old, non-diabetic, woman was referred with recurrent severe hypoglycaemia. Twenty-one years ago she was investigated for hypoglycaemia when inappropriate hyperinsulinaemia had been confirmed. Although a CT of her abdomen could not demonstrate an insulinoma she underwent a distal pancreatectomy and subsequent histology showed islet cell hyperplasia. She was managed with dietary intervention and diazoxide. At the time of the current referral she was suffering daily sev...

Aim: We previously reported preliminary evidence that use of TRH with CRH during inferior petrosal sinus sampling (IPSS) in Cushing’s syndrome gave additional information about quality of pituitary venous sampling and significance of gradients. We now report long-term experience of this technique in 40 patients investigated 1993–2005. We used standard central:peripheral ratios (C:P) of 2:1 basally and 3:1 after stimulation to indicate pituitary secretion and intersin...

Patients with Cushing's disease have high levels of circulating corticosteroids. Treatment may result in unmasking of steroid dependant conditions. We report a case of ulcerative colitis presenting after bilateral adrenalectomy.Case reportA 19 year old girl underwent bilateral adrenalectomy in November 1998 for pituitary dependant Cushing's disease. She was discharged on hydrocortisone and fludrocortisone and post operatively her c...