Endocrine Abstracts

Objective : to estimate the activative and adhesive ability of leucocytes and endothelial cells in active PDR ( with neovascularisation ).Materials and methods : 17 young patients, age mediana 26,4 years, with Diabetes Type 1 and active PDR were compared with 17 healthy controls. ICAM-1 (CD 54) on the surface of lymphocytes and granulocytes was measured by flow cytometry ' Becton Dickinson '.Serum soluble E - selectin ( CD 62 ) was identified by ELISA ( 'R and D', UK ).Mean Di...

Increased severity of periodontal disease has been reported in post-menopausal oestrogen deficient subjects, made worse by smoking. It was relevant to investigate this concept, using fibroblasts in culture and extrapolating the yields of androgen metabolites as an index of healing. The aim of this study is to establish the effects of nicotine (N), oestradiol (O) and the alkaline phosphatase inhibitor levamisole (L) on androgen metabolism in human gingival fibroblasts in this c...

The aim of this investigation is to study androgen metabolism in human gingival fibroblasts exposed to a hyperglycaemic environment and their response to insulin, the antagonist glucagon and nicotine; this may be extrapolated to their metabolic responses in vivo, in uncontrolled diabetes (obtained local Ethical Committee approval). Duplicate incubations of four cell lines of monolayer cultures of fibroblasts were performed in Eagle's MEM with radiolabelled testosterone as subs...

Aim : We compared the Hospital practice in the management of hyperthyroidism using radioiodine with the guidelines recommended by the working group of Royal College of Physicians and Society for Endocrinology. We also assessed the outcome of the treatment.Methods: All 51 consecutive patients (female - 47, male - 4) who had radioiodine treatment from Jan 1997 till Dec 1998 were included, among which 5 patients had two doses of radioiodine. All of them rec...

The purpose of this study was to measure well-being and treatment satisfaction among clinic patients with type 2 diabetes using a diabetes specific instrument as well as determine correlates of these measures. A cross-sectional survey was conducted using the Well-Being Questionnaire (1) and the Diabetes Treatment Satisfaction Questionnaire (2). Other demographic and clinical indices of age, sex, body mass index, disease duration and blood glucose levels were also recorded. Sco...

The molecular mechanisms underlying adrenal adenomas have not yet been elucidated. Many groups have sought mutations within the ACTH receptor as well as its downstream signalling pathway, although none have yet been identified. However, mutations in the alpha regulatory subunit of the cAMP dependant Protein Kinase A (PRKAR1A) have recently been described in more than 50% of patients with Carney complex. This syndrome is characterised by nodular adrenocortical hyperplasia as we...

Midnight Cortisol RevisitedD Noimark, MT Barakat, K. Meeran, JF ToddEndocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, LondonBackground: The diagnosis of Cushing's syndrome must be established before any attempt at differential diagnosis. The diagnosis of Cushing's syndrome can be made initially on an outpatient basis with the measurement of 24 hour urinary free cortisol ...

Various criteria have been proposed to diagnose and treat gestational diabetes due to uncertainties about the influence of mild degrees of maternal glucose intolerance on pregnancy outcomes. We used receiver operating characteristics (ROC) curve analysis to correlate macrosomia (more than or equal to 4000g) with varying thresholds for the 2 hour 75 gm oral glucose tolerance test (OGTT) results in pregnant women screened at our hospital from 1998-2001.Wom...

The incidence of cardiovascular diseases, diabetes mellitus and obesity is constantly growing in Latvia. Obesity in children is a globally progressing public health problem that can lead to serious metabolic abnormalities - insulin resistance and associated metabolic syndrome.Our objective was to determine the risk factors that contribute to the development of arterial hypertension in schoolchildren. 238 schoolboys between the ages of 7 and 19 were scree...

IntroductionWomen with Turner Syndrome have an increased prevalence of hearing loss. Conductive hearing loss (CHL) is thought to be caused by craniofacial abnormalities or defective mucociliary transport resulting in impaired middle ear ventilation, increased otitis media and tympanic perforations. Sensorineural hearing loss (SNHL) progresses with age, possibly due to premature aging. An adult population was assessed for the impact of childhood treatment...

Lipid sensing by pancreatic beta cells is co-ordinated through the expression and activity of peroxisome proliferator-activated receptors (PPARs). Through their action to lower triacylglycerol delivery to peripheral tissues, PPARalpha activators also oppose insulin resistance by relieving inhibition of insulin-stimulated glucose disposal. Mid to late pregnancy is an insulin-resistant state associated with hypertriglyceridaemia. We investigated regulatory interactions between P...

Activation of PPARalpha pharmacologically by WY14,643 enhances insulin sensitivity in insulin-resistant high-fat-fed rats. PPARalpha is expressed in pancreatic islets, where it affects genes involved in lipid metabolism. We investigated effects of PPARalpha activation by WY14,643 on glucose-stimulated insulin secretion (GSIS) in a rat model of high-fat feeding in which insulin resistance is observed in conjunction with compensatory insulin hypersecretion. To identify persisten...

Impaired insulin action is a characteristic feature of type 2 diabetes and skeletal muscle is the principal tissue for peripheral glucose disposal. Aims: To determine if after prolonged culture human muscle cells from characterised type 2 diabetes patients have defects of insulin action compared to controls. Design: After attaining local Ethical Committee approval six compliant type 2 diabetic patients with severe clinical insulin resistance, on greater than 100 units of insul...

A 71-year-old man presented with a three week history of nausea, vomiting, constipation, polyuria, nocturia, polydipsia and feeling weak. He had sustained a wrist fracture six weeks prior to admission. Since then he had started to consume calcium containing mineral water, cod liver oil and seven seas oil.Examination revealed a palpable mass in the right lower thyroid. Serum calcium level was 4.37 millimols/litre (ref. 2.10-2.70), parathormone level of 72...

Obstructive sleep apnoea (OSA)is associated with increased cardiovascular morbidity and mortality and is an independent risk factor for the development of hypertension. A recent study demonstrated elevated urinary catecholamine excretion in hypertensive males with OSA. However, we have recently observed the phenomenum whereby OSA can rarely induce catecholamine production of sufficient severity to mimic the clinical and biochemical presentation of phaeochromocytoma.<p clas...

IntroductionPhalangeal metastases commonly display inflammatory symptoms that mimic an acute infection. We describe a rare case of bronchogenic carcinoma with metastases to the left 3rd and 4th toes, which presented as presumed diabetic foot ulceration.Case ReportA 74-year-old diabetic man presented with painful, inflamed and ulcerated left 3rd and 4th toes. A clinical diagnosis of infected diabetic toes was ...

Background:With respect to what has been mentioned about the progression of IGT to overt diabetes, and the lack of information in rural areas, and also some unresolved questions about the relationship between IGT and some micro and macrovascular complications, this research was accomplished in the years 2001-2002.Material and Methods:The first step of this study was carried out in 1977 to screen people (1988 ...

We present a patient with asymtomatic primary hyperparathyroidism who became normocalcaemic following spontaneous infarction of a parathyroid adenoma. He was referred by the General Practitioner following an episode of renal colic when he was found to have a raised adjusted serum calcium level of 3.07 millimols/litre (ref 2.10-2.70). Parathyroid hormone level was 33.2 picomols/litre (ref 1.3-7.6), confirming primary hyperparathyroidism. A SESTIMIBI scan revealed a parathyroid ...

BACKGROUND: Diabetes mellitus results in a two to four-fold increased risk of dying from complications of cardiovascular disease. There is growing evidence that this risk can be reduced by low-dose aspirin. Evidence comes from studies of platelet function and aspirin pharmacology and from trials of primary and secondary prevention. The American Diabetes Association produced a position statement regarding guidelines for aspirin use in 1997.OBJECTIVES: To ...

Diabetes and impaired glucose tolerance are associated with increased risk of cardiovascular diseases. Criteria for high risk populations that should be screened for diabetes needs be revising.Hospital admissions are stressful events and abnormally high random blood glucose levels are not acted upon appropriately.We studied 100 consecutive admissions to coronary care unit to assess the incidence of hyperglycaemia/diabetes on admiss...

Objective:The clinical observations suggest that there is statistically significant correlation between Diabetes Mellitus(DM)type and the type of treatment on one hand, and the average duration of occurence of the chronic complications on the other hand.Material and Methods:The studied groups comprised that 1315 subjects who represent all the patients suffering from Diabetes Mellitus(DM),under the observation of Diabetic Center in Oradea.<p class="ab...

A 56 year old female on treatment for colonic Tuberculosis was referred for investigation of possible Cushing's Syndrome. She initially presented with hypertension, hypokalaemia, and proximal myopathy. Repeated Urinary Free Cortisols were elevated at 730, 738, 520 nmol/L, (normal range= 55-270 nmol/L). The patient failed to suppress on low dose dexamethasone suppression, LDDST, (0.5 mg 6 hourly for 48 hours), baseline cortisol= 390 nmol/L, 48hour cortisol = 595 nmol/L, but sup...

Prescription rates for HRT in women with type 2 diabetes are low. One reason for this is concern about adverse metabolic effects although evidence on this is limited. We report results from a 3-month randomised, double blind, placebo-controlled trial of 1mg 17-beta oestradiol combined with 0.5 mg norethisterone acetate in postmenopausal women with type 2 diabetes. The study has full local ethics committee approval.29 subjects entered the study; 1 taking ...

Lithium-induced hyperparathyroidism was first described in 1973 by Garfinkel et. al.The two cases aim to illustrate Lithium-induced hyperparathyroidism which was previously thought to be a rare occurrence and outline characteristic features of this disorder.Case 1.A 51 year old male presented with polydipsia and polyuria. He was known to suffer from bipolar affective disorder with lithium treatment was admitt...

Back ground: The reported prevalence of microalbuminuria (MA) range from 9% to 54%. Diabetics in these studies were hypertensive and were on different medications which could influence results. Aim: To know the prevalence of MA in diabetics not on antihypertensive medication, normal serum creatinine, no overt proteinuria and were also not on statins. Methods: The data were collected from the Diabetes Register of patients at annual check up at Hartlepool General Hospital. Durin...

The present study was designed to investigate the effects of Diol-ginsenosides, major active components of Panax Ginseng, on the development of diabetes in the Diabetes Prone-BB rats(DP-BB rats). Administration of Diol-ginsenosides to DP-BB rats from age 3-4 weeks to age 11-12 weeks (daily, 1mg/g body weight) resulted in a markedly delayed the onset of diabetes. Islets of the treated rats showed no insulitis or only early/intermediate-stage insulitis and preserved higher pancr...

A 66-year-old Caucasian male presented with polydipsia, profound weight loss, blood glucose of 29.1 millimoles per litre and mild acidosis. Urinalysis revealed no ketonuria. A mild acidosis was also identified. A bronzed skin appearance was noted which together with deranged liver function raised suspicions of haemochromatosis in conjunction with newly diagnosed diabetes. Initial treatment involved rehydration, intravenous then subcutaneous insulin therapy. Subsequent abdomina...

Background: The anti-hyperglycemic effects of thiazolidinedione/biguanide combination therapy are well established. However, the impact of such therapy on other clinical risk factors for cardiovascular disease (CVD) has not been extensively reported.Objective: To evaluate the anti-hyperlipidemic effects of pioglitazone (PIO) and rosiglitazone (ROSI) used in combination with metformin (MET) in patients with type 2 diabetes, a multicenter, retrospective, r...

Objective: To compare clinical characteristics in individuals with established Type 1 diabetes mellitus with and without altered hypoglycaemia unawareness (AHA) / severe hypoglycaemia (SH).Methods: Individuals with AHA and/or SH and controls matched for age, sex and duration of diabetes but with no history of AHA or SH were identified from databases of those attending the Newcastle Diabetes centre with Type 1 diabetes. Characteristics were confirmed from...

OBJECTIVE: To evaluate if follow up in a specialty clinic for Diabetics can result in lower LDL levels.METHODS: A Veterans Administration (VA) diabetes clinic established in 1996 consisted of 5 academic endocrinologists, nurse practitioner, endocrinology fellows, rotating medical housestaff, pharmacist, nutritionist and nurse. All patients enrolled in diabetes clinic for at least one year had their electronic medical record reviewed retrospectively for d...

BACKGROUND: Atherosclerosis is a major cause of mortality in diabetes mellitus. Gene therapy may be a useful approach to the treatment of this disorder. One of the main obstacles to the use of this therapeutic modality is the difficulty in obtaining safe and efficient gene transfer in vivo. Adenoassociated virus vector have been used in a number of previous studies but have never been used for vascular gene delivery. OBJECTIVE: Our goal was to characterize AAV mediated gene de...

Aims: Glycated insulin exhibits impaired glucose-lowering ability and increasing evidence supports a role for glycation of insulin in the insulin resistant state of Type 2 diabetes. We used a novel radioimmunoassay to evaluate the effect of the insulin secretagogue nateglinide on plasma glycated insulin in Type 2 diabetes. Methods: Ten patients (5M/5F, age 57.8±1.9 years, HbA1c 7.6±0.5%, fasting plasma glucose 9.4±1.2millimols per litre, creatinine 81.6&pl...

The Nottingham Diabetes web site (www.nottinghamdiabetes.nhs.uk) was launched in January 2002 as an information and education resource for people with diabetes and diabetes care teams in Nottingham. It was developed jointly by the two hospital diabetes centres in Nottingham, designed by an independent web designer and funded by the pharmaceutical industry (with no influence over content or acknowledgement on the site).The site contains information about ...

Diabetes arising in young adulthood has a wide differential diagnosis, including autoimmune and genetic causes as well as young onset type 2 diabetes (YT2D). Specific features may be associated with each of these groups, but they cannot be differentiated from YT2D by mode of presentation. Family history, clinical characteristics and laboratory investigations provide complementary strategies to help dissect different known aetiologies.We studied 268 UK Ca...