Endocrine Abstracts

A 34-year-old T1DM nurse was admitted with a history of recurrent episodes of DKA. In the current admission at our hospital, on detailed history she reported of getting DKA almost every month when her menses would start. She would be following the sick day rules of DKA but it wouldn’t help prevent her going into DKA. No other precipitating factors were found. She was diagnosed as a case of Catamenial DKA and was started on OCP’s to see how what effect it would have on her DKA the next month. She unfortunately was re admitted with DKA warranting ITU admission around the time of withdrawal bleeding of OCP’s. A joint Endocrine- Gynaecology MDT was dine and she evaluated by Gynaecology team to rule out endometriosis with USS Pelvis and CT-TAP. She was then started on GnRH analogue to cease her menses and started on HRT with all the risks and benefits explained of the same. She has been regularly followed up at Diabetic and Gynaecology clinics and hasn’t had an episode of DKA in the past 6 months now with excellent BM control. Points for discussion with the audience: 1. Catamenial DKA and its management. Your experience? 2. Guidelines for managing this rare type of DKA? 3. OCP vs GnRH + HRT ; your experience and alternatives?