Endocrine Abstracts

Background: The causes of thyrotoxicosis include hot and Graves disease. Graves’ disease can be associated with Graves eye disease, and thus have a psychological impact on the patient. The treatment of thyrotoxicosis includes medical therapy, surgical therapy, and radioiodine treatment. Treatment of thyroid eye disease includes both medical and surgical therapy in a multidisciplinary setting. Medical treatment using steroids may worsen hyperglycaemia in patients with existing diabetes. Steroid-induced hyperglycaemia is not uncommon. Baseline HBA1C, fasting glucose, and regular monitoring for hyperglycaemia are required in patients on steroids.

Aims: • To establish BM monitoring patterns on non-diabetic patients with thyroid eye disease receiving steroids.• To establish whether management corresponds with national guidance. • To develop a consensual pathway for thyroid eye disease patients requiring steroids • To present a retrospective study in the management of thyroid eye disease in the acute setting

Methods: • Retrospective study/audit using clinic letters and patients notes • Baseline Fasting glucose done- 100% • Baseline HBA1C done 100% • Follow-up fasting glucose and HBA1C done 100%

Results: • 8 Patients analysed were identified. • 7 patients had their baseline HBA1 checked, • 50% had their HBA1C months after starting the steroids and • 62% had their HBA1C checked after finishing the treatment

Discussion: • Treatment of thyroid eye disease includes both medical and surgical therapy in a multidisciplinary setting. • Medical treatment using steroids may worsen hyperglycaemia in patients with existing diabetes. Steroid-induced hyperglycaemia is not uncommon. • Baseline HBA1C, fasting glucose, and regular monitoring for hyperglycaemia are required in patients on steroids. • At present no structured MDT approach to managing these patients. A ‘One Stop Shop’ with ophthalmology & endocrinology to manage these patients