Diabetes and endocrinology

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Research outputs from the Diabetes/Endocrine service department at the RD&E.


Recent Submissions

Now showing 1 - 5 of 425
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    Narrative Review of Glycemic Management in People With Diabetes on Peritoneal Dialysis
    (Elsevier, 2023-04-01) Wijewickrama, P.; Williams, J.; Bain, S.; Dasgupta, I.; Chowdhury, T. A.; Wahba, M.; Frankel, A. H.; Lambie, M.; Karalliedde, J.
    There is an increasing number of people with diabetes on peritoneal dialysis (PD) worldwide. However, there is a lack of guidelines and clinical recommendations for managing glucose control in people with diabetes on PD. The aim of this review is to provide a summary of the relevant literature and highlight key clinical considerations with practical aspects in the management of diabetes in people undergoing PD. A formal systematic review was not conducted because of the lack of sufficient and suitable clinical studies. A literature search was performed using PubMed, MEDLINE, Central, Google Scholar and ClinicalTrials.gov., from 1980 through February 2022. The search was limited to publications in English. This narrative review and related guidance have been developed jointly by diabetologists and nephrologists, who reviewed all available current global evidence regarding the management of diabetes in people on PD.We focus on the importance of individualized care for people with diabetes on PD, the burden of hypoglycemia, glycemic variability in the context of PD and treatment choices for optimizing glucose control. In this review, we have summarized the clinical considerations to guide and inform clinicians providing care for people with diabetes on PD.
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    Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium
    (BioScientifica, 2023-07-01) Hamblin, R.; Fountas, A.; Lithgow, K.; Loughrey, P. B.; Bonanos, E.; Shinwari, S. K.; Mitchell, K.; Shah, S.; Grixti, L.; Matheou, M.; Isand, K.; McLaren, D. S.; Surya, A.; Ullah, H. Z.; Klaucane, K.; Jayasuriya, A.; Bhatti, S.; Mavilakandy, A.; Ahsan, M.; Mathew, S.; Hussein, Z.; Jansz, T.; Wunna, W.; MacFarlane, J.; Ayuk, J.; Abraham, P.; Drake, W. M.; Gurnell, M.; Brooke, A.; Baldeweg, S. E.; Sam, A. H.; Martin, N.; Higham, C.; Reddy, N.; Levy, M. J.; Ahluwalia, R.; Newell-Price, J.; Vamvakopoulos, J.; Krishnan, A.; Lansdown, A.; Murray, R. D.; Pal, A.; Bradley, K.; Mamoojee, Y.; Purewal, T.; Panicker, J.; Freel, E. M.; Hasan, F.; Kumar, M.; Jose, B.; Hunter, S. J.; Karavitaki, N.
    OBJECTIVE: The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care. DESIGN: Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium). METHODS: Clinical, imaging, and hormonal data of micro-NFPA cases between January, 1, 2008 and December, 21, 2021 were analysed. RESULTS: Data for 459 patients were retrieved [median age at detection 44 years (IQR 31-57)-152 males/307 females]. Four hundred and nineteen patients had more than two magnetic resonance imagings (MRIs) [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95% CI, 4.9%-8.1%) and 14.5% (95% CI, 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95% CI, 10.4%-17.8%) and 21.3% (95% CI, 16.4%-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all >5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required >3 years after micro-NFPA detection). Sex, age, and size at baseline were not predictors of enlargement/reduction. At the time of detection, 7.2%, 1.7%, and 1.5% patients had secondary hypogonadism, hypothyroidism, and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma). CONCLUSIONS: Probability of micro-NFPA growth is low, and the development of new hypopituitarism is rare. Delaying the first follow-up MRI to 3 years and avoiding hormonal re-evaluation in the absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.
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    HbA(1c) screening for the diagnosis of diabetes. Reply to Brož J, Brabec M, Krollová P et al [letter]
    (Springer, 2023-08-01) Young, K. G.; McGovern, A. P.; Barroso, I.; Hattersley, A. T.; Jones, A. G.; Shields, B. M.; Thomas, N. J.; Dennis, J. M.
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    The evolving continuum of dysglycaemia: Non-diabetic hyperglycaemia in older adults
    (Wiley, 2023-07-01) Golding, J.; Hope, S. V.; Chakera, A. J.; Puttanna, A.
    Identifying non-diabetic hyperglycaemia (NDH) and intervening to halt the progression to type 2 diabetes has become an essential component of cardiovascular and cerebrovascular risk reduction. Diabetes prevention programs have been instigated to address the increasing prevalence of NDH and type 2 diabetes by targeting lifestyle modifications. Evidence suggests that the risk of progression from NDH to type 2 diabetes declines with age, and that a diagnosis of type 2 diabetes in older adults is not associated with the same risk of adverse consequences as it is in younger age groups. The current definition of NDH is not adjusted based on a person's age. Therefore, there is debate about the emphasis that should be placed upon a diagnosis of NDH in older adults. This article will explore the evidence and current clinical practice surrounding dysglycaemia through the spectrum of different age ranges, and the potential implications this has for older adults.