Common Endocrine Disorders

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Common Endocrine Disorders

• Dr Amanda Stewart
• Consultant Endocrinologist
• Tawam Hospital

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Aim

• To give a general overview of important and
  common endocrine conditions

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Objectives

• Understand about different types of diabetes
• List the main hospital diagnoses for diabetic
  in-patients
• Recognise some other common endocrine conditions

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Types of diabetes

• Type 1
• Type 2
• Gestational (GDM)
• Secondary to other disorders
• Secondary to drugs

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Types of diabetes

• Type 1
• 10
• Thinner
• Younger
• Need insulin to stay alive

• Type 2
• 90
• Overweight usually
• Older (but not always)
• Can be treated with tablets or insulin

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Type 1

• Lack of insulin in body
• Insulin builds muscle, fat and sugar stores
• Pumps sugar into tissues to be used
• Sugar is a fuel
• Without insulin everything breaks down

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Diabetic Keto-Acidosis

• Not enough insulin
• Fat and muscle break down
• Pump stops and fuel builds up in the blood
• Engine starts to fail
• Very serious

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Diabetic Keto-Acidosis

• Blood sugar high
• Build up of acid in blood
• Ketones (result of fat breakdown) high
• Needs intensive monitoring and treatment
• Usually in ICU

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Causes

• Missing insulin doses
• New diagnosis of diabetes
• Infection
• Trauma
• Heart attack

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Type 2

• Body makes insulin
• Insulin does not work (resistance)
• Usually in overweight or obese
• Can have it for a long time
• Chronic problems

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Type 2

• Family history
• Increasing in young people
• Increased risk vascular diseases
• Gets worse with time
• Can be treated with insulin or tablets

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Vascular disease

• Ischaemic heart disease
• Stroke
• Peripheral vascular disease
• Diabetic foot
• Ischaemia

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Diabetes complications

• Retinopathy (Eyes)
• Neuropathy (Nerves)
• Nephropathy (Kidneys)
• Cardiovascular diseases

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Associated disorders

• Hypertension
• Hyperlipidaemia
• Cataracts
• Infection
• Longer hospital stay

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Hypoglycaemia

• Collapse
• Seizures
• Stroke
• Accident
• Other symptoms
• Incidental

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Hypoglycaemia

• Food
• Exercise
• Treatment (insulin or tablets)
• Kidney disease
• Climate
• Alcohol

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Gestational Diabetes

• High blood sugar first noted during pregnancy
• Universal screening
• Future diabetes risk increased
• Check for diabetes after delivery
• Risks for pregnancy

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Gestational Diabetes

• Big baby (macrosomia)
• Shoulder dystocia
• Birth injuries
• Intrauterine foetal death
• Neonatal hypoglycaemia

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Other types of diabetes

• Drug related steroids
• anti-rejection
• Pancreatic insufficiency
• Cystic fibrosis
• Other syndromes

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• Other Endocrine Disorders

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Thyrotoxicosis

• Causes Graves disease
• Toxic nodule
• Multinodular goitre
• Usually admitted in crisis
• Can be very unwell
• Sometimes associated with other diseases

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Primary Hyperparathyroidism

• Overactive parathyroid gland
• High calcium levels
• Found incidentally
• May have surgery

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Adrenal insufficiency

• Addisons disease
• Cortisol (steroid) deficiency
• Life-threatening
• Usually found after admission for something else
• Vomiting a common symptom

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Hypopituitarism

• Pituitary gland fails
• May be multiple hormone deficiencies
• Steroid level most important
• Associated with structural pituitary disorders

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Any Questions?
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Summary

• Understand about different types of diabetes
• List the main hospital diagnoses for diabetic
  in-patients
• Recognise some other common endocrine conditions