Free communications of the gulf association of endocrinology and diabetes virtual meeting 2021 - October 7–9, 2021

Abstract

These are the advance abstracts of the Clinical Congress (Virtual) of the Gulf Association of Endocrinology and Diabetes held on October 7–9, 2021. The declared educational objectives of the congress were to give a “state of the art in endocrine practice.” Plenary and symposia presentations were delivered online by international and regional key opinion leaders. In addition, free communications on current research and clinical practice in the region and worldwide were presented online. We present here the abstracts of the congress as submitted by the authors of the free communications after minimal restyling and editing to suit the publication requirements of the Journal. We hope that by publishing them in our open access journal, we provide an early recognition of the work and extend the benefit to those who could not make it to the live presentations. Background: Hypogonadism is the most common form of hypopituitarism in men with macroprolactinoma, but factors related to hypogonadism recovery are limited. Objectives: We aimed to study the prevalence of hypogonadism in men with macroprolactinoma exclusively treated with dopamine agonists and assess factors predicting hypogonadism recovery. Methods: A multicenter retrospective study of men with macroprolactinoma identified using ICD 9 and 10 codes and treated between 2009 and 2019 in five centers in the United Arab Emirates and the Kingdom of Saudi Arabia. Hypogonadism defined as low testosterone level with normal or low gonadotropins being evaluated at presentation and at the last clinic visit. Results: A total of 101 patients (mean age 33 years) were initially included in the study. The most common symptoms at presentation were headache (75.3%), erectile dysfunction, low, and libido. Median tumor size at diagnosis was 2.7 cm. Of 82 patients with available data, 62 (75.6%) had evidence of hypogonadism at baseline. The prevalence of growth hormone deficiency and hypothyroidism was 35.9% and 32.5%, respectively. The median (interquartile range [IQR]) serum prolactin level (PRL), available in 83 patients, was 20,000 (56,293.6) miU/l, with a median serum total testosterone (TT) level of 4.4 (5.3) nmol/l. Most patients were treated with cabergoline ( n =, %), with a median (IQR) duration of 6 (4) years. Follow‑up data on hypogonadism status were available on 60 out of 62 patients. Of those, 39 patients (65%) recovered their pituitary–gonadal Objective: There are limited longitudinal studies assessing the risk factors associated with the evolution of diabetic peripheral neuropathy (DPN). M ethods: Patients with type 2 diabetes (T2D) ( n = 78) and control participants ( n = 26) underwent clinical, metabolic, and neuropathy phenotyping using corneal confocal microscopy (CCM), vibration perception threshold (VPT), and DN4 questionnaire at baseline and 2‑year follow‑up. Results: The prevalence of DPN and painful DPN was 18% and 26%, respectively. Patients with T2D had a higher VPT ( P ≤ 0.01) and lower corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) ( P ≤ 0.0001) compared to controls. Over a 2‑year follow‑ up period, there was a significant decrease in HbA1c ( P ≤ 0.001), body weight ( P ≤ 0.05), Objectives: This study determined the prevalence and risk factors for diabetic peripheral neuropathy (DPN), painful DPN, and diabetic foot ulceration (DFU) in patients with type 2 diabetes (T2D) in secondary healthcare (SHC) in Qatar, Kuwait, and the Kingdom of Saudi Arabia. Methods: Adults aged 18–85 years with T2D were randomly enrolled from SHC and underwent clinical, metabolic, and DPN using vibration perception threshold and DN4 questionnaire, as well as DFU assessments. Results: A total of 3021 subjects were recruited between June 2017 and May 2019. The prevalence of those who present with hypothyroidism. Results: A total of 66 patients were included based on the diagnosis of TMG on biochemical, thyroid ultrasound scan, and thyroid uptake scan for 930 patients demonstrated in SQUH at specified duration. We discovered that the incidence rate of TMG was 71 new cases per 1000 people who had thyroid uptake scan. The male to female ratio was 1:12, with mean and median age 50 (standard deviation ±14.3); the disease was founded in females with 92.4% of total patients. The most reported symptom was palpitations, and the most signs were goiter and tenderness. The presence of thyroid nodules was found in 97% of patients with TMG. In thyroid scintigraphy, 50% of a total of 66 patients were found to have normal Tc‑99 uptake. Thyroid hormone test showed that the majority of patients (51.5%) appeared with normal levels of FT4 and 68.2% had suppressed in their TSH level. In pathological findings, 79.5% of 39 patients who had FNA were found to be benign with Bethesda II classifications. The management offer to our patients was carbimazole with (47%), radioactive iodine treatment was given to 13.6% of patients, and surgery was preceded in 15.2% of patients. Conclusions: TMG is a common thyroid disorder in our environment, presenting with hyperthyroidism and neck swelling. Our study showed that TMG is more common in females compared to males with palpitation as the most common clinical presentation followed by multiple nodules. The treatment offered to our patients was carbimazole as the first line, while radiotherapy was the most common permanent cure. Surgery was performed in patients with huge neck swelling and obstructive symptoms. Background: The objective of the study is to determine the effectiveness of Freestyle Libre 2 (FSL2) on diabetes‑self‑management (DSM) practices and glycemic parameters among patients with type 1 diabetes (T1D) using an insulin pump. Methods: This prospective study was performed among 47 patients with T1D (13–21 years) who self‑tested their glucose levels by the conventional finger‑prick method using blood glucose meters (BGMs). Data related to glycemic profile, i.e., mean time in range (TIR), mean time above range (TAR), mean time below range (TBR), mean glucose level, hemoglobin A1c (HbA1c), total daily dose of insulin (TDDI), frequency of glucose monitoring, and DSM responses were collected at baseline and at 12 weeks. Results: The mean TIR was 59.8% ± 12.6%, TAR 32.7% ± 11.6%, TBR 7.5% ± 4.3%, mean glycemic variability, standard deviation 63.2 ± 12.5 mg/dL, and the coefficient of variation 41.3% ± 11.4% at 12 weeks. At baseline, the HbA1c level was 8.3%, and at 12 weeks, it dropped to 7.9%. Baseline glucose monitoring frequency through BGM was 2.4/day; however, after the patients employed the FSL2, a higher degree of frequency of glucose monitoring was evident at Background: Diabetic retinopathy (DR) is a complex pathophysiological event and a major cause of blindness in diabetic patients. Hence, the study was designed to study the effect of atorvastatin on induced DR in rats. Methods: The study was conducted on 40 rats divided into four equal groups. Group 1 served as normal control group. Diabetes mellitus (DM) was induced, by a single intraperitoneal injection of streptozotocin (60 mg/kg) in Group 2 (DR model group), Group 3 (insulin‑treated group), and Group 4 (atorvastatin‑treated group). Insulin and atorvastatin were administrated daily for 8 weeks starting 24 h after induction of DM. All rats were sacrificed at the end of the study, and the following parameters were assessed in each group: glycosylated hemoglobin (HbA1c%), serum malondialdehyde (MDA), retinal histopathological changes, retinal neuronal cell death, and immunohistochemical detection of both retinal vascular endothelial growth factor (VEGF) and intercellular adhesion molecule 1 (ICAM‑1). Results: Induction of DM caused marked deterioration in all the measured parameters in the DR control group when compared to the normal control group. Administration of insulin or atorvastatin was associated with marked improvement in the measured parameters in the form of significant reduction of HbA1c%, serum MDA, the effectiveness of two beside tests (VibraTip and Neuropad) as screening tests to diagnose DSPN in South Asian male patients with type 2 diabetes mellitus (T2DM). Methods: One hundred and twenty Pakistani patients diagnosed with T2DM were recruited. There were 60 male and 60 female patients who met the inclusion criteria. Each patient had glycemic control parameters, lipid profile, and renal function assessed. DSPN was defined by a Michigan Neuropathy Screening Instrument (MNSI) clinical score greater than 2. Patients were divided into two groups: subjects with clinical DSPN (MNSI >2) and subjects without DSPN (MNSI >2). All patients had both VibraTrip tests and Neuropad tests applied. Statistical analyses were conducted using the SPSS software (V.21) and data were presented as means ± standard deviation (SD). Student’s t ‑test was used to compare the means of important variables in both groups and Chi‑ square test to compare proportions between groups. Measures of diagnostic performance (sensitivity, specificity, negative predictive value [NPV], and positive predictive values) were calculated. Results: The prevalence of DSPN determined clinically by MNSI was 35.8%. DSPN in these patients was associated with age, worsening renal function, and insulin treatment. The VibraTip test exhibited a sensitivity of 52.1% and specificity of 93.3%, with an NPV of 87.1%. The sensitivity and specificity of the Neuropad test for DSPN was 62.6% and 68% respectively. Its NPV was 84.6%. Conclusions: Both the Neuropad and VibraTip tools show considerable diagnostic power for DSPN in South Asians. However, further studies regarding the cost‑effectiveness of these tools in clinical practice are needed. Background: Successful insulin pump therapy is influenced by patients’ adherence to self‑care behaviors. Local data about the practices of patients using insulin pumps are limited. The objective was to examine insulin pump‑related knowledge and