Clinical Endocrinology and Diabetes at a Glance

Recognising a need to promote and enhance teaching of clinical endocrinology and diabetes in UK medical schools, the Society for Endocrinology, in collaboration with Diabetes UK and the Association of British Clinical Diabetologists, created a national curriculum that sets out the minimum recommended standards for undergraduate medical education.

Clinical Endocrinology and Diabetes at a Glance corresponds to the curriculum and covers all important areas of diabetes and endocrinology in a clinically relevant and concise manner, with complementary figures to ensure principles are explained clearly. It highlights key practical skills for undergraduates in line with the GMC recommendations that medical graduates should be well prepared for their Foundation posts. There is also emphasis on the importance of multidisciplinary teams in the management of endocrine diseases and diabetes. These include sections on structured education programmes, psychosocial aspects, and patient self-management and monitoring.

Clinical Endocrinology and Diabetes at a Glance will serve as a valuable resource for medical students and junior doctors treating patients with these conditions.

Dr Aled Rees, Consultant Endocrinologist, School of Medicine, Cardiff University

Dr Miles Levy, Consultant Endocrinologist, University Hospitals of Leicester

Dr Andrew Lansdown, Consultant Endocrinologist, University Hospital of Wales, Cardiff

Preface vii

Part 1 Introduction 1

1 Introduction to endocrinology 2

Part 2 Disorders of the hypothalamic–pituitary axis 5

2 The hypothalamic–pituitary axis and its assessment 6

3 Acromegaly 8

4 Cushing’s syndrome 10

5 Hypopituitarism and non-functioning pituitary adenomas 12

6 Prolactinoma and hyperprolactinaemia 14

Part 3 Disorders of thirst and fluid balance 17

7 Hypernatraemia and diabetes insipidus 18

8 Hyponatraemia and SIADH 20

Part 4 Thyroid disorders 23

9 Thyroid function 24

10 Hyperthyroidism: clinical presentation and investigation 26

11 Hyperthyroidism: management and ophthalmopathy 28

12 Hyperthyroidism: special circumstances 30

13 Hypothyroidism 32

14 Goitre, thyroid nodules and cancer 34

Part 5 isorders of calcium homeostasis 37

15 Physiology of calcium, PTH and vitamin D metabolism 38

16 Hypercalcaemia 40

17 Hypocalcaemia 42

18 Osteoporosis 44

Part 6 Disorders of the adrenal gland 47

19 Steroid physiology and biochemical assessment 48

20 Adrenal insufficiency 50

21 Adrenocortical tumours 52

22 Disorders of the adrenal medulla 54

Part 7 Disorders of the reproductive system 57

23 Physiology of the reproductive system 58

24 Growth, puberty and sexual differentiation 60

25 Menstrual disturbance 62

26 Hyperandrogenism 64

27 Menopause and HRT 66

28 Male hypogonadism 68

29 Gynaecomastia 70

30 Infertility 72

Part 8 Neuroendocrine tumours 75

31 Neuroendocrine tumours 76

32 Neuroendocrine tumours: management 78

33 Inherited endocrine tumour syndromes 80

34 Spontaneous hypoglycaemia 82

Part 9 Endocrine emergencies 85

35 Adrenal crisis 86

36 Pituitary apoplexy 88

37 Myxoedema coma 90

38 Thyroid storm 92

39 Acute hyponatraemia 94

40 Severe hypercalcaemia 96

41 Acute hypocalcaemia 98

Part 10 Diabetes mellitus 101

42 Overview 102

43 Diagnosis and monitoring 104

44 Classification 106

45 Type 1 diabetes: aetiology and clinical presentation 108

46 Type 1 diabetes: insulin and other therapies 110

47 Type 2 diabetes: aetiology and clinical presentation 112

48 Type 2 diabetes: treatment 114

49 Macrovascular complications 116

50 Microvascular complications 118

51 Diabetic foot disease 120

52 Diabetic ketoacidosis 122

53 Hyperglycaemic hyperosmolar state 124

54 Hypoglycaemia 126

55 Peri-operative management 128

56 Management of acute illness 131

57 Insulin infusions 134

58 Pregnancy and diabetes 136

59 Genetics of diabetes 138

60 The multidisciplinary team 140

61 Lipid disorders 142

62 Appetite and weight 144

63 Obesity and anorexia 146

Index 148

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