diabology Endo Endodiabology.blogspot.com

NORTHEAST NEWSLETTER

for TRAINEES, TRAINERS StR Placements

RVI Mona Abousaid ST5 Ramesh Vanka ST6/7 Su Ann Tee- ST6 (LTFT) Waqar Ahmed ST4 Yasir Ishan ST5 JCUH Muna Guma ST3 Hassan Pervez ST3 Razi Ahmed ST3/4 Northumbria Irfan Khan ST3 Rashid Razan ST3 Muhammed Chohan ST3 Gateshead Usman Javaid ST6 Darlington May Loo ST3 Durham Aziz Altayeb ST6 South Tyneside Sviatlana Zhyzhneuskaya , - until nov 10t Sunderland Owain Leng ST7 Helen Leafe ST3 (LTFT) North Tees Azmi Mohammed Mudassir Ali Research with numbers Ahmed Al-Sharefi Kerri Devine

NEEN StR representatives Owain Leng, Su Ann Tee STC trainee representative Kerri Devine, Usman Javaid Management forum Su Ann Tee, Ramesh Vanka, Mona Abouzaid CME committee Owain Leng ,Mudassir Ali, Yasir Ishan, Mona Abouzaid, Waqar Ahmed, Mudassir Ali HENE SIM steering StR Owain Leng MERIT coordinator Azmi Mohammed NEEN Website Trainee Editor Owain Leng

Chief editor: Owain Leng o.leng@nhs.net

Consultant editor: Arut Vijayaraman

Honorary editors: Shaz Wahid, Petros Perros

StR Leadership Roles

Programme Director Srikanth Mada srikanth.mada@nhs.net Education CME Leads Ashwin Joshi Ashwin.Joshi@chsft.nhs.uk Andy James andy.james@newcastle.ac.uk Quality Management Lead Peter Carey Peter.Carey2@chs.northy.nhs.uk Consultant Memebers Richard Quinton, Richard.Quinton@nuth.nhs.uk Jean MacLeod, Jean.Macleod@nth.nhs.uk Asgar Madathil asgar.madathil@northumbria-healthcare.nhs.uk Salman Razvi salman.razvi@ghnt.nhs.uk Paul Peter paul.peter@cddah.nhs.uk Sath Nag sath.nag@stees.nhs.uk Stuart Little stuart.little@nuth.nhs.uk StR Representatives- Kerri Devine, Usman Javaid

TRAINING COMMITTTEE

to another issue of our ENDODIABOLOGY newsletter. It has been a fantastic few

months for the region, from our successes in specialist trainees recruitment and

fantastic national trainee survey satisfaction, to exciting events such as the

National Taster Day in Diabetes and Endocrinology (hosted in Newcastle) and a

diverse range of publications and personal achievements by colleagues across the

region. As ever, I am indebted to everyone for their suggestions and submissions

for inclusion in this issue, and I thank you for your continued support.

Owain

www.endocrinenortheast.co.uk

Keep up with the latest news and

developments—follow us on Twitter and

check in with the regional website

@EndocrineNE

Sponsorship: It’s been agreed with the STC trainees representatives that going forward the Kelly– Young award (presented to junior most trainee on the rotation who successfully passes their SCE) will be supported through CME funding. To avoid disadvantaging the trainees who missed out on the prize money over last 2 years, we have agreed to honour the original commitment. If there is more than one trainee suitable for the prize then the award and prize money will be shared.

The CME committee will also continue to fund NE endocrine network website, and offer funding (T&C apply) toward trainees who are keen to undertake training in Human Factors, Simulation faculty, or Medical education. Details of the funding support will be shared with trainee via the STC trainee representatives.

Recruitment: National second round interviews for speciality registrars happened on September 23rd at Bristol. Myself and Dr Arut were on the interview panel. We went out to recruit 2 posts. 58 candidates were interviewed for potential 20 posts nationally. In general, the calibre of the attending candidates was quite good and appointable. I am pleased to say that Dr Hady Gad and Dr Pan Sint have been appointed to our region and will be posted when I get joining date.

Recruitment 2020: We are due to interview on March 31th 2020 for Round 1 of academic year 2020-2021. Interviews will be held at St James Park Newcastle and we are leading the process for Northern cluster. Thank you for all those who helped this year. I am keen we continue to support the process and hoping to attract best candidates after successful national speciality taster day held on September 27th 2019. Please let me have your availability to be on the interview panel.

Message to trainees: There has been some confusion about ST7 ARCP requirements. Please note that PYA targets are in addition to the regular ST7 requirements as specified in ARCP decision tool. You will need valid ALS till the last day of rotation.

GMC NTS 2019: It is great pleasure to share with all the annual GMC NTS 2019. I am pleased to let everyone

know that the D & E programme has been ranked 1st nationally in 4/18 domains, 2nd in 7/18 and 3rd in 4/18.

Our programme is the only one with no pink or red outliers and with 2 green outliers. We consistently

demonstrated delivery of high quality training programme and I thank all the trainers for their support and

trainees for continues engagement with all aspects of training.

An Update from the TPD _____________________________

Srinkanth Mada

News from South Tees

The consultant team at South Tees continues to develop, benefiting from the additions of Dr Suhel Ashraff who joined as in December 2018 and

also Dr Mavin Macauley and Dr Angeles Maillo Nieto who joined us since early 2019 and both have recently been appointed to substantive

posts. Professor Stephen Jones continues to provide clinical service along with providing leadership support to our team while taking a big role

as the Head of The School of Medical Education, Newcastle. Professor Bilous continues with a teaching role at the undergraduate education

department and has taken up a role as censor for the Royal College of Physicians London.

The Diabetes Foot team has strengthened to develop an excellent diabetes foot care service with a well

-knit MDT with podiatrists, plaster technicians, dedicated vascular and orthopaedic surgeons. The team

has succeeded in getting a digital wound mapping system (Silhouette) for the service. The foot team

continues to strive to develop the services to be the best in the world.

We have a very strong tier 3 specialist weight management service, run by a dedicated multi-disciplinary

team with 5 clinics a week. This provides a strong medical support to patients with obesity. It flows into

the tier 4 Bariatric surgery services. The Bariatric surgery clinics are arranged to happen in the diabetes

centre which gives an excellent opportunity for trainees to learn all medical and surgical aspects of

obesity management. The registrars share the office with Bariatric specialist nurses which gives a unique

opportunity to learn actively from the Bariatric team. Recently, the Training Programme Director from

Northern Ireland has arranged to send their diabetes specialist trainees to have weight management

training at James Cook University Hospitals. We are proud about the development of this excellent tier 3

and tier 4 obesity services at JCUH and Friarage.

The Friarage services have grown further with excellent work from Dr Naveen Siddaramaiah and Dr Nick Quinn.

The Diabetes specialist nurse team has been strengthened further with recent appointments of 4 more full time Specialist nurses. The Advanced

Technology and Therapeutic Services have developed further with 3 consultants running the clinics with a strong MDT. The young person

diabetes clinics are specialised with extra care into the community. We run a separate DAFNE clinic to see patients with type 1 diabetes who are

DAFNE graduates. The pump clinic serves around 600 patients on insulin pumps, 100 patients on real time CGMS, and 26 patients on new hybrid

closed loop pumps. It’s a fairly large service with multiple clinics including evening clinics. This gives the opportunity for the trainees to improve

their skills on technology. We closely work with the professors of Artificial Intelligence at Teesside

university to develop systems to help our patients.

The Pituitary services are quite streamlined with 2 pituitary surgeons with skills and expertise on

endoscopic Pituitary surgery. A monthly Joint Pituitary Clinic and a monthly Pituitary MDT meeting help to

standardise the high quality care and provides opportunity for the trainees with a structured training

scheme.

The team meets regularly for an Endocrine MDT lead and run by our Registrars

The other new services include, Lipid clinic, family cascading clinics for FH, Thyroid eye clinic with a newly

recruited Oculo plastic surgeon and Dr Ashraff, Joint Thyroid clinic with Dr Ashwell and Mr El- Saify (our

endocrine surgeon), a metabolic bone clinic with a rheumatologist and endocrinologist, strong thyroid

cancer MDT with Dr Nag as chair, antenatal services with education program for patients with gestational

diabetes , Porphyria service, Transitional Diabetes and Endocrine services, Diabetes Eye services and an

innovative Type 2 diabetes remission service

We have a well-staffed Clinical Trials Unit pursuing portfolio studies as well as constantly working towards creating self-developed projects. Our

future plans are aspirational to develop our academic portfolio over the coming years.

We, as a team, wish to provide a high standard training for all our trainees in all training domains , covering all aspects of the curriculum. With

support from other trainers in the region, the Diabetes, Endocrine services in our Unit are continuously developing to provide the highest

standards of care for people in the South of Our Region and equally high standards of Training. We believe, high standards of training equates to

high quality patient care.

“We believe high standards

of training equates to high

quality patient care”

Expanding

Consultant

Team

Many thanks to Dr Arut for his illuminating update on the exciting developments at South Tees. We would be very keen to publish

updates from around the region, so if you would like to share updates from your Trust or Team in the next issue, get in touch!

Just email o.leng@nhs.net

Updates from across the region

Appointments

It has been a great few months for appointments in the region. A warm welcome our new ST3’s, Helen Leafe , May Loo, Muhammed Chohan, Rashid Razan, Irfan Khan, Hassan Pervez and Muna Guma Congratulations to both Mavin Macauley and Angeles Maillo-Nieto for appointments to their substantive e consultant posts at JCUH. Congratulations to Dr Vikram Lal who has been appointed to CDDFT as locum consultant, and to Sviatlana Zhyzhneuskaya for her upcoming appointment to CDDFT from Jan 2020. Congratulations to Dr Satish Artham for his

The European Thyroid Journal

has appointed Prof Simon Pearce

as their new Editor-in-Chief. It is

exciting and inspiring to see

experts from the region in

prominent international roles.

ETJ EDITOR

Diabetes UK Clinical Champion

Congratulations to Alison Heggie or her

appointment as a Clinical Champion by

Diabetes UK

“As one of our Clinical Champions,

Alison plans to improve inpatient

diabetes care by delivering targeted diabetes education

to all member of the multidisciplinary teams. The aim

of this is to provide healthcare professionals with the

knowledge and the confidence to manage diabetes on

the ward. Alison will also be focusing on inpatient

diabetes foot care for all patients living with

diabetes by developing a foot examination program.“

Leadership and Development

Awards Programme: inspiring

future leaders in

endocrinology

Congratulations to Catherine

Napier and Anna Mitchell, who have ensured the

North-East is well-represented at the Society of

Endocrinology Leadership and Development Awards. A

fantastic achievement!

An Update From Northumbria The upcoming flexi-retirement of Nick Lewis-Barned means a period of change at Northumbria. Nick will be reducing hours from November, with a plan to retire next summer. This will be a huge loss for Northumbria and to the region, particularly around his contributions to pregnancy in diabetes, and also his passion and prominent national work in patient involvement and shared decision making. Nick has been a huge support to trainees working in Northumbria, and will be greatly missed. This does mean there will also be opportunities for recruitment in the near future as replacements and possible expansion of the service at Northumbria.

NERRAG Organising Committee Update ‘It has been an absolute honour and privilege to be part of organising committee for NERRAG, the region's premier Endocrine meeting. I would like to thank Dr Shaz Wahid and co-organisers Dr’s Andy James and Tim Cheetham for their invaluable work over the years in organising NERRAG and developing it into a forum for showcasing regional Endocrinology talent. I hope we can build on the energy and enthusiasm to further develop NERRAG in the coming years with strong support from the fantastic regional Endocrine community’ Ashwin Joshi

@EndocrineNE

STC Representatives Dear colleagues, We hope you have all settled well in your new rotations, and a warm welcome to the new SpRs joining us in the region. We have a number of initiatives coming up this year that we will be contacting you about including opportunities for funding, trainer awards and more. Our main role is to represent YOUR views at meetings of the training committee, with the next being held on the 5th Dec 2019. If you want us to raise any issues at the meeting, or you have other matters you wish to discuss with us, please don't hesitate to get in touch. We are also happy to be a resource for general information e.g portfolio queries, SCE exam advice etc,so again don't hesitate to ask. Best wishes for an enjoyable and successful training year.

Kerri & Usman

Trainee Update

Congratulations to Ahmed Al-Sharefi

for his successful appointment a

Research Fellow at Imperial College

London & Hammersmith Hospital. He

will be working on the regulations of

male fertility under Dr Channa

Jayasena

RESEARCH

Kerri Devine led a passionate team in

organising and delivering a fantastic

showcase of our specialty at the National

Taster Day in Diabetes and Endocrinology,

which was held at the Centre for Life in

Newcastle on Saturday 28th September

2019. There was a great turnout, and the

passion and enthusiasm of the contributors

will hopefully have convinced more than a

few of the attendees that they are right to

pursue a career in D&E. Faculty from across

the region included Anna Mitchelll,

Catehrine Napier, Sath Nag, Arut

Vijayaraman, Steve Ball, Simon Pearce,

Salman Razvi, Azmi Mohammed, Suhel

Ashraff, Ahmed Al-sharefi, Owain Leng and

Azmi Mohammed.

Many congratulations Kerri for a very

successful event!

National Taster Day 2019

CME committee appointments

The CME committee would like to thank Usman Javaid and Ahmed Al-Sharefi for

their hard work and contributions to the delivery of the CME programme over the

last few years. The new committee appointees are Yasir Ishan, Mona Abouzaid,

Waqar Ahmed, and Mudassir Ali whom will be working to further develop the CME

programme, with a plan to develop a more strategic curricular approach.

MERIT Coordinator

Azmi Mohammed is leading the efforts to coordinate our MERIT programme, but as

he is approaching the end of his training we are looking for a passionate and

enthusiastic trainee to deputise for Azmi and in time take over this role. If you are

interested, get in touch with Azmi to discuss further.

@EndocrineNE

StR Training Dates Dates for the Diary Meetings & Courses

29th—30th October: Diabetes Professional Care,

London

11—13th November: SoE British Endocrine Society,

Brighton

15th November: British Diabetic Neuropathy

Symposium , Liverpool

28th November: Update in medicine, Newcastle

28th—29th November, YDEF retinopathy Course

7th February: BSHNI Head & Neck Imaging

Refresher Course, Newcastle

12th March: SoE Clinical Cases, London

17th March: Acute Medicine, Newcastle

18—20th March: Diabetes UK, Glasgow

21—25 March: Clinical endocrinology, Boston

20—22nd April: SoE Clinical Update, Birmingham

23 —26 May : European Congress of

Endocrinology, Prague

Speciality ARCP 2020

May 5th, 6th & 7th

G(I)M ARCP 2020:

May 13th

STC and T&T meeting:

June 2nd

STC: 14:00

T&T: 16:00

CME:

Thursday 30th Jan —Sunderland Royal

Tuesday 9th June — RVI

Research / Management day

TBC

GIM teaching (Wednesday afternoons )

6th November* 15 January 2020

11 March 2020 * 13 May 2020

8 July 2020 * 16 September 2020

* followed by an evening meeting of the Associa-

tion of North of England Physicians.

MERIT Teaching (afternoons)

Wednesday 27th November, Sunderland

- followed by Management Forum

January/early Feb 2020 UHNT

March 2020 RVI

May/June 2020 JCUH

August 2020 CDDFT

October 2020 South Tyneside

MERIT Organisation Checklist

• Prepare a programme with their local faculty

(this is usually based on local expertise)

• Agree on a specific date for the MERIT and

circulate it within a good timeframe so other

SpRs can give notice to their units (8 weeks

in advance)

• Circulate the proposed programme before-

hand to the trainees or MERIT coordinator

(at least week prior)

• Keep the attendance record and pass it on

Patient Steroid Education Event

A great event for patients and professional alike—please spread

the word amongst colleagues and patients!

,

Find a Mentor

It is so worthwhile getting advice, tips and

recommendations from people who have been

through the training programme, so try and find a senior

trainee or someone who has recently completed their

training. They can be an invaluable source of informal advice!

1

Be Observed!

It can feel a little uncomfortable, but it is highly

worthwhile to have a consultant watch your clinic

consultation and give you feedback. Useful from a WBPA

point of view, but far more useful for the advice and

suggestions to tailor your consultation style you will get.

3

Keep a Clinic Diary

A good log of your clinic experience will be essential

for ARCP and PY purposes to demonstrate the

breadth and depth of your experience. E.g.

5

Explore Opportunities for Research OOP E Early

Getting research OOPE is a fabulous opportunity, but

can require a lot of leg work on your part. I would

recommend speaking now to the trainees who are / have

done research, making contact with consultants who are

active in research ASAP for advice and to show interest, and

to begin to tailor your CV with relevant experience .

7

Observe Consultations

Take the opportunities when you can to observe

consultations—there is so much to be learnt from

experienced consultants, nurse specialists, and other

members of the MDT! It is natural to want to get on and see

patients independently, but don’t miss out on the chance to

watch, learn and borrow from the best.

2

Plan Ahead

It can take a lot of organisation to make it to those

specialty clinics and learning opportunities, so it is

essential to plan your diary and commitments in advance. So

look ahead, speak to the relevant consultants and admin staff,

and commit to attending specialty clinics early on.

Remember to keep a log of the specialty clinics you attend!

4

Document your ICU and CCU experience

Keep a summary log of cases see, and make sure you

do some reflections and WBPAs that link to the GIM

curriculum . I would suggest that as part of your ES end of

your report, you should ensure that a comment is made of

your ITYU/ CCU experience

6

Take on Leadership Roles

There are plenty of opportunities for leadership roles

locally, regionally and nationally. So do grab the

opportunities when the y arise—CME committee, NEEN

committee, RCP associate tutor, YDEF representatives … the

list is endless. Very useful experience, great for your CV, and

also invaluable networking opportunities

8

Trainee Tips—advice for the new D&E trainee Here are some of my personal suggestions for making the most of your training. But most importantly , remember to enjoy your

training—it is a fantastic experience! Owain

Clinic

no.

Clinic

Type.

Review/

New

Clinical

problem

Plan Learning

Points

Swee DS, Javaid U, Quinton R. Estrogen Replace-

ment in Young Hypogonadal Women—

Transferrable Lessons From the Literature .Related

to the Care of Young Women With Premature

Ovarian Failure and Transgender Women. Front.

Endocrinol. 2019

Al-Sharefi A, Javaid U, Perros P, Ealing J, Truran P,

Nag S, Kamaruddin S, Abouglila K, Cains F, Lewis L,

James RA. Clinical Presentation and Outcomes of

Phaeochromocytomas/Paragangliomas in Neurofi-

bromatosis Type 1. Eur Endocrinol. 2019 Aug;15

(2):95-100.

Malone SA, ….. Quinton R, et al. Defective AMH

signaling disrupts GnRH neuron development and

function and contributes to hypogonadotropic

hypogonadism. eLife. 2019 8: e47198.

Quinton R & Tomlinson J. Male hypogonadism and

ageing: rejuvenating the evidence – Guidance from

the Clinical Committee of the Society for Endocri-

nology. The Endocrinologist. 2019 , 131: 22-23.

Swee DS & Quinton R. Congenital hypogonado-

trophic hypogonadism: Minipuberty and the case

for neonatal diagnosis. Frontiers in Endocrinology.

2019, 10: 97.

Swee DS & Quinton R. Managing congenital hy-

pogonadotrophic hypogonadism: a contemporary

approach directed at optimizing fertility and long-

term outcomes in males. Therapeutic Advances in

Endocrinology & Metabolism. 2019, 10: 1-15.

Dwyer AA, Smith N & Quinton R. Psychological

aspects of congenital hypogonadotropic hy-

pogonadism. Frontiers in Endocrinology. 2019 10:

353.

Dwyer AA & Quinton R. 2019 Anatomy and physiol-

ogy of the hypothalamic-pituitary-gonadal (HPG)

axis., and Classification of hypothalamic-pituitary-

gonadal (HPG) axis endocrine disorders. In-

In: Advanced Practice in Endocrinology Nursing,

Al-Sharifi A, Quinton R & Roberts G. Preventing

hypoglycemia following treatment of hyperkalemia

in hospitalized patients. Journal of Hospital Medi-

cine. 2019 14: 284-287.

Swee DS, Spickett G & Quinton R. 2019 Many wom-

en with Turner syndrome lack protective antibod-

ies to common respiratory pathogens, Haemophi-

lus influenzae type B and Streptococcus pneu-

moniae. Clinical Endocrinology. 91: 228-230

Publications from across the Region

Owens DR, Landgraf W, Frier BM, Zhang M, Home PD, Meneghini L, Bolli GB. Commencing insulin glargine 100 U/mL therapy in people with type 2 diabetes: Determinants of achievement of HbA1c goal <7.0%. Diabetes Obes Metab 2019; 21: 321–329.

Home P. Cardiovascular outcome trials of glucose-lowering medications: an update. Diabetologia 2019; 62: 357-369. doi: 10.1007/s00125-018-4801-1

Shavadia JS, Sharma A, Gu J, Neaton J, DeLeve L, Holmes D, Home P, Eckel RH, Watkins P, Granger CB. Determination of fasiglifam-induced liver tox-icity: Insights from the data monitoring committee of the fasiglifam clinical trials program. Clin Trials 2019; 16: 253-262. doi: 10.1177/1740774519836766

Klonoff DC, Aron D, Cohen RM, Home P, John WG, Little RR, Nathan D, Sacks DB. The need for accura-cy in hemoglobin A1c proficiency testing: why the proposed CLIA rule of 2019 is a step backward. J Diabetes Sci Technol 2019: 13: 424-427. doi: 10.1177/1932296819841699

Home PD. Controversies for glucose control targets in type 2 diabetes: exposing the common ground. Diabetes Care 2019; 42: 1615-1623. doi: 10.2337/dci19-0002.

Home P, Itzhak B. Is insulin therapy safe? Am J Therapeutics 2019: Final acceptance 05 August 2019

Pearce SH, ..., Perros P, Razvi , et al. Antigen-Specific Immunotherapy with Thyrotropin Recep-tor Peptides in Graves' Hyperthyroidism: A Phase I Study. Thyroid. 2019 Jul;29(7):1003-1011.

Razvi S, Peeters R Pearce SH. Thyroid Hormone Therapy for Subclinical Hypothyroidism. JAMA. 2019 Feb 26;321(8):804.

Jonklaas J Razvi S. Lancet Reference intervals in the diagnosis of thyroid dysfunction: treating patients not numbers. J Diabetes Endocrinol. 2019 Jun;7(6):473-483.

Leng O, Razvi S. Thyroid Res. 2019 . Hypothyroid-ism in the older population. Thyroid Res. 2019

Razvi S, Hostalek U. Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypo-thyroidism on replacement thyroid hormone ther-apy: a review. Curr Med Res Opin. 2019 (7):1215-1220.

Taylor PN, Razvi S, Muller I, Wass J, Dayan CM, Chatterjee K5, Boelaert K. Liothyronine cost and prescriptions in England. Lancet Diabetes Endo-crinol. 2019 Jan;7(1):11-12.

Razvi S, Korevaar TI, Taylor P. Trends, Determinants, and Associations of Treated Hypothyroidism in the United Kingdom, 2005-2014. Thyroid 1019. 29(2):174-182.

@EndocrineNE

Abouzaid M, Al-Sharefi A, Artham S, Masri I, Kotagi-ri A, Joshi A. A rare ophthalmic condition associat-ed with primary hyperparathyroidism (PHPT): sclerochoroidal calcification (SC). Endocrinol Dia-betes Metab Case Rep. 2019 Aug 3;2019(1).

Al-Sharefi A, Glenister E, Morris M, Quinton R. Is calcium supplementation always needed in pa-tients with hypoparathyroidism? Clin Endocrinol (Oxf). 2019 Jun;90(6):775-780.

Flatt AJ, Little SA, …. Shaw JAM et al.. Predictors of Recurrent Severe Hypoglycemia in Adults With Type 1 Diabetes and Impaired Awareness of Hypo-glycemia During the HypoCOMPaSS Study. Diabe-tes Care. 2019 Sep 4.

Speight J, Holmes-Truscott E, Singh H, Little S, Shaw JAM. Diabetes Technol Ther. 2019 Oct 9. Develop-ment and Psychometric Validation of the Novel Glucose Monitoring Experiences Questionnaire Among Adults with Type 1 Diabetes.

Al-Bayati A, Brown A, Walker M. Impaired enhance-ment of insulin action in cultured skeletal muscle cells from insulin resistant type 2 diabetic patients in response to contraction using electrical pulse stimulation. J Diabetes Complications. 2019 Aug 1:107412.

Taylor R. Corrigendum: Calorie restriction for long-term remission of type 2 diabetes Clin Med (Lond). 2019 Mar;19(2):192.

Lean MEJ, … Taylor R et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lan-cet Diabetes Endocrinol. 2019 May;7(5):344-355.

Ali M, Pervez M, Muhammed J, Gzuit T, Kamaruddin S, Partha P, Tarigopula Sayer J, Peter P. Gitelman Syndrome with resistant symptomatic hypokalae-mia persisting post miscarriage. SAM. https://www.acutemedicine.org.uk/wp-content/uploads/2019/05/CR-04.pdf

Houghton D, ... Taylor R et al. The degree of he-patic steatosis associates with impaired cardiac and autonomic function. J Hepatol. 2019 Jun;70(6):1203-1213.

Bano A, Gan E, Addison C, Narayanan K, Weaver JU, Tsatlidis V, Razvi S. Age May Influence the Impact of TRAbs on Thyroid Function and Relapse-Risk in Patients With Graves Disease. J Clin Endocrinol Metab. 2019 104(5):1378-1385.

Kyriacou A, Kyriacou A, Makris KC, Syed AA, Perros

P. Weight gain following treatment of hyperthy-

roidism-A forgotten tale. Clin Obes. 2019 Oct;9

(5):e12328

Many thanks for your help and support in putting together this edition of Endodiabology!

Please do keep the details of any news, announcements, letters, or publications coming.

Simply email: o.leng@nhs.net

The next edition of ENDODIABOLOGY will be due February 2020