Hypogonadism is a clinical syndrome complex which consists of symptoms with or without signs and biochemical evidence of testosterone deficiency. The symptoms of testosterone deficiency are non-specific which can make the diagnosis difficult. Symptoms which are most commonly associated with testosterone deficiency are reduced or loss of libido, absent morning erections and erectile dysfunction.1 Other common symptoms include tiredness, fatigue, impaired physical endurance, loss of vitality, lack of motivation and mood disturbance. Erectile dysfunction Erectile dysfunction (ED) is a common complication in diabetic men with some reports finding up to 70% have the condition. The pathogenesis of ED in diabetic men is multi-factorial and can be due to a combination of these which include vasculopathy, neuropathy, psychological issues and testosterone deficiency. The presence of hypertension, smoking and higher waist circumference are associated with ED in diabetic men.2 Lower testosterone positively correlates with worsening IIEF (International Index of Erectile Function) in diabetic men. 2 Not all diabetic men with ED have testosterone deficiency but evidence shows that it is present in a significant number. NICE guidelines recommendation is to ‘review the issue of erectile dysfunction annually’.3 The European Association of Urology (EAU) guidelines on ED state that measurement of testosterone is a minimum requirement in the diagnostic evaluation. 4 Penile Doppler ultrasound has shown that basal systolic velocity and dynamic peak velocity after administration of a phosphodiesterase type 5 (PDE-5) inhibitor are significantly reduced in hypogonadal diabetic men when compared to eugonadal men with diabetes.5 Failure to respond to sildenafil is associated with low testosterone in diabetes. 6 Animal work has found that castration leads to reduction in vascular smooth muscle content in the corpus cavernosum, reduced elastic fibres and increased collagen in the tunica albuginea, fat deposition between the tunica and corpus cavernosum and reduced nerve sheath thickness in the cavernosal nerve.7 Prevalence of hypogonadism
{"title":"Every obese male with type 2 diabetes should be screened for hypogonadism","authors":"T. Jones, R. Quinton, A. Ullah","doi":"10.1002/PDI.1544","DOIUrl":"https://doi.org/10.1002/PDI.1544","url":null,"abstract":"Hypogonadism is a clinical syndrome complex which consists of symptoms with or without signs and biochemical evidence of testosterone deficiency. The symptoms of testosterone deficiency are non-specific which can make the diagnosis difficult. Symptoms which are most commonly associated with testosterone deficiency are reduced or loss of libido, absent morning erections and erectile dysfunction.1 Other common symptoms include tiredness, fatigue, impaired physical endurance, loss of vitality, lack of motivation and mood disturbance. Erectile dysfunction Erectile dysfunction (ED) is a common complication in diabetic men with some reports finding up to 70% have the condition. The pathogenesis of ED in diabetic men is multi-factorial and can be due to a combination of these which include vasculopathy, neuropathy, psychological issues and testosterone deficiency. The presence of hypertension, smoking and higher waist circumference are associated with ED in diabetic men.2 Lower testosterone positively correlates with worsening IIEF (International Index of Erectile Function) in diabetic men. 2 Not all diabetic men with ED have testosterone deficiency but evidence shows that it is present in a significant number. NICE guidelines recommendation is to ‘review the issue of erectile dysfunction annually’.3 The European Association of Urology (EAU) guidelines on ED state that measurement of testosterone is a minimum requirement in the diagnostic evaluation. 4 Penile Doppler ultrasound has shown that basal systolic velocity and dynamic peak velocity after administration of a phosphodiesterase type 5 (PDE-5) inhibitor are significantly reduced in hypogonadal diabetic men when compared to eugonadal men with diabetes.5 Failure to respond to sildenafil is associated with low testosterone in diabetes. 6 Animal work has found that castration leads to reduction in vascular smooth muscle content in the corpus cavernosum, reduced elastic fibres and increased collagen in the tunica albuginea, fat deposition between the tunica and corpus cavernosum and reduced nerve sheath thickness in the cavernosal nerve.7 Prevalence of hypogonadism","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"78 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ABCD position statement on diabetes and end of life care","authors":"S. Rowles, A. Kilvert, A. Sinclair","doi":"10.1002/PDI.1547","DOIUrl":"https://doi.org/10.1002/PDI.1547","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"66 1","pages":"26-27"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High risk at high altitude: all the action, none of the content","authors":"J. Fosbury","doi":"10.1002/PDI.1542","DOIUrl":"https://doi.org/10.1002/PDI.1542","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"32 2","pages":"12-12"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Variation in practice: a useful measure or not? Looking at amputations and diabetes care","authors":"G. Leese, S. Wild, M. Edmonds","doi":"10.1002/PDI.1539","DOIUrl":"https://doi.org/10.1002/PDI.1539","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"12 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do current IDF predictions underestimate the true and future burden of diabetes","authors":"G. Thomson","doi":"10.1002/PDI.1538","DOIUrl":"https://doi.org/10.1002/PDI.1538","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"53 5","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preparing for the Specialty Certificate Examination","authors":"N. Goenka, E. Wilmot, K. Shaw","doi":"10.1002/PDI.1540","DOIUrl":"https://doi.org/10.1002/PDI.1540","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"32 4","pages":"9-9"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Autoimmune polyglandular syndrome: a diagnosis not to miss","authors":"R. Poole","doi":"10.1002/PDI.1543","DOIUrl":"https://doi.org/10.1002/PDI.1543","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"71 6","pages":"13-13"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Type II polyglandular autoimmune syndrome: an unusual presentation","authors":"S. Phillips, M. Butt, A. Robinson","doi":"10.1002/PDI.1552","DOIUrl":"https://doi.org/10.1002/PDI.1552","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"69 1","pages":"41-42"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
occurred after a two-hour cessation of the IV dextrose. The dextrose infusion was successfully stopped 108 hours after the overdose, with a total of 1.34kg of dextrose (equivalent to 26L of 5% dextrose) administered. Excision of the injection site was considered, but the patient’s CBG was maintained with IV glucose and diet alone. Potassium was measured on admission and regularly after this, and was within normal range on each occasion. Random cortisol level during the admission was within normal range. The patient was reviewed by the psychiatry team, whilst an inpatient; the team deemed him safe for discharge with counselling as an outpatient.
{"title":"Massive intentional insulin overdose","authors":"H. Barton, P. Hendy, A. Evans","doi":"10.1002/PDI.1546","DOIUrl":"https://doi.org/10.1002/PDI.1546","url":null,"abstract":"occurred after a two-hour cessation of the IV dextrose. The dextrose infusion was successfully stopped 108 hours after the overdose, with a total of 1.34kg of dextrose (equivalent to 26L of 5% dextrose) administered. Excision of the injection site was considered, but the patient’s CBG was maintained with IV glucose and diet alone. Potassium was measured on admission and regularly after this, and was within normal range on each occasion. Random cortisol level during the admission was within normal range. The patient was reviewed by the psychiatry team, whilst an inpatient; the team deemed him safe for discharge with counselling as an outpatient.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"11 5","pages":"24-24"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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