ABSTRACT CATEGORIES1 Adrenal Disorders82 Diabetes/Prediabetes/Hypoglycemia181 Lipid/CV Health187 Obesity/Nutrition

2019 AACE ANNUAL SCIENTIFIC & CLINICAL CONGRESS ABSTRACTS

A P R I L 2 0 1 9 V O L U M E 2 5 S U P P L E M E N T 1

CLINICAL AND INVESTIGATIVE ENDOCRINOLOGY AND DIABETES

OFFICIAL JOURNAL OFTHE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS ANDTHE AMERICAN COLLEGE OF ENDOCRINOLOGY • WWW.AACE.COM

195 Other 219 Pituitary Disorders/Neuroendocrinology 263 Reproductive Endocrinology 273 Thyroid

Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Diabetes/Prediabetes/Hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82

Lipid/CV Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181

Obesity/Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187

Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195

Pituitary Disorders/Neuroendocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219

Reproductive Endocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263

Thyroid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273

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ABSTRACTS

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ABSTRACTS – Diabetes/Prediabetes/Hypoglycemia

from 30-60 years old. Most 71.4 % (n=71) have less than 10 years of known diabetes. Patients had been on the drug a median of 14 months; median A1c before treatment was 7.23%,with an average delta of -0.48% after use of the drug. The median of weight before use was 86.5kg with a delta of +0.45 Kg, with a range from +10.4 kg to -13.1 kg. Urogenital complications were found in 9.5% of treated patients with 8 cases of vulvovaginitis and 2 cases of balanitis. No DKA, hypoglycemia, acute renal failure, UTI or dehydration were found.Discussion: The change in A1c was as expected 0.4-1.1% near the lower limit specially since most patients were already near glycemic objectives; the failure to lose the weight that is usually seen with this drugs is probable due to the sample size and it’s heterogeneous nature.Conclusion: This small study showed that it is safe to use this new class of drugs in this population even in those who have good glycemic control and that bigger more complete real world studies are needed for this class in our local population.

Abstract #265

CLINICAL CHARACTERISTIC OF 31 PATIENTS DIAGNOSED WITH LATENT AUTOIMMUNE DIABETES IN ADULTS (LADA) IN A MULTI-CENTRIC STUDY IN MEXICO

Raquel Faradji, MD1, Carmen Castillo-Galindo, MD2, Natalia De la Garza-Hernandez, MD3, Sigfrido MIracle-Lopez, MD, MSc, FACE, FACP4, Claudia Ramirez-Renteria, Endocrinologist5, Alejandro Romero, Endocrinologist6, Divany Montes-Valdespino, Nurse Technician, Diabetes Educator1, Maricela Vidrio-Velazquez, Master7, Aurora Rebolledo-Ramirez8, Paloma Almeda-Valdes, MD, PhD9

1. CLINICA ENDI, 2. Clinica Endi/Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 3. CEMEDIN, 4. Hospital Angeles de las Lomas, 5. UIM Endocrinologia Experimental CMN Siglo XXI IMSS, 6. Hospital Angeles Culiacan, Mexico, 7. hospital General Regional 110 IMSS, 8. Centro Nacional para la Prevención yControl del VIH y el SIDA, 9. Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Objective: Latent autoimmune diabetes in adults (LADA), is a heterogeneous disease characterized by insulin independence for >6 months after diagnosis and the presence of islet cell autoantibodies. Information regarding LADA epidemiology, patient’s diagnosis, clinical characteristics

and follow-up in Mexico is lacking. An online-system, RENACED Diabetes Tipo 1 (DT1), registers longitudinal information of Type 1 Diabetes (T1D) and LADA patients in Mexico.Methods: Descriptive analysis of 31 patients diagnosed with LADA (from 7 different Mexican States) registered in RENACED DT1 as of 10/23/2018.Results: Sixty-four percent of patients were diagnosed in the last 10 years, 51% women and 49% men. Average diagnosis age was 37 years old (yo). Mean HbA1c and BMI at diagnosis was 9.2% and 24 kg/m2, respectively. Regarding auto-antibody positivity, 61% were positive for GAD65, 9.7% insulin, 6.5% islet, 6.45% IA2, 13% ZnT8 and 19% for ≥2 auto-antibodies. At diagnosis, 22.5% were hospitalized and 9.7% presented with diabetic ketoacidosis (DKA); 54% were treated with oral agents, 19% with insulin and 9.7% with both. At the time of analysis, 30 patients remain active (a 61 yo patient died of hepatic carcinoma). Mean age and diabetes duration are 46 yo, and 8 years, respectively. Mean HbA1c and BMI are 8 ± 2% and 24 kg/m2, respectively. Initiation of insulin occurred at ≥1 year from diagnosis in 45% of patients. Mean time from diagnosis to insulin use was 687 days ( 0-2191). Three patients remain off insulin (for 314, 565 and 3144 days). Of the 87% of patients who are on insulin, 12.9% are treated with an insulin pump, 61% are on MDI, 9.7% on basal insulin and 3.2% on a co-formulation; 58% have used metformin, 29% DPP4-inhibitors and 16% sulphonylureas. DKA post diagnosis has occurred in 3 patients, and severe hypoglycemia in 2. One patient has diabetic retinopathy and 3 patients have neuropathy. Hypothyroidism occurs in 22.5% of patients, and 16% are positive for anti-thyroperoxidase antibodies. Dyslipidemia occurs in 22.5% and 2 patients have hypertension.Discussion: LADA shares clinical and metabolic characteristics with T1 and T2 diabetes and there is still a high prevalence of misdiagnosed cases. To help understand the presentation of this condition in Mexico, the registration and follow-up of more LADA cases is needed. Interestingly, in 45% of the patients insulin administration was started at ≥1 year of diagnosis.Conclusion: This is the first report regarding LADA patients in Mexico. Recognizing this condition is important to avoid delay in optimal treatment. Further analysis should study those characteristics associated with delayed insulin use and optimal metabolic control.