The Endocrine Club

The Endocrine Club General endocrinology and diabetes practical points
Chairman/admin :
Abdulqawi Almansari MBBS FACP FACE

Chairman Abdulqawi Almansari MD FACP FACE
Consultant endocrinologist
Myclinic alsafa Jeddah
American board of Endocrinology Diabetes and Metabolism2000
American Board internal Medicine 1998

04/02/2026


When diabetic patient should check his blood glucose ?
In a patient taking Basal insulin and tablets other than SU the most important test is before iftar to determine the next day dose
FBG 100-140 mg/dL is generally acceptable for fasting individuals.

04/02/2026

The use of AMIODARONE in a dose of 200-600 mg/day exceeds the recommended daily amount of iodine (150 µg) by 35-140 times.
Amiodarone can cause hypothyroidism (AIH) or thyrotoxicosis (AIT)
Nat Rev Endocrinol. 2010;6(1):34–41. 10.1038

04/02/2026

The risk of hypoglycemia in increases by
-Early suhur
-Increase activity during the day like umra or shopping

04/02/2026

Fine-needle aspiration biopsy is NOT recommended for subcentimeter thyroid nodules unless associated with symptoms, pathologic lymphadenopathy, extrathyroidal extension, history of childhood radiation exposure, or familial thyroid cancer syndrome.
MKSAP 19

03/02/2026

Obesity is characterized by a reduction in serum total testosterone concentration but a normal serum free testosterone concentration due to decreased SHBG

03/02/2026

FNA indication should be based on the following size cut-offs:
EU-TIRADS 5: >10 mm
EU-TIRADS 4: >15 mm
EU-TIRADS 3: >20 mm
2023 European Thyroid association

03/02/2026

Patients with type 2 diabetes who are not using insulin or sulfonylureas are not at risk of hypoglycemia.
Therefore, fasting during is recommended and beneficial for this group.

03/02/2026

Management in
Individuals on 3 or more drug, especially on both insulin and SU should be considered at an increased risk of hypoglycaemia
25-50% reduction in the dose of insulin is advised.
IDF DAR 2021

03/02/2026

LDL cholesterol still high though patient is on high intensity statin
Check compliance

03/02/2026

Basal insulin ( peakless) made easier. With less hypoglycemia hyperglycemia and DKA risk

02/02/2026

Patients who had DKA during the delivery hospitalization had a much higher risk of nontransfusion severe maternal morbidity compared with patients with diabetes without DKA (21 versus 2 percent)
Obstet Gynecol. 2024;144(5):579.

02/02/2026

Timing During
Thyroxine should be taken at least two hours after the last meal to ensure optimal absorption. It is best to wait at least one hour after taking thyroxine before eating again. A recommended timing during Ramadan is to take it one hour before Suhoor.

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