THE INDISPENSABLE RESOURCE FOR
CLINICAL EXCELLENCE
OXFORD HANDBOOK OF
ENDOCRINOLOGY
AND DIABETES
EDITED BY Katharine Owen | Helen Turner
John Wass
A unique pocket reference, ideal for the specialist
trainee, foundation doctors, and consultants
Provides practical guidance on investigations and
management of both common and rare conditions
in a concise format
Features new chapters transition in endocrinology and
diabetes, practical nursing considerations, and genetics
Contains appendices on COVID - 19 and
medicolegal considerations
,OXFORD HANDBOOK OF
Endocrinology and Diabetes
,Published and forthcoming Oxford Medical Handbooks
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,OXFORD HANDBOOK OF
Endocrinology and Diabetes
FOURTH EDITION
EDITED BY
Katharine Owen
Associate Professor of Diabetes and Honorary Consultant Physician,
Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe
Department of Medicine, University of Oxford, Oxford, UK
Helen Turner
Consultant in Endocrinology, Oxford Centre for Diabetes, Endocrinology
and Metabolism, Oxford University Hospitals NHS Trust, Churchill
Hospital, Oxford, UK
John Wass
Professor of Endocrinology, University of Oxford, Oxford, UK
,Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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First Edition published in 2002
Second Edition published in 2009
Third Edition published in 2014
Fourth Edition published in 2022
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ISBN 978–0–19–885189–9
eISBN 978–0–19–259438–9
DOI: 10.1093/med/9780198851899.001.0001
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, Foreword
For someone who loves endocrinology, it is a great pleasure to read and use
the Oxford Handbook in day-to-day clinical practice. The editors have tried
to make an accessible, succinct, comprehensive, and up-to-date text, laid
out to be readable and readily assimilable. It aims to cover all endocrine and
diabetes occasions, common and less common, dealing with the background
science, guidelines on investigation, and advice on treatment. It is written
by internationally highly acknowledged experts for trainees, consultants
who may have the occasional memory lapse, nurses, and those in primary
care with whom we are increasingly sharing joined-up management.
This Handbook is special, as it presents a global appreciation of
endocrinology, describing clinical pathways and medications which are
primarily based on, and used in, the European experience, while where
possible also medical therapy in countries with limited medical resources is
addressed.
It is remarkable how much has changed since the first publication in
2002, as well as since the third edition in 2014. New genetic and metabolic
mechanisms of disease, new and improved imaging techniques, new drugs,
and complications thereof, and thus new management, are all covered in
this new edition. In doing this, the editors have sought to include many of
the recent guidelines which summarize new evidence in the significantly
updated references that are given.
In the new edition, topic sections have been included on transitional
endocrinology and diabetes, and newly recognized conditions such as IgG4
disease. The sections on fertility and transgender issues have been
extensively updated to encompass new developments. There is also a new
chapter on medicolegal issues engendered by some of the complaints within
our specialty. This includes governance issues such as consent, duty of
confidentiality, and safe driving advice. The nursing section has also been
expanded to include more practical advice about travel, fasting, updated
glucocorticoid advice, and psychological challenges which face our
,patients. There is also a discussion on nurse-led clinics which are an
important newer addition to our specialty and which can not only increase
the quality of care given to our patients, but also increase throughput, in a
specialty where outpatient numbers are going up over and above those in
general medicine.
The diabetes section has also been carefully reviewed to encompass
changes in technology (continuous glucose monitoring/glucose
monitoring/closed-loop), new treatments, including immunotherapy for
type 1 diabetes and an update on new treatments in type 2 diabetes, and
their link to cardiovascular outcomes.
The section on genetics has been updated with guidance on screening, as
well as a practical overview of genetic screening for the non-geneticist.
In both the endocrinology and diabetes sections, advice has been
included on difficult clinical decisions, tricky issues, and clinical pearls in
the relevant sections. Lastly, a publication from 2021 would not be
complete without a COVID-19 section, which has been added in the form
of website links.
The Editors have to be congratulated in providing a beautiful and most
readable new edition of this now classic, internationally highly rated
handbook. This ‘Herculean’ task has resulted in a handbook that presents a
science and knowledge base for this specialty which greatly helps to
maintain high standards of care of our patients.
Steven WJ Lamberts
Erasmus University Rotterdam
Professor of Medicine
Past President of the European Society for Endocrinology
, Preface
Endocrinology and diabetes remain among the most fascinating of
specialties with a very broad range of causation, presentation, and
management. We have the ability in our specialty to radically change the
quality and quantity of life, often within a few days of starting treatment.
Editing the Oxford Handbook has been huge fun and challenging. We
have tried to make an accessible, succinct, comprehensive, and up-to-date
text, laid out to be readable and readily assimilable. It aims to cover all
endocrine and diabetes occasions, common and less common, dealing with
the background science, guidelines on investigation, and advice on
treatment. It is written by experts for trainees, consultants who may have
the occasional memory lapse, nurses, and those in primary care with whom
we are increasingly sharing joined-up management.
It is remarkable how much has changed since the last edition. New
genetic and metabolic mechanisms of disease, new and improved imaging
techniques, new drugs, and complications thereof, and thus new
management, are all covered in this edition. In doing this, we have sought
to include many of the recent guidelines which summarize new evidence in
the significantly updated references that are given.
In the new topics, we have included sections on transitional
endocrinology and diabetes, newly recognized conditions such as IgG4
disease. The sections on fertility and transgender issues have been
extensively updated to encompass new developments. There is also a new
chapter on medicolegal issues engendered by some of the complaints within
our specialty. This includes governance issues such as consent, duty of
confidentiality, and safe driving advice. The nursing section has also been
expanded to include more practical advice about travel, fasting, updated
glucocorticoid advice, and psychological challenges which face our
patients. There is also a discussion on nurse-led clinics which are an
important newer edition to our specialty and which not only can increase
the quality of care given to our patients, but also can increase throughput, in
