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Acromegaly comorbidity screening — SCE Endocrinology MCQ

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HardPituitaryAcromegaly comorbidity screeningSCE Endocrinology

A person with severe non-proliferative diabetic retinopathy is about to start treatment expected to reduce HbA1c rapidly from 108 mmol/mol. What should the diabetes team do before treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Notify ophthalmology for assessment before and after intensification

Rapid, substantial HbA1c reduction can cause early worsening of diabetic retinopathy even though sustained glucose improvement is beneficial long term. NICE advises notifying the ophthalmologist so the eyes are assessed before intensification and monitored afterwards; treatment is coordinated, not simply withheld.

Reference: NICE NG242 recommendations for proliferative diabetic retinopathy (Published 13 August 2024): https://www.nice.org.uk/guidance/ng242/chapter/Recommendations; NICE NG242 rationale for rapid HbA1c reduction and retinopathy monitoring (Published 13 August 2024): https://www.nice.org.uk/guidance/ng242/chapter/Rationale-and-impact