Endocrine Abstracts

Background: Pump has become increasingly more popular amongst clinicians in the management of children with type 1 diabetes (T1DM). It improves the metabolic control in most patients though it may have a negative effect on growth. Eighty children with T1DM at our institute are currently treated with continuous subcutaneous insulin infusion (CSII) to achieve optimum glycaemic control.Aims: To identify the effect of CSII on hospital admissions, hypoglycaem...

Background: ISPAD clinical practice consensus guidelines 2006–7 defined DKA as: blood glucose >11 mmol/l in presence of venous pH <7.3 or bicarbonate <15 mmol/l, ketonaemia and ketonuria. The level of ketonaemia or ketonuria was not specified. Blood ketones can be checked easily using a blood ketone meter (Optium). In our institution we have been measuring them on all children admitted with suspected DKA over the last 5 years. A blood ketone level of >3.0 ...

Introduction: Lipoatrophy (LA) was common before the advent of recombinant human insulin. More recently, insulin analogues have been widely introduced into paediatric practice. In the literature, LA has only been reported so far with insulin Lispro (Lily, USA) (n=4 adult patients and 3 children) and insulin Glargine (Sanofi-Aventis, France) (n=1 adult patient). To our knowledge; this is the first report of LA with insulin Aspart (NovoRapid), biphasic insulin Aspa...

Background: Central diabetes insipidus (CDI) is rare in infants and children. Up to 30 percent of cases are idiopathic and its clinical presentation is poorly defined. In critically ill paediatric intensive care unit (PICU) patient with CDI, there is increased risk of brain damage and death due to severe hyperosmolarity, hypovolaemic shock, hypernatraemic seizures or complications of treatment.Aim: To assess the causes, management and outcome of CDI in p...

Introduction: Hypoparathyroidism is typically managed with calcitriol/alfacalcidol. Close monitoring of serum calcium is required as under-treatment causes symptomatic hypocalcaemia while over-treatment will cause nephrocalcinosis. We report three cases who demonstrated resistance to treatment during an intercurrent illness, necessitating increase in medication doses and monitoring.Case series: Case 1: Two-month-old boy with newly diagnosed hypo...

Background: Lower cut-offs in TSH screening have doubled the incidence of congenital hypothyroidism (CH), particularly cases with an eutopically-located Gland-in-situ (GIS). Although mutations in known dyshormonogenesis genes, or the thyrotropin-stimulating hormone receptor (TSHR) may underlie such cases, these genes have not previously been screened comprehensively in a GIS CH cohort.Study design: We evaluated the relative contribution and mole...