Endocrine Abstracts

Despite recent advances in diabetes care and modest improvements in glycemic control, Type 1 diabetes (T1D) remains a major risk factor for early onset vascular disease, and is associated with a tenfold increase in cardiovascular related and all-cause mortality compared to the general population. Evidence of vascular endothelial dysfunction and early subclinical atherosclerotic disease can be detected during childhood, and is significantly more prevalent in children and adoles...

Advances in diabetes technology, particularly the introduction of continuous subcutaneous insulin infusion (CSII) pumps and of subcutaneous glucose sensing devices, have transformed the Type 1 diabetes (T1D) management landscape over the last 20 years. These devices have become more commonplace in our clinical practice, yet the evidence base that they have contributed to the modest improvements in glycaemic control in children and young people with T1D over these last two deca...

Background: Congenital adrenal hyperplasia (CAH) is a group of disorders caused by defects in one of the enzymes in the adrenal steroidigenic pathways. The most common form is 21-hydroxylase deficiency which leads to decreased production of cortisol and aldosterone and increased androgen production. Close monitoring of treatment is important so that adrenal suppression is achieved without excessive exposure to glucocorticoids. The current gold standard for monitoring in CAH is...

Background: Internet-based education and information resources for young people and families with DM have increased, yet the extent of use and perceived value among this patient group is uncertain. We conducted a questionnaire-based survey of parents’ and carers’ experience of currently available DM internet-based resources.Objective: To assess i) level of internet use, ii) perceived quality of patient support information currently available, i...

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...

Objectives: In the UK the majority of young people presenting for the first time with signs and symptoms of type 1 diabetes (T1D) are initially seen by general practitioners (GPs). Mis- or delayed diagnosis is not uncommon, and it increases the risk of diabetic ketoacidosis-related morbidity. This study seeks to identify the specific challenges faced by GPs in this setting in order to develop effective care pathways and recommendations for improving the timely diagnosis of T1D...

There are no established guidelines on the management of steroid induced diabetes (SID) in children. Steroids are commonly used to treat many chronic illnesses and as part of chemotherapy regimen in children. The hyperglycaemia caused by steroids is poorly recognised and can lead to adverse outcomes. Early recognition and appropriate management of hyperglycaemia is therefore crucial. Fasting blood glucose (BG) levels can be normal and the most sensitive time to test BG is 2 h ...

Introduction: The adipokine adiponectin promotes insulin sensitivity and its circulating levels are inversely related to adiposity in adults and older children. In small for gestational age (SGA) infants adiponectin levels decline rapidly with age in early life and have been inversely associated with subsequent weight gain. There are few data in early infancy, especially in non-SGA infants.We therefore investigated the association between adiponectin lev...

Introduction: Approximately 3200 children and young people in the UK receive GH therapy. Currently 12 different GH injection devices are available, with NHS guidance (NICE-TA188) recommending that patients/carers should have a choice of product. Whilst there is evidence that offering such choice may improve treatment adherence, little is known about its importance to patients/carers, nor whether device preferences should be reviewed after a period of treatment.<p class="ab...

Currently in the UK children and young people with diabetes receive variable provision of care and support in educational settings. There are concerns that this impacts on the young person’s glycaemic control, their quality of life, and their educational performance and outcome. Whilst most paediatric diabetes teams provide training for school staff, it may take several days, even weeks, after diagnosis before a diabetes educator is able to attend the school to provide ed...