Endocrine Abstracts

Introduction: Diabetic Ketoacidosis (DKA) is a life threatening complication of type 1 diabetes mellitus (T1DM) in children. An integrated care pathway (ICP) for management of DKA based on guidelines published by the British Society for Paediatric Endocrinology and Diabetes has been established in Wales with the 2nd edition published in May 2010.Aims: To audit the management of DKA in a teaching hospital following the introduction of the second edition o...

Introduction: Despite 50 years of treating CAH with steroids, clinical practice still varies considerably. In 2002 a consensus statement provided ‘best practice’ guidelines for the management of the condition. In South Wales CAH is managed by an Endocrine Network. A service evaluation was performed to obtain parents views on their experience.Methods: Thirty-one patients with CAH were identified. A questionnaire was designed using the consensus ...

Introduction: The UK Newborn Screening Programme provide guidelines which facilitate diagnosis and treatment of congenital hypothyroidism (CHT). Prompt treatment is important to ensure normal growth and development. This audit examines initial findings and growth over the first 2 years of life in CHT associated with agenesis, ectopia or dyshormonogenesis of the gland.Methods: Patients were identified from the University Hospital of Wales paediatric endoc...

Introduction: Children with type 1 diabetes mellitus (T1DM) are at increased risk of being overweight. Being overweight could be related to insulin requirements, female gender, and duration of diabetes. The aim of this study is to examine the Body Mass Index (BMI) of children and young people with T1DM at the Children’s Hospital for Wales and explore co-factors that may contribute to risk.Methods: A retrospective review of all patients with T1DM att...

Introduction: Most children & young people (CYP) with symptoms of type 1 diabetes (T1D) tend to present to primary care. Delayed diagnosis is common and is associated with a risk of developing diabetic ketoacidosis (DKA). The prevalence of DKA at diagnosis over the last 20 years remains unchanged despite current NICE guidance and Diabetes Delivery Plans which promote prompt diagnosis of T1D. The aim of this QI initiative was to develop effective pathways to facilitate earl...

Background: Achievement of treatment targets in children and young people (CYP) with diabetes represents an important intermediary step between delivery of care and ‘hard’ outcomes such as complications. Funnel plots have been proposed as a useful tool for visualising variation in performance indicators across centers and distinguishing between common-cause (centers lying within the control limits) and special-cause variation (centers lying outside the control limits...

Background: Coronavirus 2019 (Covid-19), an infectious disease caused by SARS-CoV-2 virus has been linked to autoimmunity. Graves’ disease (GD) is a common subtype of paediatric hyperthyroidism and an autoimmune condition, where antibodies stimulate the thyroid-stimulating hormone receptor on the thyroid gland to produce excess thyroid hormone. Although, paediatric GD is rare, incidence have risen before the pandemic, and this rise has accelerated since the Covid-19 pande...

Background: HbA1c remains the most powerful outcome measure for children and young people with diabetes. It is collected at every clinic visit and is used for individualised discussions around diabetes control and for national benchmarking. However, despite DCCT and IFCC standardisation, there is still no overall consensus as to the most appropriate methodology, particularly when assessing patients with haemoglobinopathies that may affect HbA1c measurement.<p class="abstex...

Introduction: The impact of ethnicity and socioeconomic status (SES) on glycaemic control in children with type 1 diabetes (T1D) is poorly understood in England and Wales.Methods: We studied 18 478 children and young people with T1D aged <19 years attending diabetes clinics in England and Wales and included in the 2012–2013 National Paediatric Diabetes Audit (NPDA). Self-identified ethnicity was categorized as white, Asian, black, mixed, other a...

Introduction: Central congenital hypothyroidism (CCH), undetected by TSH-based NewbornScreening, occurs from TSH synthesis or secretion defects. An extremely rare (<1:100,000) cause concerns the recently described ImmunoGlobulinSuperFamily member 1 (IGSF1) gene, critical in TSH biosynthesis. These 2 infants highlight intriguing clinical features.Case-1: Term male (BW 3.95 kg) with poor feeding and persistent jaundice (max bilirubin 362 umol/l) despit...