Endocrine Abstracts

Concerns have been raised that undergraduate medical education in Endocrinology/Diabetes (E&D) is not preparing students adequately for clinical practice. This project assessed trainer perceptions of the delivered D&E curriculum and identified areas for improvement. We surveyed E&D consultants at the 12 hospitals which accept students from our medical school using an online questionnaire. Emails were sent to 50 consultants. The response rate was 46% (23/50 recipien...

Background: Effective management of diabetic ketoacidosis (DKA) improves clinical outcomes. Regular auditing and performance feedback are key to achieving sustained and significant improvement in the management of DKA. One of the major limitations for maximal impact of an audit is the delay from initiation to results as the latter may not be applicable to the then current practice. In order to overcome this, we created an automated auditing system called Digital Evaluation of ...

Introduction: Effective management of diabetic ketoacidosis (DKA) improves clinical outcomes. We created an automated auditing system, Digital evaluation of ketosis and other diabetes emergencies (DEKODE), which identifies DKA episodes based on fixed-rate intravenous insulin infusion (FRIII) prescription.Aim: We validated DEKODE for its ability to audit DKA management against manually collected data.Methods: All episodes identified...

Background: The EarLy Surveillance for Autoimmune diabetes (ELSA) study is screening 20,000 children in the UK aged 3-13 years for type 1 diabetes through measurement of islet autoantibodies. Screening aims to prevent diabetic ketoacidosis at clinical onset of disease, reducing mortality, and identifies the population who could benefit from prevention trials. The ELSA-1 study aimed to explore the perspectives of parents and stakeholders on the relative benefit...

Background: Diabetes-related ketoacidosis (DKA) is a common and potentially life threatening complication in people with diabetes. Despite national and international guidelines, interhospital guideline variation and mismanagement during admission are important contributory factors to increased DKA duration and length of stay.Aim: To establish a common DKA registry to identify gaps in management, assess outcomes and share best practises across centres.</p...

IntroductionOnce thought to typify type 1 diabetes mellitus (T1DM), diabetic ketoacidosis (DKA) in people with type 2 diabetes mellitus (T2DM) is also now increasingly recognized. We explored the clinical and biochemical differences in DKA in the two types of diabetes.MethodsThis retrospective cohort study included all the DKA episodes from April 2014 to September 2020 at a large tertiary care centre in West ...

Objective: The EarLy Surveillance for Autoimmune diabetes (ELSA) study is screening 20,000 children aged 3-13 years for type 1 diabetes through measurement of islet autoantibodies. Screening aims to prevent diabetic ketoacidosis at clinical onset of disease and identifies the population who could benefit from prevention trials. The ELSA-1 study aimed to explore the perspectives of parents and stakeholders on the relative benefits and limitations of screening i...

Background: Children with pre-symptomatic type 1 diabetes (T1D) can be identified through testing for circulating islet autoantibodies (AAb). Identifying children at risk reduces diabetic ketoacidosis at onset and allows participation in trials aiming to delay disease onset. Teplizumab is the first immunomodulatory agent licensed in the US to delay the onset of T1D by 3 years in individuals at risk; a licensing decision is awaited in the UK. The EarLy Surveill...

Background: There are several good practices to improve DKA management across hospitals. However, the lack of a unified system limits comparisons and learning from each other.Objectives: To establish a DKA registry to identify best practices across centres in the West Midlands.Methods: All people admitted with DKA at four hospitals in the West Midlands (named A, B, C, D for anonymity) from 1st January 2020 to 31st December 2020 wer...

Introduction: Diabetes related ketoacidosis (DKA) is usually associated with type 1 diabetes mellitus (T1DM). However, DKA is increasingly being recognised in type 2 diabetes mellitus (T2DM). We studied the differences in prevalence and precipitating factors of DKA between T1DM and T2DM.Methods: This retrospective study included all DKA episodes from January to November 2021 in six hospitals in the West Midlands, UK. DKA was diagnosed as serum glucose&#8...