Endocrine Abstracts

Disorders of sex development (DSD) are a group of conditions caused by atypical development of chromosomal, gonadal or anatomical sex which pose complex, long-term diagnostic, investigative and management challenges requiring expert teams and close collaboration with families and peer groups. The lack of nationally agreed clinical standards for the management of DSD has been recognised by the British Society of Paediatric Endocrinology and Diabetes, and these are now in develo...

Introduction: Paediatric obesity is associated with significant long-term complications. This study investigated features of metabolic syndrome, non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnoea (OSA) aiming to establish their incidence and identify any predictive factors.Methods: A retrospective review of case notes was performed for children aged 2-16 years managed for investigation and management of obesity within a single tertiar...

Background: DSD services are evolving across the UK in response to both family, professional and societal pressures but MDT provision and access to specialist DSD services varies. In November 2017, DSD Clinical Standards were published by the BSPED Clinical Committee with the aim to improve and standardise DSD patient care and these were audited in March 2019. 95% of DSD centres responded with 85% listing psychology as part of their MDT.Aim: 1. To unders...

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...

Introduction: The incidence of Type 2 Diabetes Mellitus (T2DM) is rapidly increasing within the paediatric community, prompting searches for a simple and effective screening tool. Oral glucose tolerance test (OGTT) is the gold standard but is poorly accessible in the community. HbA1c offers an alternative which can be easily performed, but cut-offs for children have been extrapolated directly from the adult American Diabetes Association (ADA) diagnostic criter...

Background: Nearly a third of children aged 2–15 are overweight or obese (body mass index at or above 95th percentile) and children are becoming ‘obese’ at earlier ages and staying obese for longer. Obesity is linked to an array of medical conditions including hypertension, non-alcoholic fatty liver disease, and musculoskeletal pain and is associated with poor health-related quality of life (HRQoL) overall. Yet there is limited information on th...

In June 2021, NHS England commissioned 15 Complications from Excess Weight (CEW) services to pilot Tier 3 paediatric weight management services in England. This study aimed to assess initial patient experiences / responses to weight management strategies delivered in a single CEW service between January-June 2022.Methodology: We conducted an online survey to assess patient experiences, motivators and barriers to healthy lifestyle change in 45 patients se...

Background: Childhood obesity is a growing problem worldwide, with serious effects on child health. Obese children are at a higher risk of developing metabolic co-morbidities earlier in life (WHO, 2013). Manchester has worse than national average levels of obesity, with an estimated 14 000 obese children (PHE, 2014).Aims and methods: A retrospective case note analysis of 117 obese paediatric patients, seen in our service between March 2012 and 2014, was ...

Introduction: In August 2015, a revision of the BSPED-recommended guideline for the management of diabetic ketoacidosis (DKA) was published. A key difference from the previous guideline was a reduction in maintenance fluid rates, with the aim of reducing the incidence of cerebral oedema. Since implementation of these national guidelines, there have been reports within regional networks of an increased incidence in mild acute renal impairment and hypokalaemia. This retrospectiv...

Introduction: Congenital hyperinsulinism (CHI) is a rare condition of dysregulated insulin secretion causing hypoglycaemia. Oral Diazoxide is used as first line therapy for CHI. In those who are Diazoxide unresponsive, subcutaneous Octreotide is used as second line treatment. Octreotide has recognised side effects of biliary stasis. Additionally, we report hepatitis as a complication of Octreotide therapy in a child with CHI.Case report: A neonate with C...