Endocrine Abstracts

Introduction: The pathogenesis of short stature and growth failure in Turner syndrome (TS) is multifactorial, and includes low birthweight, ovarian failure and skeletal dysplasia. Although abnormalities of the GH-IGF1 axis are implicated, patients are not GH-deficient (GHD) and consequently non-GHD doses of GH are utilised ie. 45–50 μg/kg per day or 9.8 mg/m2 per week. Although initially used in GHD patients, IGF1 titration is increasingly being used in al...

Background: Germline mutations in the Phosphatase and Tensin Homolog Hamartoma tumour (PTEN) gene are associated with a number of conditions, collectively known as PTEN hamartoma tumour syndromes (PHTS). Individuals with PHTS are at increased risk of a number of cancers primarily in adulthood including differentiated thyroid carcinoma (DTC) with an estimated lifetime risk of DTC of up to 38%. International guidance recommends screening commencing from 17 years while the 2017-U...

Background: In 2019, funding for continuous glucose monitoring (CGM) commenced for children and young people with diabetes (CYPD) in our region. However, there was no local established CGM structured education programme. We developed ‘the CGM Academy’ with continuous improvement using the Plan-Do-Study-Act (PDSA) cycle.Objectives: To review the PDSA cycle of improvements to deliver structured education using CGM.Methods: ...

Background: Continuous Glucose Monitoring (CGM) is now becoming the standard of care for children and young people with diabetes (CYPD). Due to a lack of validated education programmes, we created ‘The CGM Academy’ delivering evidence-based structured education. The results of the first 50 CYPD graduating from the academy demonstrated statistically significant improvement in time in range (TIR, 3.9-10.0 mmol/l) by 8.3% (P<0.001) and HbA1c by 3.8 mmol/mol...

Introduction: Language barriers can pose a significant barrier to successful education of children and young people (CYP) with type 1 diabetes (T1DM) and their families, potentially influencing their glycaemic control.Methods: Retrospective analysis from diagnosis to 18 months post diagnosis of glycaemic control in 41 CYP with T1DM requiring interpreter support (INT) under care of our diabetes centre based within a multi-ethnic community. Median HbA1c at...

Background: Previous studies identify non-White ethnicity as predictive of poor diabetes related outcomes. However, many of these reports originate from the United States and may, in part, reflect complex interactions between ethnicity, healthcare inequality and social deprivation.Objective and hypotheses: We aimed to prospectively determine the effect of insulin intensification on glycaemic control and lipid levels in relation to ethnicity in a UK cohor...

Introduction: Good patient education is the key to successful self-management of diabetes. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ involving 20 structured education sessions delivered by the multidisciplinary team.Aim: To assess the effect of the new patient education programme on HbA1c at the end of two years and compare this to a control group undergoing the old education programme.<...

Child obesity is a major public health concern in England and worldwide. It is a risk factor for the onset of type 2 diabetes and other comorbidities. Young people from the most deprived communities, from ethnic minority backgrounds or with learning disabilities are particularly at risk. NHS England funded the establishment of Complications of Excess Weight (CEW) pilot clinics, two of which serve the Midlands region. These provide specialist multidisciplinary whole-family supp...

Background: Type 2 diabetes (T2D) in children and adults continues to rise. The relative contribution of pancreatic beta cell failure is not established. We aimed to analyse beta cell function in a subgroup of the UK T2D (JUMP) cohort.Methods: Participants were recruited at 58 hospital centres across England and Wales (n=204). Patients were 5–18 years, diagnosed with T2D (ADA criteria) and a BMI SDS>+1.0. At baseline, demographics, clin...

Introduction: NICE recommends specific annual health checks for children and young people (CYP) with diabetes aged 12 years and over to check for health of feet, kidneys, thyroid and eyes in addition to BP, BMI and HbA1c. Historically, we included annual review care processes into regular diabetes multi-disciplinary clinics. In 2017, our service was identified as negative outlier in the National Paediatric Diabetes Audit for completion of health care processes. In particular, ...