Endocrine Abstracts

Background: Neonatal diabetes is an exceedingly rare condition, defined by the presence of persistent hyperglycaemia in the first months of life. It is sub-categorised into transient neonatal diabetes mellitus (TNDM) which resolves early and permanent neonatal diabetes mellitus (PNDM), which requires lifelong treatment. Transient neonatal diabetes is reported to have a global incidence of between 1/95 000–1/400 000 births. At present, there are less than 100 patients diag...

Introduction: Prader–Willi syndrome [PWS] is a complex genetic disorder with hypothalamic pituitary dysfunction that includes obesity, diabetes and behaviour changes. Obesity in PWS is due to decrease of oxytocin neurons and leptin resistance causing hyperphagia. Prader–Willi syndrome is associated with high incidence of altered glucose metabolism. The etiology for diabetes in PWS may be related to morbid obesity and resultant insulin resistance.<p class="abstext...

Introduction: The incidence of type 1 diabetes (T1DM) is increasing, affecting approximately 1 in 500 children and young people (CYP) under 19 years of age. The diagnosis of diabetes, as well as initial investigations and management is standardised, based on national guidance. Initial education and management have huge importance for long-term glycaemic control. We review the practice in our hospital, to establish our compliance and any deviations from the guidelines. We also ...

Background: Use of Continuous Glucose Monitoring (CGM) or Flash Glucose monitoring (FGM) has increased in children with type 1 diabetes without a conclusive evidence of sustained improvement in HbA1c. Aims: To assess whether use of CGM/FGM improves HbA1c. To review admissions, complications and impact on the quality of life.Methods: Retrospective study of 33 Type 1 diabetic patients on CGM/FGM. Data collected from the case notes and Twinkle database syst...

Introduction: The British Society of Paediatric Endocrinology (BSPED) DKA guidelines endorse the use of subcutaneous (SC) insulin in clinically well patients. In our institution, routine practice is to use SC insulin to manage DKA patients, without clinical evidence of shock. We present safety and efficacy data.Methods: A retrospective review of electronic records was performed to identify episodes of DKA (pH <7.30 or HC03<18 mmol/l and ketonaemi...

Introduction: The FreeStyle Libre is increasingly employed in the management of T1DM. This audit examined if users are meeting the recommended competencies set out in the London prescribing guidelines, to ascertain if users are aware of and utilising inbuilt features of the Libre, to identify if user training can be enhanced, and to see if Libre use improves patients’ quality of life as a result of Libre use.Methods: The audit was conducted via a st...

Introduction: The prevalence of diabetes continues to rise worldwide placing an increasing burden on the national health service. In 2012 a national Best Practice Tariff (BPT) was introduced in the UK and a National Peer Review Quality Assurance Programme was developed to drive improvements in diabetes care for children and young people. Our national audit from 2010 to 2018 aims to explore trends in paediatric diabetic care within the North West Diabetes Network and assess the...

In 2014 Torbay Hospital was a national outlier for diabetes control in the paediatric population. At this time a transformative quality improvement project which tracked the patient’s journey through the service resulted in the introduction of carbohydrate counting from diagnosis. Whilst other hospitals had already adopted this approach the Torbay team introduced a system of care where the patient/parent lead the process of calculating carbohydrates and insulin doses from...