Endocrine Abstracts

Objectives: Many paediatric diabetes units in the UK have introduced 24 h telephone support to encourage self-management to reduce Emergency Department (ED) attendances and admissions. The UK national audit collects information on acute paediatric diabetic admissions; but there is no data available on ED attendances in this group. We undertook a retrospective audit of ED attendances as part of a baseline service evaluation of our newly introduced 24 h support service.<p cl...

Introduction: In August 2015, the British Society for Paediatric Endocrinology and Diabetes (BSPED) released new guidelines for the management of DKA. These new guidelines recommended a much more conservative approach with fluid management in order to reduce the risk of cerebral oedema.Aim: Based on local anecdotal evidence, we hypothesized that with the new guidelines, we have had to increase maintenance fluid infusion rates more often and that the chil...

Introduction: An HbA1c target level of 48 mmol/mol or lower in children with type 1 diabetes is recommended by the National Institute for Health and Care Excellence. Only 7.1% (national average 7.2%) of children in our unit achieved this target. In response, during a multidisciplinary diabetes away day, we explored innovative approaches to timely and efficient identification and intervention in patients with high HbA1c levels. The National Paediatric Diabetes Audit web portal,...

Background: Dumping syndrome in infants who have undergone gastrostomy or Nissens fundoplication is a recognised phenomenon. The pathogenesis is possibly due to a bolus feed causing an incretin effect and leading to hyperinsulinaemic hypoglycaemia. Continuous glucose monitoring (CGM) systems have not been used in the past to study this phenomenon. We report CGM findings which are almost identical on three such post surgical infants.Case series 1: a 36-we...

Background: National paediatric diabetes audit (NPDA) provides comparative data for local paediatric diabetes units (PDUs) on key care processes and overall HbA1c. More detailed analysis on other variables affecting HbA1c is undertaken at a national level, but not at an individual PDU level.Objective: To determine the factors influencing glycaemic control (HbA1c levels) in young children and adolescents with Type 1 Diabetes Mellitus (T1DM).<p class="...

Background: Diabetic ketoacidosis (DKA) is a common presentation of newly diagnosed type 1 diabetes (T1DM) in children but increases the disease burden at diagnosis. In UK, average frequency of DKA presentation is reported as 25% with an international variation of 16 to 67%. Data on frequency variations within the UK is limited.Aim: To compare the demographic and clinical characteristics of DKA vs non-DKA presentations in children <16 years at diagno...

Introduction: Continuous Subcutaneous Insulin Infusion (CSII) has several advantages over Multiple Daily Injections (MDI) including better hourly delivery and avoidance of injections. However usage of CSII is significantly less in Cystic Fibrosis Related Diabetes (CFRD) compared to type 1 diabetes and published literature on use of CSII in children and adolescents with CFRD is minimal.We report two cases where CSII was used in CFRD resulting in a lower T...