Searchable abstracts of presentations at key conferences in endocrinology

ea0039ep67 | Diabetes | BSPED2015

Severity of presentation with diabetic ketoacidosis at diagnosis of diabetes; India versus the UK

Dyer Emma , Amin Rakesh

Background: Diabetic ketoacidosis (DKA) is associated with significant morbidity and mortality. Comparison of healthcare systems often helps highlight areas of concern.Design: In a short survey, we evaluated severity of DKA at presentation with diabetes by comparing clinical and biochemical data from clinic cohorts from paediatric diabetes units in Delhi, India and Manchester, UK.Results: In the Delhi vs UK groups; there were no si...

ea0036oc6.1 | Oral Communications 6 | BSPED2014

Exploring variation in treatment targets across paediatric diabetes units in England and Wales

Charalampopoulos Dimitrios , Amin Rakesh , Viner Russell , Warner Justin , Stephenson Terence

Background: Achievement of treatment targets in children and young people (CYP) with diabetes represents an important intermediary step between delivery of care and ‘hard’ outcomes such as complications. Funnel plots have been proposed as a useful tool for visualising variation in performance indicators across centers and distinguishing between common-cause (centers lying within the control limits) and special-cause variation (centers lying outside the control limits...

ea0085p4 | Adrenal 1 | BSPED2022

Establishing the utility of the 60-minute serum cortisol sample in a standard synacthen test in a tertiary paediatric centre

Tollerfield Sally , Ridout Deborah , Atterbury Abigail , Wadey Hannah , Amin Rakesh , Gan Hoong-Wei , Katugampola Harshini

Background: The standard synacthen test (SST) is commonly utilised to interrogate the hypothalamo-pituitary-adrenal (HPA) axis in children. It comprises baseline and 30-minute serum cortisol concentrations (SCC), after injecting synthetic adrenocorticotropic hormone (ACTH)[1–24]. There is debate regarding the utility of a 60-minute SCC in the SST protocol with most studies to date conducted in adults.Aim: To assess the utility of a 60-minute SCC in ...

ea0066p20 | Diabetes 1 | BSPED2019

Identifying barriers and solutions to the optimal management of a patient with T1DM and a severe life limiting dermatological condition

Wijesinghe Nimasha , Drew Samantha , Cunjamalay Annaruby , Howard Sasha R , Amin Rakesh , Peters Catherine

Background: We present a case of a 10 year old female with T1DM, referred to our tertiary centre for complex diabetes care due to her other severe chronic dermatological condition. We discuss the difficulties with optimizing diabetes control in such a chronic debilitating condition which has a pervasive effect on T1DM treatment.Case: To our knowledge this is only the second reported case of a child with T1DM and Epidermolysis Bullosa. Severe Recessive Dy...

ea0039ep39 | Diabetes | BSPED2015

Young people with type 1 diabetes of non-white ethnicity and lower socioeconomic status have poorer glycaemic control in England and Wales – a national population-based study

Khanolkar Amal R , Amin Rakesh , Taylor-Robinson David , Viner Russell M , Warner Justin T , Stepenhson Terence

Introduction: The impact of ethnicity and socioeconomic status (SES) on glycaemic control in children with type 1 diabetes (T1D) is poorly understood in England and Wales.Methods: We studied 18 478 children and young people with T1D aged <19 years attending diabetes clinics in England and Wales and included in the 2012–2013 National Paediatric Diabetes Audit (NPDA). Self-identified ethnicity was categorized as white, Asian, black, mixed, other a...

ea0033oc4.1 | Oral Communications 4 | BSPED2013

Risk factors for emergency hospital admission for diabetic ketoacidosis in children and young people: national cross-sectional analysis

Khare Swarna , Soljak Michael , Warner Justin , Amin Rakesh , Saxena Sonia , Viner Russell , Majeed Azeem , Modi Neena

Objectives: To identify patient and clinical factors associated with emergency hospital admission with diabetic ketoacidosis (DKA) in children and young people with type 1 diabetes attending specialist NHS outpatient clinics in England and Wales.Design: Cross-sectional observational analysis of linked data from the National Paediatric Diabetes Audits (NPDAs) in England and Wales, and Hospital Episode Statistics and Patient Episode Database for Wales. We ...

ea0033oc4.6 | Oral Communications 4 | BSPED2013

Increased urinary megalin and cubulin excretion in children with type 1 diabetes mellitus: an association with low molecular weight protein loss

Sirka Ernestas , Manwaring Victoria , Peters Catherine , Amin Rakesh , Heywood Wendy , Hindmarsh Peter , Mills Kevin

Nephropathy remains a major diabetes related complication despite improvements in metabolic control. Current interventions are based on the appearance of albuminuria. Whether earlier detection and treatment might be beneficial is unclear. The reabsorption of low molecular weight (<70 kDa) plasma proteins in the renal proximal tubule is mediated by an endocytic receptor, megalin, and its coreceptor, cubulin.Using label free quantitative proteomics we ...

ea0033p39 | (1) | BSPED2013

Extreme hyperlipidaemia with poor glycaemic control in type 1 diabetes

Drew Samantha , Margetts Rebecca , Amin Rakesh , Hindmarsh Peter , Banerjee Kausik , Peters Catherine

Background: Poorly controlled diabetes is associated with dyslipidaemia including high cholesterol and LDL concentrations. This increases the long term risk of atherosclerosis and cardiovascular complications. In children and young people with type 1 diabetes, management with lipid lowering agents is controversial and to date long term evidence of benefit is limited. We report a case of severe dyslipidaemia and the impact of improvement in glycaemic control.<p class="abste...

ea0030oc4.5 | Oral Communications 4 | BSPED2012

The effect of insulin intensification on glycaemic control and lipid levels in children and young persons with type 1 diabetes differs in relation to ethnic group

Dias Renuka , Brown Freya , Wyatt Claire , Cheema Sharanjit , Allgrove Jeremy , Amin Rakesh

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...

ea0030p3 | (1) | BSPED2012

The accuracy of diagnosing adrenal insufficiency in children undergoing glucagon stimulation test (GST)

Subbarayan Anbezhil , Spoudeas Helen , Peters Catherine , Dattani Mehul , Hindmarsh Peter , Brain Caroline , Amin Rakesh

Background: Glucagon (GST) is used as an alternative to insulin (ITT) to diagnose GH deficiency (GHD) and adrenal insufficiency (ACTHd). However the peak cortisol response to diagnose adrenal insufficiency varies (550, and 500 nmol/l), has been extrapolated from adults undergoing intraoperative stress and not fully validated.Aim: To determine the peak cortisol ‘cut off’ level which most accurately predicts clinically significant adrenal insuffi...