Endocrine Abstracts

Constitutional delay is a common presentation to paediatric endocrine clinics. Most are boys who have been at the bottom of the normal range for height during childhood and then started to feel left behind as their peers develop in puberty. There is no agreed cut off age but most boys referred are 13–15 years old. Most boys with delay of puberty are healthy, although there is an association with chronic medical conditions (eg inflammatory bowel disease, juvenile rheumatoi...

Diabetes which is not type 1 or type 2 makes up a very small proportion of all diabetes cases in children and adolescents. The value of recognising these is that treatment and outcome can be very different from that seen in type 1 or 2.Other forms of diabetes can be divided into several groups: 1. Genetic diabetes including MODY and neonatal diabetes. MODY can be confused with type 1 diabetes in children. Making the diagnosis can b...

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...

Background: Prader Willi Syndrome (PWS) is a disorder of genetic imprinting caused by uniparental disomy of chromosome 15. It can present in the neonatal period with dysmorphic features, hypotonia and feeding difficulties. In the UK, recombinant human Growth Hormone (rhGH) is licensed for use in PWS, improving body composition and motor development, as well as final adult height. Some studies have also demonstrated an improvement in respiratory function in children with PWS. T...

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...

Background: Prader-Willi syndrome (PWS) is a complex genetic disorder caused by lack of expression of paternally inherited imprinted genes on Chr15q11-q13. rhGH has beneficial effects on growth, body composition and development. Starting age, dose titration and monitoring remain controversial.Objective: To study retrospectively children who presented in our multidisciplinary PWS clinic and assess response to rhGH treatment in terms of auxology, IGF1 conc...

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...