Endocrine Abstracts

Introduction: Newly diagnosed type 1 diabetes is characterized by a transient partial remission period (‘honeymoon’), starting shortly after initiation of insulin treatment and during which the patient’s requirement for exogenous insulin treatment declines. Improvement of peripheral insulin sensitivity as well as a partial beta-cell recovery with improved insulin secretion was speculating to contribute to the pathogenesis of this phenomenon.<p class="abstext...

Introduction: Type 1 diabetes (T1DM) occurs as a result of autoimmune destruction of pancreatic β-cells which is supported by the presence of autoantibodies well before the onset of T1DM. Individuals at risk for T1DM are characterised by a deficient first-phase insulin response and impaired glucose tolerance which is present before the onset of T1DM.Case: We describe a case of 6 year-old asymptomatic girl who took part in the TrialNet Pathway-to-Pre...

Background: Pump has become increasingly more popular amongst clinicians in the management of children with type 1 diabetes (T1DM). It improves the metabolic control in most patients though it may have a negative effect on growth. Eighty children with T1DM at our institute are currently treated with continuous subcutaneous insulin infusion (CSII) to achieve optimum glycaemic control.Aims: To identify the effect of CSII on hospital admissions, hypoglycaem...

Background: ISPAD clinical practice consensus guidelines 2006–7 defined DKA as: blood glucose >11 mmol/l in presence of venous pH <7.3 or bicarbonate <15 mmol/l, ketonaemia and ketonuria. The level of ketonaemia or ketonuria was not specified. Blood ketones can be checked easily using a blood ketone meter (Optium). In our institution we have been measuring them on all children admitted with suspected DKA over the last 5 years. A blood ketone level of >3.0 ...

Introduction: Lipoatrophy (LA) was common before the advent of recombinant human insulin. More recently, insulin analogues have been widely introduced into paediatric practice. In the literature, LA has only been reported so far with insulin Lispro (Lily, USA) (n=4 adult patients and 3 children) and insulin Glargine (Sanofi-Aventis, France) (n=1 adult patient). To our knowledge; this is the first report of LA with insulin Aspart (NovoRapid), biphasic insulin Aspa...

Introduction: The first multi-center randomised trial looking at the efficacy and safety of Insulin Aspart, a faster acting insulin which aims to mimic endogenous prandial insulin action, was published in May 2019. We report our experience of using Insulin Aspart in the Norfolk and Norwich University Hospital children’s diabetes clinic.Methods: Children and young people with type 1 diabetes seen the Norfolk and Norwich paediatric diabetes service (t...

Background: Children with HbA1cs in target within the first year of diagnosis of diabetes show tracking of future results1 and experience fewer long term complications.2 This phenomenon is called ‘metabolic memory.3 HbA1C depends on a combination of patient factors and quality of care offered by the team (intensive insulin, communication, and support). We hypothesized that well managed, supported, patients should achieve target HbA1cs at l...

Background: Prior to COVID-19, HbA1C was performed in clinic as a point of care test. As a service development project driven by the changes to our service from COVID-19 we offered either a hospital drive through point of care HbA1C test or the validated VAMS collection method to obtain HbA1C at home.Objective: Research ethics approval was obtained to assess patient/carer acceptability of these collection methods.Methods: Drive thr...

Background: Children and young people (CYP) with Type 1 diabetes are offered 4 face to face appointments annually. During the COVID-19 pandemic these were delivered virtually.Objective: We conducted a survey to assess patient and carer satisfaction with the remote diabetes service. Methods: Research ethics approval was obtained. The survey was distributed to 280 CYP and their families; one response per family was collected. Data on...

Familial hypocalciuric hypercalcaemia types 1, 2, and 3 (FHH1, FHH2, and FHH3) are caused by loss-of-function mutations of the calcium-sensing receptor (CaSR), G-protein subunit α11 (Gα11) and adaptor protein 2 sigma subunit (AP2σ), respectively; whilst autosomal dominant hypocalcaemia types 1 and 2 (ADH1 and ADH2) are due to gain-of-function mutations of CaSR and Gα11, respectively. We therefore hypothesised that gain-of-function AP2σ mutations may re...