Endocrine Abstracts

Over the last 20 years, the phenomenon of type 2 diabetes in childhood has been increasingly recognised. National Audit data shows that in the UK there remains a relatively low prevalence of childhood type 2 diabetes, whilst the incidence has increased sharply in other parts of the world.This presentation aims to cover the pathogenesis of type 2 diabetes, its presentation, investigation, diagnosis and management, with a discussion of some of the newer tr...

Introduction: We present the contrasting cases of two siblings diagnosed with Wolfram’s syndrome aged 2 and 10 years old. We discuss several family factors which have made management of this rare condition even more complex, emphasising the importance of holistic medicine.Case: The older sibling was diagnosed with diabetes mellitus age 4. Parents struggled to cope with the diagnosis, however, and emotional and psychological support was offered. She ...

Background: Childhood obesity is a growing problem worldwide, with serious effects on child health. Obese children are at a higher risk of developing metabolic co-morbidities earlier in life (WHO, 2013). Manchester has worse than national average levels of obesity, with an estimated 14 000 obese children (PHE, 2014).Aims and methods: A retrospective case note analysis of 117 obese paediatric patients, seen in our service between March 2012 and 2014, was ...

Background: The UK Newborn Screening Programme Centre Clinical Referral Standards and Guidelines for CHT (2013) define TSH cut-offs for screen positive (>20 mU/l) and borderline (>10 and <20 mU/l) results. In Manchester levels >8 and <20 mU/l are classified as borderline. This audit aims to assess whether adopting the national cut-off would result in babies with significant and permanent hypothyroid disease being missed.Patient popula...

Background: Continuous subcutaneous insulin infusion (CSII) is proving superior in reducing HbA1c compared to multiple daily injections (MDI) in both the adult and paediatric populations. This study aims to compare the two methods, and evaluate the importance of education when starting insulin pump therapy in children.Design: Patients who attended a ‘pump school’ provided by the Royal Manchester Children’s Hospital between January 2010 and...

Introduction: Congenital hyperinsulinism (CHI) is a rare condition of dysregulated insulin secretion causing hypoglycaemia. Oral Diazoxide is used as first line therapy for CHI. In those who are Diazoxide unresponsive, subcutaneous Octreotide is used as second line treatment. Octreotide has recognised side effects of biliary stasis. Additionally, we report hepatitis as a complication of Octreotide therapy in a child with CHI.Case report: A neonate with C...

Introduction: Paediatric obesity is a growing concern for the health service. There is currently no consensus for routine screening of metabolic profiles and medical treatment in obese paediatric patients.Aims/methods: We aimed to determine medium-term outcomes of Metformin treatment on BMI, glucose and insulin levels in obese paediatric patients. In a retrospective review, data were collected from obese paediatric patients on Metformin for insulin resis...

Introduction: There is limited data on the psychological sequelae of obesity in paediatric patients.Aims/methods: We aimed to assess the prevalence of psychological comorbidities in obese paediatric patients. Internationally validated self-report questionnaires were offered to 19 patients and their parents from a tier three paediatric obesity clinics. These included the Paediatric Index of Emotional Distress (PI-ED); Beck Youth Inventory exploring self-p...

Background: Harrington et al.1 suggest that basal LH of ≥0.3 IU/l as measured by ICMA (Immulite 2500) has 100% specificity and 90.5% sensitivity in identifying progressive central precocious puberty (CPP).Aims: To examine the utility of basal LH measured with the DELFIA assay for identifying CPP in girls.Methods: All girls under age 9 years (median 7.3 years) investigated for precocious puberty with a GnRH...

Background: The standard dose Synacthen test (SDST) is commonly used to identify glucocorticoid deficiency. A subnormal SDST in young infants raises the possibility of adrenal insufficiency (AI) due to pathology such as congenital adrenal hyperplasia (CAH). A physiological delay in maturation of adrenal glucocorticoid secretion may be another explanation especially in asymptomatic infants with a transiently subnormal SDST.Aims: To review the diagnoses an...