Endocrine Abstracts

Acute and long-term complications attributable to diabetes are regrettably still common. To monitor for the development of such complications NICE recommend regular measurement of certain criteria to enable early intervention. A previous audit performed in our hospital looked at the adherence of paediatric diabetic reviews to NICE guidelines. As a consequence of this audit a detailed pro-forma to be used at all paediatric diabetic reviews was introduced....

Background: Local guidelines for infants born to mothers with a history of thyrotoxicosis previously recommended that infants were observed in hospital until thyroid function tests were checked on day 4, with follow up on day 10, causing inconvenience to families and unnecessary cost to services. Following a literature search, our revised local guidelines recommend low-risk infants can be discharged on day 0 without follow up, stratified using maternal TSH-receptor antibody (T...

Introduction: Graves’ hyperthyroidism affects 0.2–2% of women and 1–5% of infants born to these mothers will be symptomatic. Neonatal thyrotoxicosis is a potentially life-threatening condition and infants are currently monitored in hospital till day 4 of life. Graves’ disease is caused by TSH-receptor antibodies (TRAb) which can cross from the maternal to the foetal circulation where they may stimulate the developing thyroid gland causing neonatal thyrotoxi...

Background: Incidence of type 2 diabetes (T2DM) is increasing in children and young people under the age of 18 years. This group has a higher risk of microvascular complications and a more adverse cardiovascular risk profile than those diagnosed later. Weight loss is essential for remission, but intensive input is often required to achieve this.Aims: 1. Describe the demographics of our T2DM population2. Look at our remission rates<...

Queen’s Medical Centre, Nottingham, United KingdomTyrosinemia type-1 is a rare autosomal recessive disorder. It usually presents in an acute form in early infancy. Rarely, it can also present as a chronic form with gradual onset. The key presenting features are failure to thrive, liver dysfunction and/or Fanconi syndrome. We present a perplexing case of a 2-year-old girl with tyrosinemia type-1, who initially presented with failure to thrive and hypophosphatemic rickets w...

Introduction: Children with adrenal insufficiency require emergency hydrocortisone for serious illness in addition to any regular requirements. Individualised emergency plans for patients during sick days, detailing their oral and intramuscular hydrocortisone requirements, should be maintained, alongside appropriate alerts on hospital and pre-hospital systems to ensure health professionals are aware of their requirements promptly if they present acutely unwell. Following a chi...

Background: NICE guidelines (NG18) state that paediatric patients aged <18 years old with suspected diabetes mellitus (DM) should be immediately referred to specialist care to confirm diagnosis and provide immediate treatment. The Nottingham University Hospitals (NUH) Paediatric Endocrine team advise primary care to investigate suspected hyperglycaemia using a POCT (point of care testing) glucose meter at the primary care facility to avoid the delay incurred by sending a s...

Aim: To compare the BMI z-score of children with type 1 diabetes (T1DM) in Nottingham with that of national and local background populations and to identify factors associated with increased BMI.Methods: A retrospective observational cohort study of patients with T1DM aged 2–15 years under the care of the paediatric diabetes team at Nottingham Children’s Hospital, between April 2013 and March 2014. Mean BMI-z-score for the year was com...

Brown adipose tissue (BAT) is present in small quantities in human adults (~100 g) and can have a significant influence on metabolism. This effect is mediated by rapid activation of the BAT specific uncoupling protein 1 (UCP1), following stimulation of β-adrenergic receptor (AR) by the sympathetic nervous system. AR agonists stimulate rodent BAT, but have so far provided inconsistent findings in humans when administered orally (Vosselman et al. 2012). Rapid activ...

Background: Pubertal induction with incremental doses of oestrogen replacement is an important component of care offered to hypogonadal patients with Turner Syndrome (TS). Low dose oral ethinylestradiol (EE) has been extensively used in the UK but natural 17-β oestradiol (more physiological, cheaper and easily monitored in blood) is becoming increasingly popular. We undertook this audit to compare the efficacy and acceptability of oral (EE) and patch (Evorel) oestrogen pr...