Endocrine Abstracts

Background: In 2013 the Diabetes Team at a large children’s hospital commenced ‘Pump School’ for all children and young people (CYP) transitioning from multiple daily injections to insulin pump therapy (CSII) using Medtronic, Accu-chek, Animas and Omnipod pumps.Aim: To provide CYP and their parents/carers with structured education to improve their outcomes including glycaemic control, hypoglycaemic episodes and quality of life (QOL).<p...

Background: Alstrom syndrome (AS) is a very rare multisystem disorder secondary to mutations in the ALMS1 gene, associated with infantile cardiomyopathy, retinal dystrophy, early onset obesity, and diabetes. Whilst a previous international review, including 35 males, cited pubertal delay and hypogonadism to be common, no detailed characterisation of puberty exists. This retrospective longitudinal analysis aims to describe puberty in boys with AS.<p class="...

Introduction: Poor HbA1c in the first year following diagnosis of type 1 diabetes is a predictor of poor metabolic control and early development of complications. Achieving good glycaemic control requires compliant, well-educated patients. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ in which a total of 20 sessions are delivered by the multidisciplinary team.Aim: To assess the effect of the...

Objectives: Many successful European centres provide intensive education as 2 week inpatient admissions for newly diagnosed type 1 diabetes. Prolonged inpatient stay is resource intensive and disrupts the family unit. Our centre aimed to determine the feasibility of delivering an intensive education programme in an ambulatory care setting.Methods: The curriculum, introduced in October 2013, comprised 20 hours face to face education by paediatric diabetes...

Introduction: In children, tumours occupying the pituitary fossa are mainly craniopharyngioma (80–90%) and pituitary adenomas (2–3%). We present two cases of pituitary adenoma and the challenging management when complete surgical resection is not possible. Case 1: A 13.5 year old girl presented with tall stature. Pituitary hormone profile revealed high IGF1 123 nmol/l (24.5–66) and prolactin 722 mU/l (102–496). Growth hormone (GH) was not completely suppres...

Introduction: The pathogenesis of short stature and growth failure in Turner syndrome (TS) is multifactorial, and includes low birthweight, ovarian failure and skeletal dysplasia. Although abnormalities of the GH-IGF1 axis are implicated, patients are not GH-deficient (GHD) and consequently non-GHD doses of GH are utilised ie. 45–50 μg/kg per day or 9.8 mg/m2 per week. Although initially used in GHD patients, IGF1 titration is increasingly being used in al...

Background: In 2019, funding for continuous glucose monitoring (CGM) commenced for children and young people with diabetes (CYPD) in our region. However, there was no local established CGM structured education programme. We developed ‘the CGM Academy’ with continuous improvement using the Plan-Do-Study-Act (PDSA) cycle.Objectives: To review the PDSA cycle of improvements to deliver structured education using CGM.Methods: ...

Background: Continuous Glucose Monitoring (CGM) is now becoming the standard of care for children and young people with diabetes (CYPD). Due to a lack of validated education programmes, we created ‘The CGM Academy’ delivering evidence-based structured education. The results of the first 50 CYPD graduating from the academy demonstrated statistically significant improvement in time in range (TIR, 3.9-10.0 mmol/l) by 8.3% (P<0.001) and HbA1c by 3.8 mmol/mol...

Our large tertiary hospital-based diabetes service high HbA1c policy selects Children and Young People (CYP) with HbA1c above 64 mmol/mol for additional support. Two-week average blood glucose (ABG) is utilised in the high HbA1c clinic as a proxy for HbA1c and CYP are encouraged to reduce their 2 week ABG as a primary goal.Aims: To determine the relationship between HbA1c, 2 week and 3 month ABG and standard deviation (S.D.) in CYP with Ty...

Introduction: Language barriers can pose a significant barrier to successful education of children and young people (CYP) with type 1 diabetes (T1DM) and their families, potentially influencing their glycaemic control.Methods: Retrospective analysis from diagnosis to 18 months post diagnosis of glycaemic control in 41 CYP with T1DM requiring interpreter support (INT) under care of our diabetes centre based within a multi-ethnic community. Median HbA1c at...