Endocrine Abstracts

Introduction: Abnormalities in glucose tolerance and diabetes have been described in various types of bone marrow failure including Fanconi’s and Diamond-Blackfan anaemia. It is also recognised that transmission of type 1 diabetes can occur following bone marrow transplantation (BMT).Case report: We report a 9-year-old girl who presented with a three week history of lethargy and petechial spots. She was pancytopenic and subsequent investigations dia...

Aim: To audit the current practice of investigations for children presenting with type I diabetes in our centre and identify delays in referral to secondary care.Standards: Guidelines published by ACDC: Care of the well child newly diagnosed with type I diabetes, NICE: “Diabetes (Type I and Type 2) in children and young people” August 2015 and local trust guidance “Paediatric diabetes - management of newly diagnosed well child”.<p...

NICE guidelines (2010) recommend two different GH provocation tests demonstrating subnormal peak GH levels to diagnose isolated GH deficiency (GHD). Choice of stimulation test varies in different units. In our centre, glucagon (GST) and clonidine (CST) stimulation tests are used to make a diagnosis of IGHD. IGF1 is done as part of the initial screening tests.Purpose of this study was to compare the GST vs CST and to establish if IGF1 level provided any e...

Background: In March 2022, NICE guidelines advised that real-time continuous glucose monitoring (rtCGM) be offered to all children and young people with type 1 diabetes mellitus (T1DM). Using rtCGM alongside the hybrid closed loop system (HCLS), has transformed management of T1DM in adults and children alike by linking insulin delivery to sensor glucose levels.Aim: To evaluate how the T-Slim pump with control IQ HCLS aff...

Introduction: Non-ketotic hyperglycaemic hyperosmolar (HHNK) coma is rare in children, is associated with high mortality rate. The incidence of this condition is reported to be increasing and considered to be related to increased prevalence in obesity and type 2 diabetes in children. Hyperglycaemic hyperosmolar syndrome (HHS) is rare in children. The pathophysiology and management of HHS is a distinct entity from diabetic ketoacidosis (DKA).Case report: ...

Introduction: The paediatric diabetes team in Leicester identified an unmet need for educating children about carbohydrate counting, following the initiation of most diagnosed patients on multiple dose insulin therapy (MDI). The team therefore started a new structured group education programme (SGEP) for children with type 1 diabetes (T1DM) called flexible adjustment of basal bolus (FABB) that has run since January 2007.Aims: To determine the effectivene...

Introduction: In 2014 the diabetes multidisciplinary team at Gloucestershire Royal Hospital Foundation Trust introduced dedicated annual review clinics for children with type I diabetes over the age of 8 years. Children receive their Consultant appointment, foot check, annual review bloods and structured education sessions in a single afternoon clinic visit. We present the results of two annual service evaluation projects, which have helped us improve the clinics and allowed u...

Case history: We report 7 weeks old with central diabetes insipidus, holoprosencephaly (HPE), immunodeficiency and severe colitis. She was first admitted with severe diarrhoea and hypernatremia. A diagnosis of central diabetes insipidus (CDI) was made and she was commenced on subcutaneous desmopressin (DDAVP). Her initial hypothalamic–pituitary axis (HPA) was normal (ACTH 10 ng/l, cortisol 635 nmol/l, GH 23 μg/l and TSH 3.30 μ/l). However repeated cortisols and ...

Introduction: Gloucestershire Paediatric Diabetes Team has implemented several innovations including carbohydrate counting from diagnosis, annual review clinics and family events. We seek to improve our patient engagement and experience to improve health outcomes.Aim: Improve the clinic experience for patients, their families and staff, based on their input, thereby encouraging greater engagement and patient attendance as part of the RCPCH quality Improv...