Endocrine Abstracts

A young female with autosomal dominant hypoparathyroidism type 1 who had inherited the gene defect from her mother was under the care of paediatric endocrinologist. Since childhood she was on a large dose of calcium (elemental calcium 5 g) along with Vitamin D, potassium and magnesium replacements. Despite careful monitoring there was significant fluctuations in serum calcium levels which led to recurrent hospital admissions with hypercalcaemia and acute kidney injury or sever...

Background: National Paediatric Diabetes Audit report 2012–2013 showed an increase in the number of patients with HbA1C >80 mmol/l at our paediatric diabetes unit.Aim: Two methods of intensive support for patients with high HbA1C were trialled- monthly clinics and weekly telephone contact.Method: From January to June 2014 we offered monthly ‘Target’ clinic appointments to a cohort of ten patients with high HbA1C....

Neonatal diabetes mellitus (NDM) is a rare form of monogenic diabetes affecting 1 in 100 000 to 500 000 live births.We report the case of a term baby born to a diet controlled gestational diabetic mother with a birth weight of 2.8 kg. Baby was persistently hyperglycaemic from day 1 of life, leading to a diagnosis of neonatal diabetes being considered. She was breast-fed on demand and although insulin pump therapy was discussed, it was felt not to be suit...

Introduction: Exposure to deficient/excess glucocorticoids can lead to long-term health problems in patients with adrenal insufficiency. An age-appropriate low dose hydrocortisone formulation is not available therefore manipulation a 10 mg tablet is required with potential for inaccurate dosing.Aims: To assess the variability in manipulation procedures recommended by healthcare professionals and undertaken by parents/carers. To quantify the dose-variabil...

Introduction: Exposure to deficient/excess glucocorticoids can lead to long-term health problems in patients with adrenal insufficiency. Historically and age-appropriate hydrocortisone formulation has not been available. Adrenal crisis is associated with significant morbidity and mortality.Aims: To assess prescribing practice for oral hydrocortisone and sick day advise across the UK.Methods: Paediatric endocrinologists and parents[...

Background: X-rays of the hand and wrist are routinely performed to evaluate bone age (BA) in children with endocrine and growth disorders. BA is used essentially to assess growth potential, but the BA x-ray can reveal additional morphological abnormalities. Incidental findings on the BA x-ray can aid clinical diagnosis and prompt appropriate further investigations to establish the child’s final diagnosis.Methods: A 10-year retrospective review of 1...

Objectives: The Department of Health introduced a Best Practice Tariff (BPT) to finance Paediatric Diabetes Services in England, in response to variation in service provision and outcome. The tariff became mandatory in April 2013 and depends on achievement of 13 quality standards (QS). The West Midlands (WM) Region covers an area of 5020 square miles, where 2700 Children with Diabetes receive care from 15 Hospital Trusts who are members of the Regional Paediatric Diabetes Netw...

Background: Childhood obesity is increasingly associated with type 2 diabetes (T2D). Metformin reduces the risk for T2D in adult obese non-diabetic patients, but the evidence in obese children and young people (CYP) is inconclusive.Design: The metformin in obese children and adolescents (MOCA) trial was a prospective, multi-centre, randomized, double-blind, placebo-controlled trial of 1.5 g metformin daily in CYP with raised fasting or post-prandial insu...