Endocrine Abstracts

Maintaining good diabetes control is essential to avoid long-term complications. NPDA data show that the percentage of children and young people achieving good control has increased year on year since 2011 and the percentage with very poor control (HbA1c >80 mmol/mol) has nearly halved in that time (28.7% in 2010-11, 16.4% in 2016-17). In Nottingham, we have managed to reduce the percentage of children and young people with very poor control from nearly 40% when we first s...

Introduction: Racism is a fundamental determinant of health, described by Prof Kevin Fenton (PHE) as a "wicked problem"- a complex problem highly resistant to solutions. The amplification of the voice of black lives matter” and disproportionate number of deaths from Covid-19 in Black and Asian people has re-focussed attention on racial health inequalities. Structural racism and unconscious bias is present throughout medicine. The National Paediatric Diabetes Audit...

Continuous glucose monitoring (CGM) allows continuous real-time blood glucose monitoring and informs users of blood glucose trend data and alarms which warn users of high or low blood glucose readings. Current evidence suggests that CGM can reduce episodes of hypoglycaemia in conditions such as congenital hyperinsulinism and metabolic disorders. Hypoglycaemia secondary to these conditions is serious with almost 50% of children demonstrating neurological impairments as a result...

Introduction: Adolescence is recognised as a period where compliance to diabetes treatment is challenging and adolescents assume increasing responsibility for their diabetes self-management. In this study we investigated whether giving modest financial rewards motivated teenagers with type 1 diabetes to improve glycaemic control.Methods: Population; young people with type 1 diabetes, age 13–16 years at entry, duration of diabetes of >2 years and...

Background: Recent NPDA 15/16 data shows that nationally 17.9% of children and young people (CYP) with type 1 diabetes mellitus (T1DM) have a HbA1c level >80 mol/mol (7.9% at Nottingham Children’s Hospital (NCH)), putting them at increased risk of diabetic ketoacidosis and long-term sequelae. To support patients on the high HbA1c pathway (>80 mmol/mol) at NCH, a 5-day inpatient stay for stabilisation is offered. The process involves daily re-education from paediat...

Introduction: Hypocalcaemia is a recognised cause of neonatal seizures most often related to vitamin D deficiency in the mothers of exclusively breast fed infants. There have also been case reports of an underlying diagnosis of hyperparathyroidism in a reportedly well mother becoming apparent after the infant presents with hypocalcaemic seizures. Maternal hypercalcaemia suppresses parathyroid activity in the foetus, which causes transient neonatal hypocalcaemia.<p class="a...

Introduction: The prevalence of coeliac disease (CD) in type 1 diabetes (T1DM) is 4.4–11.1 vs 0.5% in the general population. The compliance to gluten free diet (GFD) in symptomatic patients vs those diagnosed on screening is significantly higher as expected. The impact of untreated CD on patients with T1DM ranges from malabsorption and frequent unexplained hypoglycaemia to no symptoms.Aims: i) To describe the demographics of our children with CD.</...

Introduction: 45XO/46XY karyotype has varied phenotypic spectrum ranging from short stature, ambiguous genitalia (60%), clinical signs of Turner’s syndrome in both males and females and normal male phenotype. We report six phenotypically male cases with a varied clinical presentation.Case 1 and 2: Short stature: Two pre-pubertal, phenotypical males, were referred with concerns regarding short stature (height <0.4th centile, height velocity &#150...

Background: 71/270 (26%) of our patients with T1DM, diagnosed for more than 1 year, had an ideal HbA1c of less than or equal to 48 mmol/mol. Are there factors within this group that may be transferred into groups with higher HbA1cs to improve control?Methods: Clinical records were reviewed for the whole year and download data from a randomly selected 2 week period was reviewed. Age, gender, time from diagnosis, ethnicity, postcode, other medical conditio...

Introduction: ‘Transition’ is the period of movement from paediatric to adult healthcare. These patients are in their adolescence when the brain is maturing, causing changes in behaviors including greater risk-taking. The period of transition can be associated with poor adherence to insulin and blood glucose monitoring regimens and an increased risk of diabetic ketoacidosis (DKA). This study looks into how effective our transition programme has been at addressing thi...