Endocrine Abstracts

Published in August 2015, this was an update of the 2004 guidelines including for the first time guidance concerning Type 2 in Children. Monogenic diabetes fell outside the scope of the group and the update should be read alongside recent publications on Adult type 1 diabetes, diabetes in pregnancy, the diabetic foot, coeliac disease and the Technology Appraisal of insulin pumps. The Adult type 2 guidance will be published shortly.Guidelines must meet st...

Introduction: The short Synacthen test (SST) is a popular diagnostic investigation for adrenal insufficiency (AI). Cannulation and blood sampling are required making it invasive, time-consuming and resource-intensive. Salivary cortisol is a well-established alternative to serum sampling. We have developed a non-invasive alternative to the 1 μg SST, using a novel formulation of Synacthen (with a nasal drug enhancer, chitosan) given nasally and utilising saliva to measure t...

Rationale: Although many adolescents meet the NICE criteria for bariatric surgery there is a reluctance to undertake or commission such irreversible procedures in young people. Balloons are temporary, reversible, safer and more acceptable and in adults have been shown to promote a clinically significant change in BMI of 4.0–9.0 kg/m2 But due to subsequent weight regain, bypass surgery is preferred.This is a feasibility study of endocsopic...

Although pituitary abnormalities are the most commonly reported endocrine feature in septo-optic dysplasia, other endocrine abnormalities have not been described so far. We present a case of septo-optic dysplasia (SOD) and pituitary dysfunction, complicated by X-linked adrenoleucodystrophy (X-ALD) and primary adrenal insufficiency.A 4-year-old boy was referred with hypoglycaemic episodes and seizures during intercurrent illnesses. He had a history of pol...

Introduction: A 2009 BSPED survey revealed that 90% use a low dose Synacthen test (LDST) and 44% had noticed increased referrals of asthmatic children prescribed inhaled corticosteroids (ICS). Approximately 21% of UK children have asthma of whom 70% are prescribed ICS (10% at ‘high dose’). There is an increasing need for a simple, less invasive, alternative to the LDST to evaluate their adrenal function. We are developing a non-invasive LDST, with Synacthen administe...

Background: The effect of profound weight loss following obesity surgery on skeletal microarchitecture and strength in adolescents has not been studied. Obese children are at an increased risk of fracture and childhood obesity leads to reconfiguration of trabecular bone without augmenting bone strength.Objectives: To examine the impact of weight loss following 6 months treatment with an intragastric balloon supported by a lifestyle intervention programme...

Background: Many young people have inadequate follow up because they lose contact with adult care following transfer from paediatrics. There is a need to adapt communication interventions to help young people to determine and enact their preferred involvement in consultations with health professionals.Objective: To develop interventions to support communication with young people in endocrine care and to assess the feasibility of implementation in routine...

Background: Many premature infants experience significant early growth failure in the weeks following delivery. Subsequent catch-up growth has traditionally been assumed to have occurred by early childhood. Most studies have focused on cohorts defined by birth weight, for example, <1500 g resulting in disproportionate numbers of small for gestational age (SGA) infants as opposed to those small solely as a consequence of prematurity. Few studies have examined growth compare...

Background: Severe obesity in childhood is associated with significant morbidity including systolic hypertension, fatty liver, obstructive sleep apnoea, dyslipidemia and type 2 diabetes. Evidence that even small changes in BMI SDS bring about significant clinical benefit is strong.Objectives: To assess the impact of weight loss associated with intragastric balloon therapy supported by a life style programme on biomedical outcomes (glucose metabolism, blo...

Background: Type 2 diabetes (T2D) in children and adults continues to rise. The relative contribution of pancreatic beta cell failure is not established. We aimed to analyse beta cell function in a subgroup of the UK T2D (JUMP) cohort.Methods: Participants were recruited at 58 hospital centres across England and Wales (n=204). Patients were 5–18 years, diagnosed with T2D (ADA criteria) and a BMI SDS>+1.0. At baseline, demographics, clin...