Endocrine Abstracts

Severe insulin resistance (SIR) is an umbrella term which encompasses a number of clinical conditions, all of them rare. This talk will use a case based approach to demonstrate a practical approach to the investigation and management of severe insulin resistance and will include severe insulin resistance secondary to insulin signalling defects and to different forms of lipodystrophy. The aim of the talk will be to provide clinicians with a useful framework to approach the clin...

Background: In the UK, Growth Hormone (GH) is indicated for treatment of children with short stature secondary to growth hormone deficiency (GHD), Prader Willi syndrome (PWS), Turner syndrome (TS), SHOX gene mutation, chronic renal insufficiency and born small for gestational age (SGA).Objectives: The aim was to assess the compliance of our local practice with the NICE guidance for GH therapy in children in addition to local guidance that TFTs and IGF-I ...

Introduction: Continuous subcutaneous insulin infusion (CSII) can improve glycaemic control and quality of life in Type 1 Diabetes patients. It is uncommon for paediatric patients to discontinue CSII and return to multiple daily insulin injections (MDI) often due to concerns regarding worsening metabolic control. However a trial off CSII is a requirement before transition to the adult clinic. We review the outcomes of those who discontinued CSII in our centre (total 248 patien...

Introduction: Recently a serious incident due to failure in rechecking blood glucose (BG) after hypoglycaemia treatment was reported in an adult inpatient. We evaluated adherence to network guidance on hypoglycaemia management in inpatients and changes in practice following an intervention based on education and system changes.Methods: In an audit (audit-1), hypoglycaemia episodes (BG level <4 mmol/l) were identified in paediatric inpatients (age &#6...

Background: Tissue hypoxia is a hallmark of rapidly proliferating tumours which most frequently adapt and prosper under low oxygen tension. The transcription factor, HIF-1α, is mediating these effects and induces target genes involved in survival, invasion and resistance to drugs and radiation. No data are available on the functional regulation of HIF-1α in thyroid carcinoma cells.Methods: Using thyroid carcinoma cells derived from papillary (N...

Question: What is the Prevalence of undiagnosed Monogenic diabetes mellitus when a formal case ascertainment protocol is followed?Background: The estimated prevalence of monogenic diabetes in the UK is 3.6%. The UNITED study (Shields et. al 2017) reported the use of urinary c-peptide:creatinine ratio (UCPCR) and autoantibodies as biomarkers to screen diabetes cohorts diagnosed at <30y and currently <50y in two UK cities. Cases found to have UCPCR...

Introduction: Diabetic ketoacidosis (DKA) remains a common presentation of type 1 diabetes (T1D) in children. During the COVID-19 pandemic, rates of presentation in DKA increased. Electrolyte abnormalities can occur during DKA treatment, but they are uncommon at presentation. We report a teenage girl with new-onset T1D presenting in severe DKA, complicated by profound hypokalaemia and hypernatremia. Case Report: A previously healthy 13-year-old girl was ...

Monitoring patients with NETs reveals a significant prevalence of gastrointestinal symptoms, often unrelated directly to the tumour1. Exocrine pancreatic insufficiency exemplifies a common treatable cause of gastrointestinal symptoms in NET patients undergoing therapy with somatostatin analogues. There is a paucity of data regarding this important issue which affects quality of life in NETs. We explored the value of faecal elastase (FE) as a marker of exocrine pancr...

Introduction: The management of type 1 diabetes (T1D) in young children can be extremely challenging due to high insulin sensitivity, unpredictable eating and activity and difficulty recognizing symptoms of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) therapy is beneficial in managing young children, however the small insulin doses required challenge the accuracy of standard concentration (100 IU/ml) CSII.Case report and literature revi...

Background: GH therapy during the transition period is important for somatic maturation. Identification of factors associated with low IGF-I levels may be useful in optimising GH replacement therapy.Objectives: To explore the prevalence and determinants of insufficient GH replacement during transitionMethods: Childhood-onset GH deficient (CO-GHD) patients (n=65) who stopped therapy, and were started on adult GH dose during t...