Endocrine Abstracts

Background: Continuous Glucose Monitoring (CGM) is now becoming the standard of care for children and young people with diabetes (CYPD). Due to a lack of validated education programmes, we created ‘The CGM Academy’ delivering evidence-based structured education. The results of the first 50 CYPD graduating from the academy demonstrated statistically significant improvement in time in range (TIR, 3.9-10.0 mmol/l) by 8.3% (P<0.001) and HbA1c by 3.8 mmol/mol...

Our large tertiary hospital-based diabetes service high HbA1c policy selects Children and Young People (CYP) with HbA1c above 64 mmol/mol for additional support. Two-week average blood glucose (ABG) is utilised in the high HbA1c clinic as a proxy for HbA1c and CYP are encouraged to reduce their 2 week ABG as a primary goal.Aims: To determine the relationship between HbA1c, 2 week and 3 month ABG and standard deviation (S.D.) in CYP with Ty...

Introduction: Language barriers can pose a significant barrier to successful education of children and young people (CYP) with type 1 diabetes (T1DM) and their families, potentially influencing their glycaemic control.Methods: Retrospective analysis from diagnosis to 18 months post diagnosis of glycaemic control in 41 CYP with T1DM requiring interpreter support (INT) under care of our diabetes centre based within a multi-ethnic community. Median HbA1c at...

Background: HbA1c is a marker for the risk of long-term complications of Diabetes. Our unit cares for 349 children and young people (CYP) from a population with a higher than average prevalence of low-income families, ethnic minority families, and high unemployment. Over the last 10 years there have been service improvements, increased resources and changes in practice.Aims: To review HbA1c outcomes achieved annually from 2003, compared with published na...

Introduction: Good patient education is the key to successful self-management of diabetes. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ involving 20 structured education sessions delivered by the multidisciplinary team.Aim: To assess the effect of the new patient education programme on HbA1c at the end of two years and compare this to a control group undergoing the old education programme.<...

Introduction: Early-onset androgen excess commonly presents in pre-pubertal girls as premature adrenarche (PA). Girls with PA have clinical signs of androgen excess, such as pubic/axillary hair, body odour, greasy hair, and moderately elevated adrenal androgens before their 8th birthday. There is conflicting evidence if girls with PA are at higher risk to have or develop metabolic dysfunction, or progress to developing Polycystic Ovary Syndrome (PCOS), the mos...

Introduction: NICE recommends specific annual health checks for children and young people (CYP) with diabetes aged 12 years and over to check for health of feet, kidneys, thyroid and eyes in addition to BP, BMI and HbA1c. Historically, we included annual review care processes into regular diabetes multi-disciplinary clinics. In 2017, our service was identified as negative outlier in the National Paediatric Diabetes Audit for completion of health care processes. In particular, ...

Objectives: Children and young people (CYP) with Type 1 Diabetes Mellitus (T1DM) are at risk of acute clinical emergencies. Wearing medical identification (ID) is recommended by the National Institute for Clinical excellence (NICE). Information on adherence to this recommendation in CYP with T1DM is scarce. This study aimed to assess parent and CYP’s knowledge of the recommendation, to explore adherence and barriers to carrying ID and understand preferred forms of ID....

Background: Our practice is to commence newly diagnosed children and young people (CYP) with diabetes, over 5 years old, on multiple daily insulin (MDI), using fixed Insulin to Carbohydrate ratios (ICRs) with meals across the day. ICRs are subsequently adjusted according to blood glucose response, individualising insulin treatment. We know intensified insulin therapy includes use of varied ICRs, reflecting varying insulin sensitivity at different times of day. We do not know w...

Introduction: Chiari-1 malformation (C-1M) is defined as the crowding of the craniocervical junction as a result of congenital cerebellar tonsil descent past the foramen magnum. Reported association between endocrine disorders and C-1M is mostly anecdotal.Aims: To evaluate the prevalence of endocrine disorders in C-1M against the prevalence of C-1M in those with isolated Growth Hormone Deficiency (GHD) with the aim of determining if there is a significan...