Endocrine Abstracts

Introduction: Gender minorities, including transgender and gender diverse (TGD) individuals face health disparities and significant barriers in accessing healthcare. Lack of access to providers knowledgeable in TGD health needs is the single greatest barrier to care. Existing literature on TGD care has almost exclusively focused on physicians and there is scant literature on the role of nurses. We aimed to describe exemplars of nurse-led TGD care internationally to better unde...

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, ...

Background: Management of patients with CAH remains challenging. There is increasing evidence to suggest that failure to optimize treatment during childhood not only affects final height but also leads to psychological and psychiatric problems. Previous qualitative structural T2-weighted MRI studies have identified white matter hyper-intensities in up to 46% of CAH patients. The nature and functional relevance of these abnormalities remains unknown.Objec...

Background: An association between breast cancer (BC) and thyroid autoimmunity has been frequently observed, and several small-scale studies correlated the presence of autoantibodies to thyroid peroxidase (TPOAb) with an improved BC outcome. We aimed to clarify in a large cohort of patients whether circulating TPOAb are prognostic for BC recurrence.Materials and methods: Available plasma samples for patients with node-positive or high-risk node-negative ...

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: About a half of all children with a clinical diagnosis of Silver-Russell syndrome (SRS) have a detectable molecular genetic abnormality (maternal uniparental disomy of chromosome 7 or hypomethylation of H19). The selection of children for molecular genetic testing can be difficult for non-specialists because of the broad phenotypic spectrum of SRS and the tendency of the facial features to mitigate during late childhood. Several clinical scoring systems for SRS hav...

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...

Aim: To describe the prevalence and natural history of retinopathy in a cohort of children and young people with type 1 diabetes attending a tertiary hospital diabetes clinic.Methods: We analysed follow-up data from 2008 to 2010 on all children eligible for retinopathy screening using the ‘Twinkle’ diabetes database and the regional retinal screening database.Results: 88% (149/169) of eligible children were screened in 20...

Introduction: Two insulin regimes are commonly used in type 1 diabetes (T1D): twice daily (BD) premixed insulin (short and intermediate acting), and multiple daily injections (MDI) of short acting insulin with once daily bolus of long acting insulin. MDI is associated with better glucose control in adults, but the evidence base is weaker for children.Objectives: We aimed to compare children started on MDI to BD from diagnosis, on HbA1c as a measure of gl...

Type 2 diabetes (T2DM) is increasing in children in the UK and worldwide, most likely related to the rising prevalence of obesity. We are developing a UK national cohort of children (under 18 completed years) with diabetes defined by WHO criteria, suspected type 2, BMI above 85th centile; but who do not have genetically confirmed monogenic diabetes, secondary diabetes, or any evidence of pancreatic autoimmunity. The aim of this study is to describe the characteristics of the f...