Endocrine Abstracts

Introduction: The National Paediatric Diabetes Audit (NPDA) in 2012 reported a twofold increase in the incidence of diabetes ketoacidosis (DKA) admissions from 2005/6 to 2010/11 in children and young people with type 1 diabetes mellitus (T1DM). The paediatric diabetes best practice tariff (BPT) was introduced in 2012 to incentivise provision of high quality care to those under the age of 19.Aims: We examined DKA admission rates in children and young adul...

Obesity is a growing epidemic and a major cause of morbidity and mortality. Maintaining a healthy weight is of even greater importance for diabetics, due to the increased risk of micro-vascular and macro-vascular complications.There is suggestion that type 1 diabetic children are more likely to be obese than their peers (e.g. ‘Type 1 diabetes children often overweight’, www.diabetes.co.uk/news). In o...

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...

DKA guidelines aim to reduce risk of cerebral oedema. We present the outcomes of three young females with severe DKA with reduced conscious level at diagnosis that required deviation from these guidelines.A. 12-year-old, pH 6.88 with DKA and sepsis. Received 20 ml/kg initial fluid bolus. CT head scan was normal. Hypotension required further fluid boluses, inotropes and an increase in fluids to 65% above the rate on DKA protocol. Although slow to wake aft...

Background: The paediatric diabetes team at our Children’s Hospital were part of a national clinical trial considering whether long term outcomes are better for patients on MDI (multiple daily injection therapy) or insulin pump therapy from diagnosis. Patients and their families had to be approached, consented and treatment for the trial commenced within two weeks of diagnosis. Many centres struggled to recruit, but this was not the case with our centre.<p class="abst...

Background/Introduction: The Best Practice Tariff was introduced in 2012 in England and Wales to provide adequate funding and ensure quality care for all children with Diabetes. The tariff criteria states that units must provide “24 hour access to advice and support” including “24 hour expert advice to other healthcare professionals”. The aims of this audit were to: evaluate the Nottingham Children’s Hospital out of hours paediatric diabetes service, d...