Endocrine Abstracts

Introduction: The NPDA presents data on management, treatment, and complications for all diabetes units in the country. This acts as a driver for quality improvement and aims to improve standards of diabetes care. The 2019 report identified a relatively high proportion of children with hypertension locally. An audit aimed to identify the proportion of local diabetes patients with ‘hypertension’ or ‘pre-hypertension’, and their clinical identification. The s...

Introduction: Type 2 diabetes mellitus is a known complication of childhood obesity. It is currently diagnosed by undertaking an oral glucose tolerance test (OGTT). Continuous glucose monitoring (CGM) is used predominantly by patients with type 1 diabetes mellitus to monitor glucose levels.Aim: The aim of the study was to investigate glycaemic variation in children and adolescents with obesity who have had no evidence of pre-diabetes or type 2 diabetes o...

The PTEN gene is a tumour suppressor gene with high risk of breast, thyroid, endometrial, colorectal, kidney tumours and melanoma, mucocutaneous lesions, macular pigmentation, and macrocephaly. Germ line heterozygous pathogenic variants in this gene leads to a spectrum of disease now called PTEN hamartoma tumour syndrome (PHTS). Cowden syndrome (the predominant phenotype of PHTS) is estimated to affect 1:200,000 individuals - however it may be under-diagnosed. Guidelines for s...

Background: The National Patient Safety Alert (2020) and introduction of the NHS Steroid Emergency Card has led to the development of guidelines, publications and patient information, aiming to improve safety and management of adrenal insufficiency and prevention of adrenal crisis. Health Education England (HEE), ‘Plain English’ and NHS England guidance recommends patient information is accessible and clear to a broad range of people, to ensure patients are fully awa...

Introduction: Diabetic Ketoacidosis (DKA) is a known risk factor for ischaemic and haemorrhagic stroke in children and young people. Cerebral oedema may predispose to ischaemic or haemorrhagic brain injury, however not all cases of stroke are associated with cerebral oedema. This case illustrates severe complications of DKA including ischaemic stroke and cardiac arrest, and raises questions about fluid management in severe DKA.Case report: We describe th...

Overeating contributes to obesity epidemic and has many causes. Evidence shows that problematic eating behaviours can be modified with mindfulness. In the UK the use of mindfulness in management of obesity has been studied only once before. We aimed to pilot a new weight management course that would improve patients’ skills and confidence in ability to lose weight, and reduce patient waiting time. The course covered mindful eating, compassion and self-esteem, managing rel...

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...

Introduction: Paediatric hypoglycaemia is a relatively common medical emergency. In order to allow identification of the underlying cause, investigations need to be performed urgently prior to treatment being given. If done correctly this can save the need for future investigations. A ‘hyposcreen’ costs ~£450 so careful consideration is needed to ensure correct patient selection, as inadequate investigations have further cost and patient safety implications....

Introduction/aims: Adrenarche, the gradual increase in adrenal androgen secretion resulting in clinical features of pubic hair, axillary hair, body odour and acne, is independent from gonadotrophin-dependent central puberty. It is important that children presenting with these features are not unnecessarily investigated, whilst ensuring significant pathology is not overlooked.There is variation in practice in management of adrenarche. We identified curren...

Introduction: Multiple endocrine neoplasia type 2B (MEN2B) is a rare autosomal dominant neuroendocrine neoplasia syndrome characterised by early onset medullary thyroid carcinoma (MTC) in all patients, phaeochromocytoma and multiple extra-endocrine features. We present a case of late diagnosis of MEN2B illustrating the challenge of early diagnosis.Case report: A 12 year old boy presented after lifetime of investigation. There was no relevant family histo...